Condom rupture - please assess my risk

[SoCal07]

I would appreciate any input/assessment from the knowledgeable folks out there.  Here's my horror story...

I am a heterosexual male who has *always* used protection (latex condom) when having sex, and that horrifying day was no exception.  I engaged in vaginal insertive sex with a sex-worker on May 21, 07 and didn't realize that she rubbed some "lubrication" during the intercourse which I later found to be mineral oil.  That caused the condom  to break during the act without my realization.  According to my estimate the unprotected sex did not last more than 2 minutes. 

After withdrawal, I didn't notice any blood, but obviously, my penis was wet due to the unprotected act.  I immediately rushed to the bathroom and washed my penis under the shower.  I also urinated with the hope of "flushing" out any germs...  not sure if there's any scientific bearing to this, but I did it anyways.

Now, I haven't been following the hiv/aids news in a while since I considered myself at relatively low risk. So I call up the AIDS hotline and ask if there's any preventive measure immediately after possible exposure.  Unfortunately, I got the response 'No'.  Only recently after extensive researching and reading I have learned about PEP.  Anyway, the sex worker, who apparently was very new to her profession, said that she was fine and did not have any STD's.  When I asked her about her hiv status, she looked blank, as if she had heard that for the first time.  This is the cause of my worry!

I got tested for HIV1 (Orasure 2 week) a day after (5/22/07) contact to make sure I was not infected as of then and it came back negative.

I took the second test for HIV1/2 (Oraquick - 20 min) 4 weeks after exposure (6/15/07), and that was negative too.

Then I came down with a nasty cold/flu-like symptoms on 6/19 that lasted for 1 week and then minor symptoms lingered on for another week after that.  My symptoms were:

Fever and Chills - 1 night
Night sweats - 2 nights
Severe laryngitis - couldn't speak louder than a whisper - 3 days
Sore throat; post nasal drip; green sputum - 10 days
Cough - 2 weeks (bad); 1 week (mild)

My other symptom that started around week 5 as well was inflammation of my foreskin and redness of the glans of the penis.  I have also noticed white cheesy deposit (yeast infection?) under the foreskin that itched badly for about 2 weeks than stopped itching.  I still continue to have the white cheesy substance develop everyday that I wash off during shower.

During my  2-week 'illness' I noticed that although I coughed around people none of my co-workers/family caught the "infection" from me.  Is this an indication of hiv seroconversion?

At 6 weeks I tested for Hepatitis panel since I have never tested for Hep B and C before.  Those tests came back negative too.  Now, I am waiting for my 13 week mark (8/20/07) for conclusive tests.  In the meantime, I am turning out to be a nervous wreck. 
Any words of wisdom from the members of this forum would be highly appreciated. Thanks in advance!

[Andy Velez]

Here are a few basics. HIV is not an easy virus to transmit. It is significantly more difficult to accomplish from female to male. You had a single and brief possible exposure, even assuming the woman you were with is HIV+.

The average time to seroconversion is 22 days. All but the smallest number of those who are going to seroconvert will do so within 4-6 weeks. So your negatives so far are quite encouraging.

Symptoms never tell you anything accurately about HIV status. Even though your head has been doing a job on you about this incident, there is absolutely nothing you are reporting symptomatically which is in any way HIV specific.

If your symptoms persist you should discuss them with your doctor.

You have a bit more waiting time to test for a conclusive result. Stay as productively busy as possible and those last few weeks will pass more quickly than you imagine possible. At the end of this I expect you to continue to test negative.

Good luck and keep us posted.

Cheers,

[SoCal07]

Andy, thanks for your response. 
When you say "... absolutely nothing you are reporting symptomatically which is in any way HIV specific...", I am bit confused.  I came down with flulike symptoms (fever/chills), exactly 4.5 weeks after possible exposure, that lasted for 2 weeks.  Don't my symptoms sound like those associated with early hiv infection? I know one might say - "Symptoms don't mean anything...", but what is it in your opinion are not hiv specific?

[Matty the Damned]

SoCal,

The point is that the symptoms some people experience during the acute primary phase of HIV infection are not terribly specific. They are largely indistinguishable from the symptoms one might experience during the acute phase of any infection.

Not only that a very large proportion of HIV positive people don't experience any symptoms during in seroconversion. I should know. I'm one of those people. My seroconversion was symptomless. If my GP hadn't questioned my sexual history and determined that my dedication to frequent and lengthy sessions unprotected receptive and insertive anal sex with any and every male that would stand still long enough warranted an HIV antibody test, I wouldn't have found out I was HIV positive.

Until things went horribly wrong that is.

Now the reason I raise this is to illustrate the point., Symptoms are really nothing to go by when it comes to diagnosing HIV. All that matters is whether or not you've had unprotected sex and, if necessary, having an antibody test at the appropriate time. The appropriate time is 13 weeks, but as Andy notes the overwhelming majority of people who will test positive, do so by the 6 week mark.

The chances of you having contracted HIV from this encounter are extraordinarily low. You were protected up until the condom broke. But HIV is nothing to guess about so you do need to test at 13 weeks. Keep in mind that your negative results so far point to an excellent outcome on that joyful day after the window period has elapsed.

You might want to ask your doctor or local clinic about having a full STD screen too. There are other STD's out there which are far more prevalent and transmissible than HIV. All sexually active people should have a full screen at least once a year. Twice is better.

Finally I'd encourage you to read our Welcome Thread which contains links to our lessons on HIV testing and transmission.

MtD

/edited for a small typo and a missing comma/