Assessment

[sk1234]

Background: I am a 27 year old gay man who has engaged in unprotected anal sex within the last two months: two months ago as the top, two weeks ago as the bottom.

Two months after the first unprotected sex I broke out with an itchy, red, rash all over my cheeks and splotchy all over my face. I should note that I have a skin condition called psoriasis that causes these sort of breakouts, however I have never had a breakout such as this on my face, and breakouts are usually prevented by the medication I take for the condition (Enbrel). I went to the dermatologist and was prescribed some topical ointments that cleared up the rash on my face within several days. All told, the rash lasted about 1.5 to 2 weeks and it hasn't returned since.

Fast forward to two weeks ago, I had receptive unprotected anal sex. 24 hours later I was in the worst pain of my life with severe stomach cramps and diarrhea. This lasted for about 1.5 weeks with no let-up of the diarrhea - together with pretty bad fatigue. After a round of steroids and antibiotics my stomach has calmed down significantly, but the fatigue remains - as does slight fever and now a mild headache throughout the day. Just a general crappy, run-down feeling.

I test regularly, and a week after the receptive unprotected anal sex I took an HIV rapid test at home which was negative (so I think that would NEARLY rule out the possibility of getting something from the partner two months ago at least?).

I'm still pretty worried here. Everything I've read tells me that it is unlikely that I have HIV and that symptoms are very unlikely just 24 hours after infection, but my immune system is already compromised because of the Enrbrel injections I take for the psoriasis. I suspect my body has been fighting this viral stomach thing I've been having and it just mimics any kind of infection (and therefore the symptoms of recent HIV infection). 

Both partners say they are negative and the recent one was tested right before our encounter. I am planning on getting an early detection test at the three week point, but in the meantime does anyone have any thoughts on what I've written? Thanks in advance. I feel so dumb for posting this. This anxiety is NOT worth doing it without a condom.

[Jeff G]

You know you have a risk so the only thing you can do is test 6 weeks past the last unprotected anal or vaginal sex you had . You can follow up the 6 week test at 3 months for a conclusive result .

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

ALTHOUGH YOU DO NOT NEED FURTHER HIV TESTING AT THIS TIME, anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Please stop having unprotected sex . I have lived with HIV for over 30 years and I promise you that you do not want to live with HIV . The truth is that its not only your health at stake , had you been in the seroconversion stage with a high viral load you may well could have transmitted the infection every time you engaged in unprotected intercourse .

[sk1234]

Hello - pretty straightforward question (if this is in the wrong forum, I apologize...please move if necessary).

Is there any evidence (clinically or anecdotally) of late or delayed seroconversion in patients with previous ongoing autoimmune disorders? The autoimmune disorders in my case are psoriasis (treated with a TNF-inhibitor called Enbrel) as well as a thyroid condition called Hashimoto's disease (not requiring treatment).

I understand the usual tests and their associated window periods but would like to know if there's evidence of autoimmune disease having an effect on these window periods and whether or not an already-supressed immune system can also have a similar effect. Thanks in advance for any information.

[Andy Velez]

Our rule is for members to keep all entries in a single thread. Your entries have been merged here and this is the only thread in which you should be writing. Thanks for your cooperation.

Stop making your situation more complicated than it is. If you use a standard HIV test at 6 weeks and again at 3 months and get negative results those will be reliable and at 3 months conclusive. The illnesses you are concerned about will not affect the window period for a reliable result.

[Ann]

sk,

Autoimmune diseases do not cause delayed seroconversion. They can, however, cause false positive antibody results. Any positive antibody result must be confirmed with a Western Blot test, because a WB will weed out false positive antibody results.

The med you're on for psoriasis also will not cause delayed seroconversion. You'll still test positive within the normal window period.

Unfortunately there are no short-cuts to hiv testing for a conclusive result. The gold standard remains at three months post exposure.

Ann

[Ann]

Thank you all for the information. This community is such a great resource.

sk,

You're welcome. I've quoted your post so I can remove it - you have one free post left. Use it wisely.

You still have a few weeks to go until you can get a six week test over the unprotected, receptive anal sex. While a negative result at that point will be highly unlikely to change, it must be confirmed at the three month point.

Please learn from this and stop having unprotected intercourse. Hopefully you'll come out of this ok.

Ann