HIV Prevention and Testing > Am I Infected?

HIV, Anxiety or Something Else?

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nido:
Hello, I am new to this forum. If you have any thoughts about my situation and the questions below, I welcome your comments. Thank you so much.
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I am a male adult 30 yrs old. About 6 weeks (Jul 2) ago I had protected sex with a young female prostitute in Bangkok. She performed oral sex for 2 minutes and then intercourse for 2 minutes (she was on top) and I came. She seemed to be careful with the condom and took precautions. The condom did not seem to break but I did not examine it afterwards for leaks.

Q1) Is it ok to do a blowjob on a condom and then use the same condom for intercourse? Will the blowjob do any damage to the condom like cause leaks?

The next day (Jul 3), I had liposuction surgery at a well known hospital there (Bumrungrad Intl) which was really the purpose of my visit to Thailand. I am also afraid that maybe I contracted the HIV virus during the surgery as well (but hopefully this is unlikely given its high international standards). They did some 'anti-hiv' tests before the surgery but obviously it was too soon to detect anything. In the weeks after surgery, I developed 2-3 small fevers which did not last more than a day or two and which i perceived as normal.

Now, I know you will say there is no risk due to the condom usage but please read on.

About exactly 4 weeks after the exposure (Aug 1) I started developing symptoms that indicate HIV and I have started going crazy with worry. First, I had a rash on my upper chest, one side of the neck and one armpit and across my stomach. Tiny red and somewhat itchy spots that were initially raised but disappeared within a day or two. Well, they are flat now and hardly visible but sometimes itch if I scratch them. I thought it might be due to the compression garment I had to wear as part of the surgery recovery and that it was causing heat or sweat rash (I had been wearing it continuously for a month without washing it). However the rashes weren't limited to just the vest area but also the neck. I removed the vest to wash it and the rash did not recur although I still do get one or two spots here and there now and then at different parts of the body, again somewhat itchy. I checked my neck and armpits and did not feel any swollen lymph nodes. I should also mention that about the same time just preceding the rash, my bedroom was sprayed with strong insecticide. I waited for a few days until the smell had reduced but slept for 2 days there. I thought maybe this might have caused the rash too or the bugs that may have emerged from my mattress. I have stopped sleeping in this room now.

Q2) Do you know the effects of insecticide on the immune system? Can this mimic the effects of HIV symptoms and seroconversion?

Q3) Are the rashes caused by HIV itchy? Do they disappear after a day or two but then come again as isolated small spots around the body?

However, the rash was soon folllowed by low-high fever which has lasted for the past 7 days, on and off. I have been really stressed out and don't know if this is causing further symptoms. I also had some night sweats and chills very early on. I cannot sleep and this is causing me to become more fatigued in the mornings with headaches. I had some aches and pains at different parts of the body on different days.

Recently, for the past 4 days, I have been urinating frequently (upto 8 times a day) but it is painless and mostly clear. Also experiencing mild chronic diarrhea on some days. I also have a somewhat dry mouth now and have been checking my tongue and I seem to have some small white patches around the edges but not sure it is thrush. it does not disappear if I scratch it. My tongue appears especially withered on the sides in the morning and my throat very dry then too. I am feeling a sore throat coming on now. I don't feel particularly nauseous and have not lost my appetite, no weight loss or gain. It is almost the 6 week mark now and I still feel most of these symptoms.

Q4) Could anxiety cause the dry mouth and does that in turn cause the white patches? Is this candida? Could anxiety cause frequent urination like this? Is frequent urination a symptom of HIV? I think I feel more hot when I worry about my situation. If I go outside or see a movie, I don't feel so feverish. I should also mention I have been somewhat stressed throughtout the past 4 weeks due to the surgery recovery and other factors in my life but no symptoms until the last week after the rash.

Normally I would dismiss many of these symptoms as par for course, but since it happened right 4 weeks after the intercourse and in the window for HIV symptoms, and are so simultaneous, there seems to be few other explanations. Hopefully the condom indeed protected me.

Q5) Can you offer any other explanations that explain these symptoms apart from HIV? Perhaps any other infection like Mono/EBV? What about the surgery? Will major cosmetic surgery like this cause immune suppression? I guess what I am really looking for is do you know of people who have had all these symptoms simulataneously after exposure and not had HIV but something else? That would be very reassuring 

Q6) If I take a HIV test, I heard that it only tests for production of antibodies. If any other disease like pesticide causes immune suppression and consequent production of antibodies, will that cause the tests to be positive?

Please help. I am currently living in a small town in India where everyone knows everyone and I have to wait for about 2-3 weeks before moving to another city and getting the HIV tests done or seeing a confidential doctor. I am going crazy with worry in the meantime. Thanks again for your help and support.

Ann:
nido,

1. If the condom had been damaged during the blowjob, it would have broken during the intercourse. Damaged condoms are designed to break in a very noticeable way. They don't develop leaks, they split completely.

By the way, the condom during the blowjob was more for HER protection, not yours. Getting a blowjob is NOT a risk for hiv infection, with or without a condom.

2. I've never heard of insecticides mimicking seroconversion. However, you need to know that seroconversion symptoms, if they happen at all (they often don't), are very general symptoms, like flu. As far as I am aware, insecticides affect the nervous system, not the immune system.

3. The rash associated with hiv seroconversion is NOT itchy. If it appears at all, it is normally on the trunk and it does not come and go. From what you report, it sounds like your rash was caused by poor hygiene.

4. Neither a white tongue nor frequent urination are hiv specific. They can indicate many other things - if you're concerned about either of these problems, you'll have to see your doctor about it. We cannot possibly diagnose you or speculate as to what is going on.

5. Again, we cannot possibly diagnose you or speculate as to what is going on. If you're worried, see your doctor.

6. There are certain things, like pregnancy, that can sometimes cause false positive results. Insecticides are not one of the causes of false positives and I trust you're not pregnant.

The bottom line here is that you have not had a risk for hiv infection during the sexual experience you bring to us. As for your medical procedure, Thai medics use universal precautions just like any other medical personnel and they would not put you at risk for hiv.

You have not had a risk for hiv infection in ANYTHING you bring to us. If you're worried about your physical symptoms, see your doctor. They're not being caused by hiv.

Ann


nido:
Thanks very much for replying Ann! It helps a lot. Especially your reassurances about the condoms. It's good to know they are designed to break completely and not leak.

What I meant with the insecticide is that if it 'could' damage the immune system like HIV does, even temporarily, it might cause similar symptoms and naturally the body will react by producing necessary antibodies (seroconvert) and finally therefore show false positives on tests. Of course, in this hypothetical scenario, I would hope the effects of the insecticide are temporary not permanent like HIV.

I know I am somewhat grasping at straws in my comments. (Also looking at mono, diabetes, water poisoning as other explanations). I'm an engineer and I need a cause for an effect). I just need some alternate explanation for some hope to hold onto to explain the weird coincidence of symptoms like the fever, white tongue etc. Hope and Faith in Goa is all I got right now.

Anyway, will keep you and other curious readers updated. Thanks agaiin.

Ann:
nido,

If you need an explanation for your physical problems, then you need to go see a doctor who can look and diagnose. We cannot do that here.

You did not have a risk for hiv infection in anything you brought to us. Keep using condoms and you won't have a risk in future either.

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together. To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex with a condom lasts only a matter of minutes, but hiv is forever.

Have a look through all three condom and lube links in my signature line so you can use condoms with confidence.

Although you do not need to test over the situations you bring to us, 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.

Use condoms, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

nido:
Hello again,

I am finally going to get tested next week at the 9 week mark. I know you have always insisted I do not have a risk but the symptoms are just so overwhelming and persist. I just have a couple more questions, it would be great to have your opinions.

1) I heard that all ARS symptoms come and go at the same time. Is this true? My rash went in about 3 days and my fever went in ~9 days. Are they connected? In your previous response, when you said rash does not come and go, do you mean it would be present as long as the fever is present?

2) How long does ARS last at the max? 4 weeks after my rash appeared and 8 weeks after my exposure, I am still having frequent urination and fatigue, insomnia, mild diarrhea etc. Wouldn't it be true that after seroconversion, all your symptoms should go?

3) Also I did not mention this before, but I have been losing a lot of hair - again around the same time the rash and fever appeared, so don't think it is anxiety related. Is hair loss a common ARS symptom or early indication of hiv? I know hair loss can be caused by other auto immune diseases like lupus, diabetes, thyroid disorders.

4) I am seeing some new white spots on the side of my tongue this week looks like OHL (8 weeks after exposure) and experiencing dry mouth again.  Is this also a typical ARS symptom and why would it appear now again at 8 weeks? A light fever and sore throat seem to be coming on too.

Thanks very much. I am getting so freaked out since I can't find any other answers to my symptoms.

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