Very worried

[connor-j]

Hello everyone, I have been very worried that I have acquired HIV. So worried, that I have been constantly googling things since my exposure and it has seriously affected my mental health.

Anyway, I would like your opinions on my worrying.

on 23/08/2019 I had protected sex with a female sex worker (I am male). We had sex two times, the condom didn't break the first time and I can't remember for the second time. Though, I have no reason to believe it broke I just don't remember. I received unprotected oral sex, but apparently this has no risk?

After about 10 days I came down with a pretty bad flu/cold. I have a fever, chills, aches, cough and lost my sense of taste for a while. At the time I didn't realise this could have been HIV.

About 8 weeks after I got a 4th gen combo HIV test as part of a full std test, including stuff like chlamidya and ghonorrea etc... This was negative, and I still wasn't thinking about HIV.

It was only later that I realised that it said tests before 12 weeks aren't conclusive that my anxiety started kicking in. My biggest fear was that I would transmit the virus to my girlfriend, (which is why I got the 8 week test in the first place, to make sure I didn't have any STIs before we started having sex).

So, I felt horrible and anxious because I stuffed up. I had sex with my girlfriend despite my result not being conclusive. This realisation came early January, so I immediately got tested again at the same place (4th gen combo) and it was negative. This negative test was 20 weeks after.

But, that anxiety I got from realising I didn't test properly (as in, I should have tested at 12 weeks before having sex again) has got me worried about everything and hasn't gone away. My lymph nodes on my neck and groin seem permanently swollen (I can always feel them), and I've been getting ulcers in my mouth (I think their canker sores) as well as oral thrush in my mouth and balantisis. I can't help but think this is because I have an undetected hiv infection and my immune system is weakened, allowing all these conditions to take place.

Should I go for another test now? Is there any chance of me having HIV and the tests not picking it up? The thought of infecting my girlfriend for a mistake I made (despite getting tested) is eating me up inside, I can barely do anything aside from google things and worry.

Apologies for the long post. I would appreciate your thoughts.

P.S. I would also like to add that I have been lurking these forums for a while in my constant doctor googling and I think the work you admins are doing helping people here is admirable. Thank you.

[Jim Allen]

Hiya,

Sounds like a lot of guilt prehaps and stressing over nothing.

Firstly, HIV can't transmit through an intact latex or polyurethane condom. If a condom fails during the act of intercourse it's obvious to the insertive partner. There is no reason to be stressing about intercourse as long as this obvious issue did not happen.

Also, getting your penis sucked is no HIV concern for you.

So no need to run out and test over this incident, you did and the result you have as expected is conclusively negative.  You are not on your death bed, dying of end-stage AIDS so that does not apply to you either, and your left testicle could fall off it's not going to change that you did not acquire HIV from the concerned encounter.

girlfriend

Obvious perhaps, if you have been engaging in condomless sex with your partner it would meet all the biological conditions needed for you to acquire HIV.

Now I don't judge couples that decide to engage in condomless sex, it's often based on trust within a relationship or past test results. However, just note this trust or past results does not prevent HIV and any unprotected intercourse is simply accepting a possible risk towards you of acquiring HIV.

Test regularly for HIV and far easier to transmit STI's.

I can barely do anything aside from google things and worry.

Stop googling, it will only make you paranoid and if you can't stop this irrational fear from controlling your behaviour and thoughts consider speaking to a therapist.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP going forward as an additional layer of protection against HIV

Keep in mind that some sexual practices which may be described as safe in terms of HIV transmission might still pose a risk for transmission of other easier to transmit STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also, note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

Kind regards

Jim

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[connor-j]

Thank you Jim, you have relieved some of my anxiety I'll do my best to stop worrying in future. Thanks again.

[Jim Allen]

You're welcome.

Ill that regarding whatever is making you sick, it could be everything or nothing at all, so instead of stressing about it, simply go see your doctor and treat whatever it is.

I hope you feel better soon.

Best. Jim

[connor-j]

I couldn't handle the worrying anymore and went to my doctor again to get another lab blood test. He refused to give me another, saying my 20 week test was conclusive and that my 'oral thrush' wasn't actually thrush. I want to believe him, but my tongue has never looked this way before. And, I can still feel my lymph nodes on my neck and groin, but I forgot to mention that part to him.

Since he wouldn't give me a test, I went to a separate clinic and got a rapid test. It was on of those Ab/Ag combo finger-prick ones. It is now 200 days after my exposure, and it the test was negative.

I just want to confirm, is there absolutely any doubt here about my HIV status? I have only had sex with two people in my life, that sex worker back in August and my current girlfriend who tested negative for HIV recently as well. Can I finally move on with my life? Also, as per your suggestion, Jim, I have started to see a psychologist.

Thank you for any advice you can provide.

[Jim Allen]

Hiya,

I am glad the doctor refused to test you, to be honest. The merry-go-round of endless testing over non-existent risks is not a healthy or sustainable coping strategy. 

You had no risk from the concerned event to test for, you tested anyway unneeded and the result was negative.

I just want to confirm, is there absolutely any doubt here about my HIV status?

There never was any doubt of the concerned incident, the only doubt is if you have had ongoing exposures like condomless sex with your GF.

Also, as per your suggestion, Jim, I have started to see a psychologist.

I am glad that you are seeking professional support and I wish you all the best for the future, I truly hope you can start to put these fears behind you soon.

Best, Jim

[connor-j]

Hello everyone, unfortunately I am here again; I have donated so I am able to post again. I did try to stop googling, but since I am stuck in isolation because of COVID-19 I have found it impossible to not google about HIV.

Here is a more clear timeline of what has happened, I have put more thought into it and went through tens of text messages to get an accurate timeline of my symptoms.

23/08/2019: Protected (although, I am not sure if condom broke or not. I can't remember/didn't check because she both put the condom and took it off) insertive sex with CSW; unprotected oral.
2/09/2019: Started to get a tingle in my throat; this later turned into a sore throat.
3/09/2019: Visited doctor, had a sore-throat but only a very mild fever. She says I have a upper respiratory infection. Given I am in Australia, and late-august and early September is Cold/Flu season, I don't blame her for suggesting that.
4/09/2019: Full-on sore throat, mild fever and cough.
7/09/2019: Fever and sore throat gone, but cough remained. Also, I had lost my sense of smell. I could barely smell anything. Anything I ate tasted weird and disgusting.
14/09/2019: My sense of smell had returned by now.
After this, my only symptom was being constantly tired. Which has been on an off since then to this date.
22/10/2019: Tested negative for HIV on Abbott Architect 4th gen HIV Combo Test
11/01/2020: Tested negative for HIV on Abbott Architect 4th gen HIV Combo Test. Around this time, I noticed I had palpable lymph nodes on  the left side of my neck. Also, I noticed many palpable lymph nodes in my groin region.
10/03/2020: Tested negative for HIV on Alere HIV Combo 4th gen Rapid Test

1. I can't get over how my symptoms seemed to come exactly the time they would if they were ARS. Considering this happened after my first sexual experience, I can't help but worry that it's HIV. Is anything about this timeline concerning for ARS?

2. I have been googling for hours every day and have come across this paper which I can't get out of mind.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213245/

In this paper, they describe someone who tested negative on a 4th gen lab test at 6 months, the very same test I had at 4.5 months. The person wasn't on ART, nor was he on PREP when infected or PEP after exposure and they don't mention extreme cases, like him being on chemo. They did note that he just always had a low viral load for whatever reason.

I understand your recommendations cover 99.99% of cases, but if I was this man and followed the official recommendations of 3 months is conclusive, I would have been a false negative. How can I not be anxious knowing that me having HIV is a possibility?

I know am a layman when it comes to this and that I have very likely misinterpreted the paper, but what is the explanation for this? Is there one and I'm just missing it? Or, do I just have to hope that my case isn't like this person's? I can't get it out of my head that it's technically possible for me to be infected with HIV from the proposed incident and not know about it, like this person was.

3. Furthermore, I've been rethinking about the 'symptoms' I had 10 days after my potential exposure. In particular, I had a cough that lasted for a while and lost my sense of smell/taste for an extended period of time. It took a week or two for my smell/taste to return, and the cough also lasted a week or two after the mild fever subsided. Some articles say that coughing is a symptom of ARS, but some don't. I haven't found any mention of loss of smell to be a symptom of ARS, but I did see it mentioned once in a forum post here which is why I'm worried about it. So, is a cough and or loss of smell a symptom of ARS?

4. I still have palpable lymph nodes on the left side of my neck and my groin. I noticed these in between my 20 week test and my 28 week test. If these lymph nodes has anything to do with HIV, would that mean my 28 week test would definitely be positive?

5. I understand that anxiety is getting the better of me here, but that also doesn't change the possibility that I could be infected with HIV from the proposed incident. I know this question is a bit off-topic, but I imagine on these forums you see this intense anxiety over a possible HIV infection often and may be able to offer some advice on how I get over this? The constant worrying that I might be some edge case is consuming my life. I know HIV is a manageable condition, and that if I had contracted HIV I could still live a healthy life provided I take my medication, but the thought of infecting someone else (despite taking every precaution; condoms and getting tested well after the window period) is fueling this anxiety.

I apologise for the extreme detail here, but I need to be absolutely 100% sure HIV is not my concern. I do feel guilty about coming back here with my questions and seemingly wasting your time, but as I mentioned in an earlier post, my GP refuses to test me again and all the HIV testing clinics are closed due to COVID-19 so I have no one else to ask these questions.

Thank you again, and I truly am sorry if it seems that I am wasting your time.

[Jim Allen]

Hiya,

In short, unless you have had ongoing exposures the result you have are not going to change and testing outside of standard yearly routine is not warranted.

Your issue is you have had ongoing exposures and, you are focusing on stuff that is absolutely irrelevant. Prehaps it's guilt, I don't know but that's a topic for your psychologist.

doesn't change the possibility that I could be infected with HIV from the proposed incident.

So now, you are back focusing on a single paper that doesn't apply to you, out of context, ignoring the assessment provided already to find an issue you don't have ...

If you post about this again you are getting a ban to encourage you to continue to work with your psychologist.

I am truly sorry this continues to be an issue for you, but let me be clear that I am not willing to entertain your fantasy. As explained, you had no risk from the concerned event to test for, not testing over the incident would have been conclusive, you tested anyway, unneeded and the result no surprise was negative.

You have pushed your doctors to the point that they are refusing to test you anymore with good reason.

The only true ongoing HIV risk you have mentioned here would be sex with your GF, test regularly as past test results don't mean anything if you continue to have exposures. 

Jim

[connor-j]

OK. Thank you for the quick reply; I won't post again about this incident again.