Sex worker, broken condom, symptoms - terrified

[Lothianlad]

Hi, firstly thank you for having this fantastic forum available I've found it really informative these past weeks where I've been worried out of my mind and am scared. Sorry in advance for the long message.

I've had a horrible fear for the past while after I was at risk of exposure on 14 October 2018 after a very ill-judged decision to see a Romanian sex worker in Scotland. Combined with various relationship/emotional problems with my long term girlfriend (zero sexual intimacy for a long time), I'd bottled things up and came to a stupid drunken decision to do what I did. 

I had protected oral (receiving only) and vaginal sex with the sex worker who's status it's impossible to know. The condom broke/ripped at some point during the vaginal sex (10-15 mins long) and as she was on top neither of us noticed until after I withdrew - when she went to take the condom off me it was clearly broken, I can't recall how badly as I'd drank too much. Although I hadn't ejaculated she was quite wet. She didn't seem to panic at all and we put on a new condom to have sex again which this time didn't break. She carefully removed and checked the second condom. There were no signs of blood, cuts or lesions around the sex workers vagina however I may have had a very small cut around the top of my penis from masturbating earlier that morning (a possible easy route for infection?). The next day when I was sober I realized the risk I put myself in.

My worries are:
Week 1 - for about a week from the day after the exposure I experienced a distinct tingling sensation in my penis that had me worried. After three of four days a good sized single pus filled pimple around a hair follicle emerged on my pubic area which I popped and quickly healed in a day or two. A second pimple came up about 7 days after exposure in the same area and on the inside of my thigh opposite. Can single pimples appearing be a symptom? It is pretty unusual for me. No more since that week.

Week 3 - 5 November I got a very strong very dry cough that wouldn't respond to any over the counter treatment and lasted a full 10 days, the last three days the cough changed in nature a little and produced mucus. I've read that this type of dry cough can be a typical symptom? If the cough was seroconversion at week three would antibodies be picked up at week 4?

Week 4 - on 13 November (30 days post exposure) I went to a GUM clinic run by NHS to get a blood test (I think NHS do 4th gen) and a finger prick rapid test. The nurse confirmed that I was exposed to a risk for HIV and other infections. The finger prick test was negative, which I would have expected since I have had no other exposure 12 weeks prior. The blood test came back negative and I also tested negative for chlamydia, gonorrhea, and syphilis. I was advised to re-test for HIV at 12 weeks which I will do on Monday 7 January (84 days post exposure). I've read on the NHS website that the 4 week test is considered 95% accurate?

In the time since I got the 4 week negative result I have had a range of symptoms that are out of the ordinary for me and cause concern:

Week6/7 - strongly aching arms and legs out of the blue, lasted about 8 or 9 days before disappearing. I've read this is a common symptom? This prompted me to go for a 6 week test but I was told by the clinic to come back in another 6 weeks as sex workers in Scotland are a very low risk for HIV.

Week 8 - From about this time I got a few red spots on my back, chest and shoulders that appeared like pimples but mostly had no pus in them. They would appear in small groups of 3 or 4, say my shoulder area and on my neck other side of my body. Randomly placed pimples come and go on my trunk too. Some have stayed, others come and gone but others appear in their place and they have persisted - by now (week 11) they are appearing larger and varying in size in the centre of my chest and shoulders in particular, say 10-15 of these randomly spread over my body and two or three of the larger ones are yellow/pus filled like they are infected. This is causing me some serious worry as it's something I have never experienced before. Is this what an early infection rash might resemble? Just this week (week 10-11) they have also began to appear on my thighs, 4 or 5 little raised red bumps coming and going.

Weeks 9-11/present - in addition to the worsening the skin issue I have a really nagging ache in my throat up to the ears area on both sides and in the lymph area of my groin. I've also had 5 or 6 of mornings where I wake up with a damp t-shirt like night sweats, although not dripping wet or anything. Would this type of symptom be very obvious in that it would have severe night sweats to suggest early HIV? I have had raw gum on one side of my mouth in the same area and a single small painless mouth ulcer on my cheek  these past weeks too.

I've spoken with the clinic again this week to see if I could come in at week 11 and they have said I'm really not considered a serious risk based on my exposure. Then again I've read cases where people make a single stupid mistake like I did and from that one exposure get HIV. The nurse has said HIV is very difficult for female to male transmission, although I'm scared that if the sex worker was only recently infected she would have had a high viral load to pass the virus on.

From the moment I felt that tingling feeling in my penis the days after exposure I have had a gut feeling that something is just not right with me and I don't feel myself and I really think I have contracted the virus. Ultimately I'm completely scared out of my mind given some of the symptoms I'm showing. Does evidence show symptoms generally all come at once or gradually build up over time? I am aware I should have gone for PEP, but given I've been deemed a low risk by the clinic I'm not sure I would have got this.

I know testing is the only way to know for sure - that's happening on Monday. Do you know if there are many cases where a negative 4 week test changes at week 12? Or have sex worker encounters in the UK led to many infections? Or even any accounts that others have written about their seroconversion experience? If you've come across anything like this I'd just like to know if possible so I can try set my head straight.

I'd be really grateful for any advice or thoughts on my experiences. Apologies for such a long message, I just wanted to give a complete overview of where I'm at and also get some of this off my chest. I am completely terrified from this experience and now afraid of losing my girlfriend plus ruining her life due to an idiotic drunken decision that I'll somehow have to explain to her.

Thank you for reading this message. I will let you know the 12 week outcome after next Monday's test when I get the results later next week.

Sincerely and best wishes, 
Terrified man / Lothianlad :-(

[Jim Allen]

Yeah look sorry to hear that you are feeling unwell.

However I think you are seriously overthinking this, and Ill spare you the speech about why her background & it being Schotland are totally irrelevant, I'll email the NHS on that  point again anyhow I do not expect your negative results from the 6 weeks test to change when do you retest, it's only an very odd outlier that sees s change beyond that point and the exposure was minimal to start with, I'll add that the symptoms you mentioned are between unrelated/ not specific.

Test if you must next week for a conclusive result and peace of mind but than move on with your life

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions.

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 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.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

Please Note.
As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.

[Lothianlad]

Hi Jim, thank you so much for quick response it's really appreciated. Sorry again for the essay...

Absolutely, thanks for pointing out that nationality/location don't mean a thing really as it was a risk regardless! From what I've read although the blood test was at 30 days, the NHS blood testing is very accurate by this time. In terms of outliers after 4 weeks, how common might that be statistically - pretty rare? Or is there any consensus that seroconversion symptoms all come together at the same time or in stages? Out of interest, is the nurse really right that it's comparatively fairly difficult to get infected female to male through vaginal sex?

From the number/dates of the posts within the 'am I infected' forum compared to the number in 'just diagnosed' I can see most people in a similar position to me have not tested positive so I suppose that should also give me some comfort (although I'm aware a risk only needs to happen once). 

I'll save my third/final comment for an update after my 12 week test next week. Hoping I can simply move on after that and never repeat my mistake again.

Thank you very much again for your time and advice, you are providing a great resource and helping so many people.

Best wishes

[Jim Allen]

Look in my personal opinion the NHS are about as useful as far as I can throw them. Same people who installed carpets in a surgical bay as it was cheaper on paper or gave physical therapy to a corpse, and continue to treat PrEP as if it's witchcraft that needs UK testing instead of accepting  scientific fact    ...

Anyhow thankfully the labs, and test used have nothing to do with them or the UK. Testing positive bejond the initial result you already had is for a minute minority (outliers) only and testing at 3 months post exposure is realistically just to confirm the result you already have.

You only had minimal risk even to start with as the insertive partner following condom breakage ..  I really don't expect your results to change and testing should be seen by you as peace of mind and confirming your earlier result without expecting any change

Relax ! Simply test and move on with your life.

Jim

[Jim Allen]

Out of interest, is the nurse really right that it's comparatively fairly difficult to get infected female to male through vaginal sex?

Yes, I mean HIV is difficult to transmit to start with sexually speaking and, the risk estimate for the easiest transmission senario is less than 2% per instance even ... That said it does happen and hence keep using condoms and test for peace of mind.

Really you are over thinking this and see your GP in the meantime and treat whatever is making you sick

Jim

[Lothianlad]

Hi, i wanted to come back to use my last available post with an update to my previous and raise another query.

Long story short my previous posts set out a potential exposure on 14 Oct 18 due to broken condom with a sex worker. This was followed up by a negative rapid test at 4 weeks, a negative test at 84 days 7 Jan 2019) and a further negative test at 5 months 2 weeks (4 April 2019).

I had moved on with my life as Jim kindly advises everybody hiwever in recent months I've had various illnesses like persistent itchiness, skin infections, minor mouth ulcer issues including mild thrush, and bad acne/hives around torso, neck, shoulders and face and occasional single pimples in the pubic area - just not feeling great and it all brings me back to the potential exposure i had.

Having read various advice and contacted my local hiv charity for advice i'm told my tests 'should' be conclusive and I can rule out hiv, however despite these tests I still worry that I'm showing signs of stage 2 or 3 infection (described here https://bettercare.co.za/learn/adult-hiv/text/01.html). I've had no other risks or possible exposure since that one time.

There's so much variation in advice, like tests in uk saying conclusive at 3 months and in the usa 6 months and I wondered if I should test again and in anybody's experience whether a blood draw test at 84 days or a rapid test at 5 months and 2 weeks would realistically change? There would still be a very small chance i tested false negative if I read the test stats correctly? Or would anything over 5 months in the uk using a rapid test at a hiv charity not change? 

Just wanted to share my experience again and good luck to those who read this and are worrying too. I will see a gp regardless and anybody here in fear should also do the same really, but no harm asking questions here too i guess.

Thanks for any advice in advance and best wishes during lockdown.

[Jim Allen]

Hiya

Look your symptoms have nothing to do with HIV from the concerned incident last year, sorry to hear you have felt unwell but keep working with your GP.

As for testing, you have conclusively tested negative post the 2018 incident. Continue to use condoms for any intercourse, no exceptions and test out of routine as everyone should at least yearly for HIV & STI's.

Jim