POZ Community Forums
HIV Prevention and Testing => Do I Have HIV? => Topic started by: treefrog on May 16, 2012, 11:36:29 am
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I was recently in Thailand and had sex with a transgendered prostitute. I had been drinking and foolishly penetrated her anally without a condom. I didn't thrust much if at all. I just entered her maybe a little past the head of my penis and was pretty much still there. After about 20 to 30 seconds I realized what was happening and pulled out. I then put on a condom and had sex with her again until I ejaculated (no broken condom). All this with no lube.
The next day I considered it a close call but didn't give it too much thought as I've always assumed that the penetrator was at much lower risk than the penetrated (and it was so brief). Then ten days after I returned to my home in Singapore I came down with a sudden fever, intense body aches, and a throbbing headache. The fever lasted three days before breaking and then I began getting a blotchy red rash all over my body. It started on my shoulders and back and has since spread all over my torso, front and back, down my arms, on the back of my hands and feet, on my legs. The palms of my hands are bright red and slightly swollen. My arms, hands, and feet are itchy, but not my torso. The fever has not returned. I've been to the emergency room three times since the first day (It is now day seven). The doctors think I may have dengue fever and are monitoring my blood platelet levels (they along with my white blood cell count have steadily dropped since day one). I've been doing research on-line and have learned that the symptoms of dengue fever and ARS are very similar. I'm in a state of panic and high anxiety. While it seems possible that I have dengue fever, it seems equally likely that I may be seroconverting. Can you please help me with some perspective? How risky was the brief unprotected penetration that I've described? I have had a hard time finding pictures of a ARS rash on-line but would really like to know what it typically or generally looks like to compare it to what I have. I know that the reddening and swelling of hands and feet is a symptom of dengue fever. Is it also found as part of a ARS rash?
For what it's worth the transgendered prostitute told me that she rarely does anal with her clients but had unprotected anal regularly for two years with her ex-boyfriend. I didn't ask if she'd recently been tested because I figured I wouldn't be able to believe her answer. It really has me freaked out that she was so eager to be penetrated without a condom and then was able to take me inside with a condom and no lube. Also, for what it's worth, there was no sign of blood on my sheets or on the condom when I pulled out.
Please help as soon as possible. I'm having a really hard time coping with the anxiety.
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Tree, anytime you have unprotected anal (or vaginal) intercourse you are at risk for HIV. It is also true that the risk is significantly less for the insertive partner than it is for the receptive one. However, low risk is not the same as no risk, so you do need to get tested.
Given the very brief period of insertion without a condom and that it was a single incident, the odds are in your favor that ultimately you will test negative.
There is nothing HIV specific about your symptoms and in any case neither symptoms or the lack of them is ever the way to know reliably what your HIV status is. Only an HIV specific test can give you that answer.
You can test initially at 6 weeks after the risk. If you test negative as I think may well be possible, that negative at 6 weeks will strongly indicate you are likely to test negative at 3 months. A 3 months negative will be a conclusive result about your status.
In the future you can have sex with anyone you want to. Just do it the safer way and always without exception use a condom for intercourse.
Good luck with your tests.
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Thanks, Andy. Is this a typo in the following sentence? I had brief insertion "without" a condom, not "with." Just want to make sure you understood me clearly.
"Given the very brief period of insertion with a condom and that it was a single incident, the odds are in your favor that ultimately you will test negative."
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Yes, that was a typo. I've corrected it. I got your story clearly and I consider yours to have been been a very low level risk as you reported it.
You can sttop freaking out. I expect you to come out of this ok.
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Thanks again, Andy. Your advice has settled me down substantially.
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I'm sorry to be a bother, but I feel my anxiety levels rising again. I went for another doctor's appointment today and they are now not sure if I have dengue fever or another type of viral infection. What they are calling my illness is "viral exanthem," which is a diffuse widespread rash that covers most of the body following certain types of viral fever. If you are familiar with viral exanthem could you tell me if it is significantly different than the typical ARS rash? If I knew there is a significant difference it would really set my mind at ease.
Yes, I understand that you have assessed my risk as low, but the coincidence of contracting an unknown viral infection just 10 days after my episode is still making me nervous. I'm doing my best to manage the anxiety, but it creeps up suddenly and is hard to control.
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Tree,
Yes, the ARS rash is a "viral exanthem" type rash, but this type of rash can be caused by many different viruses, not just hiv.
I totally agree with Andy. You have had an extremely brief, insertive exposure. Your exposure isn't any different to the insertive exposure where the condom has broken. We see those here all the time and in over ten years of working in this forum, I have yet to see the insertive partner end up positive over a condom break.
While you have had a risk it is very, very much on the low end of the scale. You do need to test to make sure you are hiv negative, but I do expect you to test hiv negative.
I'll say this - if the symptoms you have been experiencing have anything to do with hiv infection, you will most likely test positive now, or indeterminate at the very least (indeterminate is a weak positive).
The symptoms that some (not all) people experience are not cause by the virus itself. They are caused by the process the body goes through while creating antibodies. This is why I would expect you to test positive now if you indeed have been infected.
By the way, that thing going on with your hands does not sound like hiv at all. It sounds like dengue fever symptoms.
If you do test hiv negative as I expect you will, you will need to test out to three months to be absolutely sure. However, if you get a negative now, I would not expect that to change.
Ann
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Hi Ann, thank you so much for the reassurance. I did go for a rapid test tuesday morning (the 6th day of symptoms and 2 days post fever) and it was negative. Is that recent enough (it's Thursday night now in Singapore) or should I test again tomorrow?
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As Ann has told you, with that negative in hand which you received, it is unlikely to change through subsequent testing. You need to test at 3 months for a conclusive negative result.
The red flag in your story is about mxing casual sex with excessive drinking. You can have all the sex you want to. But mixing it with excessive drinking reduces your ability to make safer sex decisions as you have found out. Have sex when you will, but do it soberly.
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Wow that is so awesome!!! Thank you so so much!! I'll be sure to test at 3 months and let you know the results.
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In terms of the excessive drinking and casual sex believe me I have been taking a long hard look at that this week. This has been a huge wake up call for me. It will not happen again.
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That's good to know. It's a wakeup call worth paying attention to. Hopefully as I expect you are going to come out of this one ok. But it's not something you want to go through again in the future.
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Hi Ann, thank you so much for the reassurance. I did go for a rapid test tuesday morning (the 6th day of symptoms and 2 days post fever) and it was negative. Is that recent enough (it's Thursday night now in Singapore) or should I test again tomorrow?
You're not supposed to base your testing time-line on the onset of symptoms. You're suppose to base it on when you last had unprotected anal or vaginal intercourse.
The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.
A six week negative is highly unlikely to change, but must be confirmed at the three month point.
It is unclear where you are in the window period. If it hasn't been six weeks since you last had unprotected anal or vaginal intercourse yet, you should wait until the six week mark before testing again.
Ann
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Hi Ann, First you said this:
"I'll say this - if the symptoms you have been experiencing have anything to do with hiv infection, you will most likely test positive now, or indeterminate at the very least (indeterminate is a weak positive).
The symptoms that some (not all) people experience are not cause by the virus itself. They are caused by the process the body goes through while creating antibodies. This is why I would expect you to test positive now if you indeed have been infected."
and then this:
"You're not supposed to base your testing time-line on the onset of symptoms. You're suppose to base it on when you last had unprotected anal or vaginal intercourse.
The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.
A six week negative is highly unlikely to change, but must be confirmed at the three month point.
It is unclear where you are in the window period. If it hasn't been six weeks since you last had unprotected anal or vaginal intercourse yet, you should wait until the six week mark before testing again."
They seem to contradict each other? For the record, my initial fever began 11 days after possible exposure. The fever lasted three days, immediately after which I broke out in a rash. On the 6th day of symptoms I tested negative on a rapid test. It is now the 9th day since initial symptoms (20 days into the window period) and my rash is almost completely gone, as are all other symptoms. Further, my blood tests yesterday showed that my paletelets have stopped declining and my white blood cell count has returned to normal (it was initially down). The doctor thinks that whatever it was, dengue or another viral infection, has been effectively cleared by my immune system.
So my question: Can I be reassured by the negative test result at the 6th day of symptoms/17th day into the window period? I understand that I should get tested again at 6 weeks and then again at 3 months. But based on what you said about the symptoms being the beginning of the body producing antibodies, can I be reassured by the early negative? I'm sorry to keep bothering you. I just want to make sure I'm understanding you clearly.
By the way, thanks to both you and Andy. Your support here has made this process so much easier for me. You are both doing a tremendous service. Thank you!
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So my question: Can I be reassured by the negative test result at the 6th day of symptoms/17th day into the window period?
Tree,
Sorry, I didn't mean to sound contradictory. I was trying to convey that regardless of symptoms (or even lack of symptoms), one must count the window period beginning with the risk.
And yes, I was trying to reassure you that if your symptoms were down to hiv seroconversion, you most likely would have at least tested indeterminate - if not outright positive - when you tested six days after the onset of symptoms.
However, you're still quite early in the window period. Perhaps you might want to test again at four weeks (rather than six) for your peace of mind. Given that your symptoms are abating, if they're due to hiv seroconversion, a four week test would be positive.
Good luck with your next test. I'm fully expecting another negative but you do absolutely need to test to make sure. Remember, a four or six week negative will still have to be confirmed at the three month point, but is highly unlikely to change. Unfortunately there are no short-cuts to hiv testing.
Hang in there. I really do think you're going to be ok.
Ann
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Ok, I understand. Thank you so much again. I really don't know how I would be dealing with this crisis without your advice and support. I will test again at 4 weeks.
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Tree,
You're welcome.
Now do yourself a favour and stay off hiv websites while you wait to test again. Keep your mind busy with other things and the time will go faster than you might imagine.
Ann
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Dear Ann and Andy,
Today was day 27 since my possible exposure and I tested negative again on a rapid test. I was going to wait for day 28 as you recommended but day 28 lands on a Sunday in Singapore and I didn't want to wait an extra day. I'm now convinced that I am ok but will test again in 2 months just to be absolutely sure.
I really can't thank you enough for your support. It was such a brutal coincidence to come down with a viral fever and rash just 10 days after my careless exposure. Before connecting with you both here I seriously feared that I had contracted HIV. Your good advice and support really helped to settle me down and assured me that all the odds were in my favor. It is such a great service that you do for people here. I am eternally grateful. Thank you, thank you, thank you. You are really fine people doing really good work. Thank you!
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tree,
I fully expect you to continue to test hiv negative.
Ann