Asking for the Third time! Please Help me out


Dear Dr. Bob:

Not sure if this note will also find its way into your waste bin, but I implore the person who sorts Dr. Bobs email to get this to him I am only asking for the third time, not sure if that warrants an answer but I can continue to try if you feel I havent paid my dues yet. I can't seem to settle my worries. I have two young kids and am totally convinced that I am HIV+ and wouldn't be around with them for long... Please! I beg of you, reply to my questions. Exactly 23 days ago I had a sexual encounter with a professional sex worked. Bad decision but I suppose I had to make one and made it with her. We had protected viginal intercourse; I checked the condom afterwards. It was intact and covered me properly. However, the problem is that she performed fellatio on me without a condom. It lasted for maybe around 5 minutes. We also kissed although not very deep. Although, I do have slight gingivitis + a slight sore inside my mouth at the time of the act. I did not perform cunnilingus on her.

Anyhow, 2-3 days after the encounter I came down with a sore throat accompanied with fatigue and headache. These symptoms lasted for around 7-10 days. After that the sore throat went away although not completely. Continued to have some pain swallowing especially in the right tonsil. Also developed neck pain and pain in the shoulder-blade muscles + continued fatigue. During the course of my sore throat I had stuffed painful ears and pain in the eye sockets (like the one you get with sinus infection). However, there was no fever, no rash, no diarrhea. Then on 21st day after the potential exposure I felt my right tonsiluar node swollen up and was painful to touch. That situation exists today i.e. the swollen tender node has been there for 3 days now. Also, my whole neck feels stiff and painful and my throat feels cloggy as if a weight is hanging below it (probably its the swollen lymph nodes). Other nodes i.e. in armpits and groin are normal. I visited my general practitioner a week after the exposure with complaints of sore throat and mentioned my encounter to him. He asked whether it was protected and I said yes although I didnt explain that the fellatio was not. He felt my nodes (no swelling there at the time), looked at my throat and concluded that it was viral and would go away. Well, sure as hell the sore throat as settled some what but the swollen nodes are new now. Also, I noticed a slight rash on my neck on the left side. Not sure it is pimples due to shaving or ARS rash.

So there you have it. I am totally freaked out and did the FDA approved HIV-1 home access express test (blood based finger prick) at five days which came out negative (well ofcouse right). I did another one at 22 days and will be getting the results tomorrow. So my questions are:

  1. Can ARS symptoms start 2-3 days after potential a exposure.
  2. Are my symptoms consistent with ARS.
  3. I have never before experienced enlarged painful nodes in the throat with the exception of tonsils. If this is not ARS that what could be causing these (BTW I did have tooth infection for a root canal I had done a while back that was giving me tooth ache. I am on antibiotics for that right now not sure if that has something to do with it).
  4. Wondering if you know what testing mechanism is used by the HIV-1 Home Access Express testing. They dont state that on their website. Is it 3rd generation ELISA.
  5. If the 22 day HIV-1 Home Access test does come out negative, how much credence should I put in it.
  6. Should I also get tested for HIV-II.
  7. Instead of using the home access test, should I get tested by going to a doctor.

Sorry for the whole story but I felt your counsel would be more relevant if you know the entire situation. You are my saving grace doc please help me out with you advice.

My donation is promised to your foundation.

  • Worried Soul


Hello Worried Soul,

The person who sorts Dr. Bob's email is none other than yours truly, Dr. Bob!

First off, let's ratchet down your level of anxiety several notches, OK?

You're "totally convinced" you are HIV positive from protected "viginal" intercourse and unprotected fellatio. Hmmm . . . here we go again! And you're very worried because your throat feels "cloggy" and you have a slight rash on your neck. Blah, blah, blah . . . . Plus your five-day Home Access test was negative and you are waiting for your 22-day results . . . . Yeah, I can see why you are so certain you're HIV positive. Gosh, the evidence is just so overwhelming, isn't it??? Dude, you haven't spent much time reading through the archives of this forum, have you?

OK, let's proceed to your specific questions before you stain your tighty whities.

  1. No, that would be too early.

  2. No.

  3. HIV-related swollen nodes are not localized to just one area and are not painful. Your neck nodes are most likely due to your tooth infection/root canal.

  4. Home Access uses a double EIA (enzyme immunoassay) with a confirmatory IFA (immunofluorescence assay). Its sensitivity and specificity approach 100%.

  5. HIV-antibody tests taken prior to three months are not considered to be definitive. The best we can say is that a negative 22-day test is encouraging.

  6. Personally I don't feel it's necessary. I should mention some HIV tests screen for HIV-2 automatically OraQuick and Multispot, for instance.

  7. That is purely up to you, sir.

Your exposure consisted of five minutes of insertive oral sex with a partner of unknown HIV serostatus. Assuming the latex condom was used properly and did not fail for your "viginal" sex, my overall assessment is that your HIV risk is minimal to negligible.

Your symptoms are not at all worrisome for or suggestive of HIV ARS or HIV disease.

Your preliminary HIV tests are encouraging, but not definitive.

Your assertions that you are HIV positive are unwarranted and unsubstantiated by the facts. In fact, the statistical odds are astronomically in your favor that you are not HIV infected.

My advice:

  1. Read through the archives of this forum. Yes, all of them! You should find the information there encouraging and enlightening.

  2. Get an HIV-antibody test at the three-month mark to calm your unwarranted fears.

  3. Consider psychological counseling to help you cope with your anxiety, guilt and irrational fear of being HIV positive.

Thanks for your donation ( I'll send my good-luck karma in return that your three-month definitive test remains negative, as I very strongly suspect it will.

Good luck.

Dr. Bob