Help downunder

Question

Hi Doc,

You're doing a great job. I can't get to proper testing (cowboy in a remote location downunder)Would you recommend further testing in this case?

Risk - Brief unprotected vaginal intercourse (male perspective), suspect female of unknown status

Symptoms: Week 2 - Mild fever/temperature overnight, white furry tongue for a day, headache for 4 hours and two nights with night sweats (one night quite severe), and one mouth ulcer/canker sore lasting 2 weeks. These symptoms did not all occur simulataneously, but were seperate and at all different stages throughout the week or so. Week 4 - Coldsore lasting a week, sensitivity to light (eyes hurt watching bright TV or in direct sunlight) face felt sunburt but appeared normal Week 10 - Myalgia/arthralgia (joint/muscle pain) for 2 weeks, particularly in the knees and elbows

  • No rash, lymphadenopathy or pharyngitis

Testing: -ve result from rapid test kit (hivkits.co.uk) at 6 and 8 weeks.

Answer

G'day Cowboy from Down Under,

Symptoms are notoriously unreliable in determining who is and is not HIV infected. Consequently, I wouldn't rely on them. The reason to worry (or test) is HIV-exposure risk. You had unprotected sex and therefore you do have some degree of risk for STDs, including HIV. Your negative HIV tests at six and eight weeks are extremely encouraging. Some testing sites in the Land Down Under use eight weeks as the definitive window period for a conclusive test. Most international guidelines still recommend three months. Personally, I'd recommend you get a repeat test at the three-month mark to conclusively reconfirm your negative status. And then I'd suggest you run wild through the outback screaming WOO-HOO like a banshee in heat.

Good luck Aussie-Cowboy.

Dr. Bob