Question: I have question regarding two encounters I had. For the first encounter, I have known a lady for almost 7 years now. She is married with 4 kids and is a house wife .Before engaging in sexual act, I got her tested for STI's for below and got the results on 22nd Feb’14. TPHA - Negative Anti HCV - Negative (Anti HCV is a chemiluminescent mictroparticle enzyme immunoassay for the qualitative detection of antibody to hepatitis C virus in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) Anti HIV - Negative (Anti HIV is a chemiluminescent mictroparticle enzyme immunoassay for the simultaneous qualitative detection of HIV p24 antigen and antibodies to human immunodeficiency virus type 1 and/or type 2 in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) HbsAg - Negative (HBsAg is a chemiluminescent mictroparticle enzyme immunoassay for the qualitative detection of hepatitis B surface antigen (HBsAg) in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) When we engaged in sexual encounter 2 days after getting the reports, she sucked me off for like a minute or so without condom, before penetrating her vagina with my penis, I inserted my finger inside her and felt some small hard bits. Upon removal of the finger I saw it was blood clots and blood. Later she told me she had done intentional miscarriage two weeks before as she and her husband were not planning to have another baby and she got pregnant unintentionally and that next day she got her monthly menstrual flow. I inserted my penis in her vagina by using condom but during intercourse I lost erection and became semi erect and continued to pump her in the same way. When I removed my penis, the condom was covered with blood and clots. As far as I remember, the condom didn't tear during the complete process. But when I removed the condom, I noticed some blood on the start point of my shaft, a few moments later I checked inside the condom to ensure whether the blood reached my tip but I couldn't find any traces. I washed my penis thoroughly with water and we called it a day. Regarding the second encounter. There is a friend of mine. She has told me that her last encounter with another person was in the end of Oct'13 which was unprotected oral sex both giving and receiving and protected anal sex, there was no vaginal sex. Before getting physical with her, I got her tested for the below on 11th Feb, 2014 Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive HbsAg - Non reactive V.D.R.L - Non reactive When we got physical on 28th Feb’14, her vagina got real wet and sloppy. I gave her head and sucked her for good 10 to 15 mins. I was having swollen gums and perhaps light bleeding. During the process, I did insert my tongue inside her vagina. Afterwards, I rubbed my penis on the outside of her vagina on her genitals while it was wet with her vaginal secretions for about 5 mins. After this, I inserted my penis inside her vagina for about 10 to 15 seconds but as she squirmed with pain, I removed it. After this nothing more was done. During all this, I didn't use condom at all. After this and due to my concern about being infected with HIV, we repeated her below tests again on 14th March’14 along with the below results. Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive Do I have anything to worry about for HIV infection? Should the tests be repeated for any of the above both partners I had keeping in view the details of encounter?

Dear Doctor. Thanks a lot for your reply. Your reply has helped a lot to ease my tensions. As I mentioned in the initial question, after the second encounter and due to my concern about being infected with HIV, we repeated her below tests again on 14th March’14 along with the below results. Though her story of having protected anal intercourse in October 2013 and no other exposure with any other person till 28th February’14 is reliable, the only issue is that she is not sure if it was in Oct’13 or sometimes in the first half of Nov’13 and due to this we repeated her tests on 14th Mar’14. Before this, all his tests were done in Oct'13 start carried out by her employer to make her permanent which all came out negative. Below are the details of the tests done on 14th March, 2014. Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive The main reason I became concerned is that after the encounter on 28th Feb’14, I got mild sore throat and mild fever on 5th Mar 2014 which went away after 4 or 5 days. Though I know this happens to me yearly when weather changes. Now I am experiencing body aches all over my body including in the axilla. It is not a constant pain,,,,,,,actually travels….sometimes in one place and then in another. I have read about ARS symptoms online and I continue searching them in my body. I try to feel my lymph nodes trying to palpate them thinking perhaps I have enlarged lymph nodes. I haven’t had rash or upset stomach. I have traveled to another part of the world 2 days after the encounter. Is any further testing required? Should I be looking for such symptoms in my body? Should I be concerned about HIV? Can these be due to anxiety? What is your opinion on all this?

Dear Doctor. Thanks a lot for your reply. It is really relaxing. I am experiencing below issues lately: • Intermittent pain in the ears. • Stiff neck • Pain in the left triceps which moves to biceps also. • Pain in the axillas and groin, seems like it’s superficial, not deep, when I examine the skin, nothing is seen and it’s not rashy. But does feel like its injured by rubbing together. • Muscle pain here and there all over the body. • One pimple in the groin. • Muscle pain in the pectorals. • The feeling of being low on energy as I keep on thinking of being infected to name some. Can these be symptoms of ARS? I really don’t know how to palpate and feel the lymph nodes so that I can give you an exact picture about them. This thing is really driving me crazy, the more I try not to think of it, the more it comes to my mind again and again. After reading your replies, I did get some peace of mind. Shall we repeat any tests for my partner with whom I had unprotected encounter in the end of May’14 to ease my mind? I do want to mention here that I was on vacation and have from about a week started going back to my job. I have office related job where all day I need to sit in front of the computer screen to work.