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Recieved An Oral Sex Without Condom. HIV Ag/Ag Test And PCR Test After Four Weeks Negative. Having Anxiety With Gastrontestinal Problems

Posted on Sun, 17 Nov 2013

Question: Hi doctor

I am a male and I recieved an oral sex without condom for about 3/4 seconds by a massage lady, which I eyaculate

I have got tested by HIV Ag/Ag test and PCR test after 4 weeks, and It came negative. I did test for a combo HIV 1/2 and P24 Ag after 6 weeks and it came negative as well.

During this period (from three weeks) I had a big anxiety with gastrontestinal problems, some fever, oral trush, changes on the skin and lost completly my appetite, which made me losse about 4 kilos in 3 weeks. My total weight was 70 Kg

The question is if I have get re test again or I can leave in peace.

Thanks in Advance

Answered by Dr. Dr. Prasad J (22 minutes later)

Brief Answer:
HIV risk it too low...

Detailed Answer:
Hi,

I am fairly confident that you do not have HIV.

HIV risks is extremely low through oral sex. Even if your partner has HIV infection, the chances of HIV through unprotected sexual intercourse lasting for few seconds is extremely rare. I haven't seen a patient who has got infected through HIV. Neither have my colleagues seen or read about such incidents for years together.

In all probabilities, I consider your chances of HIV to be close to zero. You need to repeat the test only if you are still not convinced with what you have read now.

Hope this helps. Feel free to discuss further and get your concerns sorted.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (23 minutes later)

Thanks very much for the answer.

My level of axiety is very high, heart rpm never goes down 110 and all my back is contracted due the nerves.

I was worried because I had some candida un my genitals and I heard is easy for the virus to go in. After this happen to days after I asked the lady to test for HIV and came negative, but my paranoia stils there, because she could be just infected.

Kr
Francesc

Answered by Dr. Dr. Prasad J (33 minutes later)

Brief Answer:
Antianxiety drugs to be considered...

Detailed Answer:
Hi,

HIV test that was negative is 'the conclusive' evidence to prove that wouldn't ever get HIV from this exposure. All attempts to repeat HIV test would be futile and just a means to escalate your anxious mind.

At this point of time, it is more important to treat your anxious mind than worry about HIV. There is no way that you will develop HIV. If you don't feel settled with this response, I suggest you to consider antianxiety treatment through a professional. A brief use of antianxiety drugs such as low dose clonazepam along with counselling session are the options to try.

Hope this helps rest your mind. I will be glad to discuss further if needed.

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (23 minutes later)

HI Doctor, thank you very much for your advice is very helpful. I know that the doctor are the only doctors can do diagnosis, but reading through internet in some many places are recomending conclusive test is at 12 weeks or 3 month. I guess its the 3th generation test. How I can read this. Should I do it my self after a 6 weeks HIV Ag/Ab negative.
XXXXX

Answered by Dr. Dr. Prasad J (16 minutes later)

Brief Answer:
Do not test any more...

Detailed Answer:
Hi,

Yes, 4th generation HIV test, the HIV antibody + P24 antigen combo is more sensitive than 3rd generation HIV elisa (IgG and IgM) test. It can rule out HIV as earlier than 12 weeks.
Further HIV DNA PCR test is more sensitive and I prefer this test to detect HIV infection earlier than 4 weeks.

If I were to be your treating doctor, I would not order you to repeat the tests. I have found more than enough evidences (both from you and from the partner involved) to prove that you don't have HIV. If doubts still linger in your mind, treating anxiety rather than repeating tests is the ideal treatment.

Hope this helps.

Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (3 hours later)

Hi Dr. XXXXXXX

Many thanks for your advice. I am already on lorazepan to sleep the last three weeks, so I will seek further help to my GP

My GP express the same view as yours, that the test is conclusive, though he order a PCR test after my HIV Ag/Ab at 6 weeks. Which is the thing I am not fully understand if the other one was conclusive.

XXXXXX
Francesc

Answered by Dr. Dr. Prasad J (21 minutes later)

Brief Answer:
I'm convinced that you don't have HIV

Detailed Answer:
Dear,

Through the various test conducted till date, I'm convinced that you don't have HIV infection. I don't see any point repeating PCR when the initial test was negative.

Perhaps you need to inform your GP that you have tested your partner and she was proved to be negative too. That would make your physician believe your non infective state.

As far as lorazepam is concerned, it has good sedative effects. But I would use clonazepam than lorazepam for anti anxiety benefits.

Hope this helps. I'll be glad to discuss further if you need clarification.
If all your questions are answered please close this discussion.

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (45 minutes later)

Hi doctor,

On the hospital she got tested they did had 3rt generation HIV test, only antibodies, so could be she was just infected with hight viral load. So in this case I believe could be a risk right? I know this is very very unlikely to happen, but I guess the most infections happen during this period.

Answered by Dr. Dr. Prasad J (11 hours later)

Brief Answer:
But HIV is unlikely....

Detailed Answer:
Apologies for the late reply...

If we should think of various possible situation, they can be multiple scenarios. In the worst case of she being HIV, then chance of HIV infection through unprotected sexual intercourse lasting for 3-4 seconds is 1 in 0000. I consider this risk as extremely low to insignificant. There has not been reports of HIV transfer recorded in history following this kind of exposure.

Besides that, as I said in my previous replies HIV PCR test is most sensitive and can pick up possible infection within 4 weeks of exposure. If you had been 1 in 0000 individual, no doubt PCR would have picked it up.

In all probabilities, even if she was positive, I would rate your chance of being HIV infected as zero.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (4 hours later)

Many thanks doctor. You information it has been very helpful. I will move on with my life, and apologies for being so insistant, but the same anxiety itself can make you live a nightmare.
Thanks again, this was my last question
XXXXX

Answered by Dr. Dr. Prasad J (6 minutes later)

Brief Answer:
You are welcome...

Detailed Answer:
I am glad that I have helped in clearing your mind about HIV. I hope that you get your anxiety treated early with good medications and therapy sessions. I am sure you will be able to lead a normal and healthy live.

You are welcome to contact me again if you feel you need further clarifications about this topic. You can ask me on this link:
WWW.WWWW.WW
Best Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (2 days later)

Hi Doctor, today I did recieved the results of my PCR HIV test after 6 weeks of exposure, my doctor said that is conclusive I am not infected with HIV, but he said as well to test after 3 month for a simply routinary test, this worried me again.
What is you view?
XXXXX

Answered by Dr. Dr. Prasad J (16 minutes later)

Brief Answer:
No, I wouldn't repeat the test...

Detailed Answer:
Hi,

I don't see any point in repeating PCR test. The test done until now is clear and conclusive to exclude HIV infection. I believe the repeat test is only going to add on to your anxiety.

The ball is in your court now.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (21 minutes later)

He said to repeat the antibodies test at 12 weeks, not the PCR, sorry for not mention before
XXXXX

Answered by Dr. Dr. Prasad J (1 hour later)

Brief Answer:
You need not repeat the test...

Detailed Answer:
Yes, a few doctors do suggest repeating the test after 6 months. However I do not suggest the repeat test in low risk patient's such as yours.

Be rest assured; HIV is least likely.

If you plan to repeat the test, you can get it done without a fear of it coming positive. It's close to impossible that you will get a positive result. Stay assured.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (10 days later)

Hi doctor, it seems i am getting better from my anxiety. Even though still

During this period, I have had GI problems, one day with diarrea went to the doctor and had a parasit in the stomach, she gave me special antibiotics for bacteria, after 6 days of taking them, I had a big candida overgrowth on my mouth, doctor said that was ok, did gave oral cream. After two weeks I saw an specialist on infections (Same HIV expert), he said that was a little candida, not to worry, but I had candida on my penis for about 3 month, going and back, different doctors, different creams, he game fluconazole 100 mg per day for aweek, did improve both, mouth and penis, but he gave me another week in a second visit. After 14 days I still see candida in my tongue less though, almost disapear in my penis, but I am afraid after medication is taken everything comes back. What is your recomentadation, he told me eat iogur and do exercise, which I have done. Living in a hot country like thailand is not helping.
My stools are going from constipation to almos loose, with a yellowish colour, not white for sure.
Any advice
XXXXX

Answered by Dr. Dr. Prasad J (17 hours later)

Brief Answer:
Continue antifungal medication...

Detailed Answer:
Hi,

Apologies for the late reply...

Candida is known for opportunistic infection. Further recurrence is common when treatment is inadequate. I treat my patients with 150mg flucanazole over 2-3 weeks. Besides that the latest antibiotics would have caused the flare up.
Iwould prefer that you get this treated by dermatologist who handle such cases more frequently on daily basis. I refer my patients to them when I'm unable to treat fungal infection adequately.

Bowel problems are caused mostly for due to intestinal infection, antibiotics, stress and so on. Your latest sexual experience or HIV has no role with it. I would wait for a few more weeks since
stools are not watery before choosing to investigate further.

Hope this helps.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (21 minutes later)

Hi Doctor,

I have heard that this is common in HIV patients. Taking the assumption I am HIV negative, I did have sex with my wife after 2 weeks of of my incident, vaginal with no protection. If I am not hiv infected based on my tests, its impossible that I did infect her? on top of that she is preganant.
She is having some white tongue, but dematologist said she does not have candida, normally HIV infected developed.
She used to have on her vagina 3 months ago, now we are scared again. We did this test of placing saliva on a glass of water and did not dissolve meaning that there is candida?
Please give some advice, we are scared to dead again, anxiesty is back and lack of appetit
XXXXX

Answered by Dr. Dr. Prasad J (14 hours later)

Brief Answer:
Two answers below should clarify your doubts;

Detailed Answer:
Hi,

1. There are almost nill chance of your wife becoming HIV as you are not infected.

2. Spit test is no where close to diagnose candida infections. It does not be any means confirm she has oral candidiasis.

Do not be worries. Every thing looks clear.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (15 hours later)

Hi Doctor,

First picture is mine, and second one is my wife. Do you think there is some candida, both have white tongue, which at some extend is normal, do you see candida on out tongue.

Answered by Dr. Dr. Prasad J (4 hours later)

Brief Answer:
A clinical examination is apt...

Detailed Answer:
Hi,

I'm sorry diagnosing this problem is beyond ehealth forum abilities. Your doctor who can examine the white area under broad light can look for redness, blistering and other features to suspect oral thrush. If your doctor are not convinced they can order for microbiological test to confirm thrush infection.

That being said, if you have no burning or painful symptoms with white spots, it is less likely to be an active Candidiasis.

I apologies I have not been very useful with confirming oral infection; a competent dermatologist might be able to give you more information on this topic.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (27 hours later)

Hi

Doctor, I do understand, its difficult to see through a picture. No problem at all. I was diagnosed candida in my mouth and pinus, took two weeks of fluconazol, after that I went to a dermatologist, she said that that candida overgrowth was gone, but few days after finish medication (5 days), my tongue seems to be whiter and my pinus more red. What I can do to stop the candida overgrowth, because taking medication seems to not improve, which diet should I follow
XXXXX

Answered by Dr. Dr. Prasad J (25 hours later)

Brief Answer:
Diet has no significant role according to me...

Detailed Answer:
Hi,

I'm not aware of any particular food that helps in preventing oral candidasis. However avoid yeast containing drinks. Yoghurt can prevent this infection from spreading down into lower gut.

As far as recurrence is concerned, it might be due to incomplete treatment or due to lower body resistance. We know that your HIV status is ruled out, but your blood sugar also need to be examined.
It is also worth while to consult a dermatologist and study the lesion. If it is indeed a recurrence, then I would choose a stronger antifungal like amphotericin in this case along with antifungal mouth paint.

Discuss with your dermatologist.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (21 hours later)

Hi Doctor,

My tongue seems to stay as it is, not getting worse, but not getting better, allways some white colour, I do my oral cleaning 3 times a days, when I brush my tongue, never see behind any red spots, never bleeding. My penus is another story, is about 3 month I have not, seems to go and back. I have check my anual blood check from 4 month ago, and my level of sugar was a bit high, never payed attention to it, will get another one, problem could only this right?
Whats is a helthy colour of a tongue, because went I went to the dermatologist worried about my candida, she showed her tongue and was quite white as well.
I know you believe HIV has been ruled out, but I am still going to get the 12 week mark test, to conclude
XXXXX

Answered by Dr. Dr. Prasad J (8 minutes later)

Brief Answer:
Yes get your blood sugar checked...

Detailed Answer:
Hi,

Repeating HIV test is your call, I don't see a need to repeat the test.

As far as recurring fungal infection is concerned, it is essential you check sugars and keep it in control.

Good luck...

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (10 days later)

Hi doctor,

I am finding very dificult to move on my HIV experience, and on my mind still thinks I can be infected. I know is due my anxiety but I am having sort of healt problems, now I have soar throat and my tongue still has a white thin layer on it. Dont know what to do, check my sugar in blood, doctor said everything ok. I did full sti at 10 weeks, because doctor missed some, everything was negative, as well the HIV Ag/Ab rapid test.
The combo test makes any difference in accuracy if you get the results on a hour or it takes days?
I know it sounds paranoic, but it really is. I did check with my country (Spainish XXXXXXX minister) and they do consider a combo test conclusive after 6 weeks. And they do have it on the web side as well.

Answered by Dr. Dr. Prasad J (16 hours later)

Brief Answer:
Consider visiting a physician...

Detailed Answer:
Hi,

I'm sorry you are finding it difficult to move on. ButHIV test have conclusively excluded remote popossibility of HIV infection perse.

White tongue is normal sometimes. It is abnormal on some occasions. Based on the pictures, I did not find alarming features. Further sore throat is not the only feature of HIV. Nor does it mean STI's.

I suggest you to find courage to visit a physician near by. A detailed clinical examination would provide missing elements if any to diagnose the entity. At this point a talk with your physician can be worth while.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (38 minutes later)

Hi Doctor

Same doctor who assist me on the last HIV test, said that my tongue and thoat was normal, but I actually have some pain. I had namness in two fingers of my left hand for 6 weeks now, i did an Electromiografy and found a nerve was slighly trapped, they said just wait 6 month to see of it goes, no cure, just take vitamin B.
I understand HIV its been ruled out, but I feel bad, can all these symptoms can be caused pure by extreme anxiety and stress?
Due this high anxiety period, can be that my inmonologic system is down, slowing down the HIV antibodies creation?

The feeling I have in my tongue is rough, like when you got it burned by food or hol liquid, the white film is creating a pasty environment in my mouth, I haven't seen any candida growth anymore, but this pasty taste never goes. I am taking some diazepam and Vitamin B1-6-12, not sure if this can cause that.

XXXXX

Answered by Dr. Dr. Prasad J (4 hours later)

Brief Answer:
Anxiety doesn't affect immunological system...

Detailed Answer:
Hi,

Anxiety produces multiple symptoms described as somatic complaints. It doesn't affect physical functions including immunological functions. Be rest assured, anxiety has no role to plain in development of HIV antibodies; neither will it suppress your antibody functions.

You can tackle anxiety much better once you get the thought of HIV out of your minds.

Hope this helps you. Let me know if you need more clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (4 minutes later)

Hi Doctor
I believe the results, but still having sympoms and not feeling well, that's why I am still concerned, some days due anxiesty I vomit, week after one day of diarrea. Everthing is very strange, I had the candida...

Answered by Dr. Dr. Prasad J (2 hours later)

Brief Answer:
Symptoms are not due to HIV...

Detailed Answer:
Candida infection is an opportunistic infection. And HIV is not the reason here. This is proved beyond doubts. I am sure with right guidance and measures your doctors can handle the situation very well.

You need to take a step forward and visit them.

HIV infection is not the reason for your problems.

Hope this answers your query.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (1 minute later)

Cheers

Answered by Dr. Dr. Prasad J (2 hours later)

Brief Answer:
Good luck!!!

Detailed Answer:
Good luck and warm wishes....

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (45 hours later)

Hi Doctor,

Since Yesterday a couple/three days I am having mild fever (37.3 37.5) lost of appetite and not feeling very well, can all this come from my anxiety or I should visit a doctor, I know if I go with this sympthoms will tell me I am ok, take paracetamol, what do you think?

Answered by Dr. Dr. Prasad J (2 hours later)

Brief Answer:
Infection...

Detailed Answer:
Hi,

The low grade fever, reduced appetite and feeling of unwell might be due to acute viral illness. There are many benign virus which produce similar symptoms only to disappear spontaneously in a few days to week. They rarely cause concerning symptoms.

You can take paracetamol briefly to treat fever. Drink plenty of fluids. You should get over this fresh problem very soon.

Anxiety has no role with the current illness. Cheer up and take care of your food and hydration.

Hope this helps. Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (27 minutes later)

For sure that has nothing to do with HIV infeccion symtoms? My god, I am scared to dead again, I am in my week 11 after the exposure, I know its ruled out, but I never was sick before all this start

Answered by Dr. Dr. Prasad J (16 hours later)

Brief Answer:
It isn't HIV....

Detailed Answer:
Hi,

Viral infection can occur in all healthy human. No single man is free from common viral invasion. Be rest assured that this is a common infection and not from HIV.

You should feel better in a few days... Just as in every normal human being.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (2 hours later)

Its about now 5 days I an feeling like this, the fever never goes up 37,3, taken from my axila, I dont know if this can be considered fever anyway, I am taking paracetamol, but is not changing anything, and for sure if I go ro my GP with this numbers will telll I am ok, nothing wrong with me.
Forget to mention before my stool its looking a bit pale, not white for sure, but not brown as they use to be. I eat iogurt everyday and banana, do you think this is coming from my diet or could something else

Answered by Dr. Dr. Prasad J (22 hours later)

Brief Answer:
Temperature of 37.3 is not alarming...

Detailed Answer:
Hi,

37.3 deg C is just marginal elevation of body temperature. It is not alarming. Further, mild temperature fluctuation can occur due to varied circumstance - thermometer error, surface temperature difference, stress and anxious state and so on.

Stool color as well as consistency is again dependent on the type of food one eats.

At this point of time, do not be very concerned. Monitor the progress of your symptoms. Be relaxed, eat plenty of fibres and drink plenty of fluids. If you don't feel better symptomatically, you can opt to visit a physician for clinical examination.

Since I am sure this isn't HIV related, there is no doubt you should be better very soon.

Hope this helps.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (7 days later)

Hi Doctor

FYI, I did my last HIV test at 12 weeks (HIv Ag/Ab), exactly at 84 days and it came back negative. Rapid one, my doctor insist that I didn't need it, but he accept it just to help me out with my anxiesty and to proof that it again. The truth is that I am more relaxed now, all the anxiesty camr down, I am feeling super tired, which I know it's my body reaction to 12 weeks of high anxiesty.
Promise last question on HIV, I have seen some international guidelines recomend to re test at 6 month? I know I don't need it, but whats your view on this.
Thanks in advance Doctor

Answered by Dr. Dr. Prasad J (2 hours later)

Brief Answer:
No need to retest...

Detailed Answer:
Hi,

I am glad that you are finally at peace. Before I answer your last question, this information is only for your information; it does not apply to all.

Retesting is to identify late seroconverters; a condition which was considered existent in the past. I say this because now we have very sensitive and specific tests which can pick up HIV even during the window period. Therefore this entity of late seroconversion has not been seen or heard off - thanks to those wonderful modern diagnostic tests. So for all practical purposes, I believe a retest at 6 months is a futile attempt. It serves only as a means to alleviate anxiety especially in patients who are exposed to very low risk of HIV.

You need not look forward to 6 months recheck as all the current tests including PCR have proved beyond doubts that you are non infected.

Hope this helps. If you need answers to any other questions in future you can ask me here: WWW.WWWW.WW If all your questions are answered, please close this discussion.

Good luck and wish you good health!!

Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar