Q. I am having swollen lymphnode in my neck after protected sex. Does it indicate HIV?

Answered by
Dr. Ravinder Kaur Sachdeva
and medically reviewed by Dr. Nithila A

Hello doctor,

I had protected sex before two years. As I recall she was on the top and then later I was on top of her. During the act, my condom slipped, but there was no exposure to my bare penis. I could not achieve an erection, so she removed the condom and applied lotion on my penis. My question is,

1. Can her vaginal fluids enter my exposed penis as she applied lotion, making me infective (unknown status)?

2. I had two p24 tests done at four and nine weeks. Both came negative. Should I go to 12 weeks or is this conclusive? Is there any chance of turning negative to positive?

3. I feel swollen lymph node in my neck which occurred close to 12 weeks now. Am I HIV infective? Please help with your reply, and I am getting stressed.

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Dr. Ravinder Kaur Sachdeva

MBBS., DGO., PHD (HIV MEDICINE
HIV/AIDS Specialist

Hello,

Welcome to icliniq.com.

Answers to your queries are,

1)This is not a likely situation of entry of HIV through the vaginal fluid. Acquisition of HIV in this scenario is non-existent. Your fears are unwanted.

2) It is good that your p24 test is negative at four and nine weeks. Majority of the individuals (approximately 97 %) turned positive after an HIV exposure in two to eight weeks, and a very few take six months for the test to become positive. As per the recommendations and I also suggest you undertake a repeat HIV antibody test at three months and if negative then at six months. You need not repeat it in between.

3) Enlargements of lymph nodes can be in multiple conditions. Get it evaluated. Lymph node biopsy helps in establishing the diagnosis. I hope your queries are answered, but if you still have, feel free to ask.

Thank you doctor,

One more thing is that during the first few weeks, I had fever, cough, and lethargy. And then it was recurrent. There were no rashes or lymph node swelling. Do you think that ars symptoms can get presented late close to 3 months, particularly skin rashes and lymph node swelling? 2. Are p24 combo test reliable? Because I have read that it is accurate, 99% within the first four weeks? And not to do retesting afterward.

Dr. Ravinder Kaur Sachdeva

MBBS., DGO., PHD (HIV MEDICINE
HIV/AIDS Specialist

Hello,

Welcome back to icliniq.com.

Fever, cough, and lethargy a few weeks after the incident and then recurrent can be a manifestation of any viral infection, frequent upper respiratory tract infection. There can be multiple causes for these. No consistent physical symptoms are having been observed in people with HIV. With that information, some infected people do experience flu-like illness two to three weeks post exposure, which lasts for some days. However, some individuals do not experience any symptom at all.

The best thing is that you used condoms and a test which you underwent is highly accurate and gives conclusive results. It is essential to know how HIV transmission takes place, for a risk to a exist specific HIV positive fluid (anal or vaginal fluid/blood/semen) must come in direct contact with the bloodstream of HIV negative person. Since you do not know about partner status and also chances of HIV acquisition is dependent on multiple factors: HIV status of partner, HIV viral load of that person, associated tears or abrasions or fresh wound at the time of penetration.

Even though you used protection and later, unfortunately, it slipped, and partner status is unknown. Therefore I suggest you undertake a repeat HIV antibody test at three months and if negative then at six months to be sure about your condition. No need to repeat it in between.Hope your query is answered, but, do revert if you still have something with you.

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