Q. I had negative HIV tests with a swollen lymphnode in my underarm. Am I in window period?

Hello doctor,

I am 29-year-old, married male. I have a baby who feeds on breast milk. I had a sexual encounter before 8 months with a professional with a condom. I am 95 % sure that my protection was intact. Then I started reading about the HIV symptoms and technicalities of testing online. Five days later, I went to a Dermatology and Venereology specialist and described about the incident. He was confident enough that he advised me not to go for any testing. Although my fear of infection remained.

Around two months post-exposure, I felt tenderness here and there like on the back of my head, arms, one lymph node in my underarm was swollen and I developed cold and cough. I started sweating during that time as well. I looked a bit thinner. I got panicked and went to the doctor again. He checked me and was still confident that I am not infected. But for my mental satisfaction, he prescribed me thorough testing which includes HIV1/2, VDRL, HBsAg, HCV along with urine R/E, M/E, C/S analysis.

On 74th day post-exposure I took all those tests and they all came back negative. After lapse of a few days again I felt some skin irritation on the back and burning sensation on my forearms. Although no skin changes can be seen. Again I got panicked thinking that I may be in the window period for HIV. But the doctor remained confident and he advised me not to go for any repeat testing. But my sense of fear, anxiety, panic, guilt, and impurity continues.

On 110th day post-exposure again I repeated the tests but I excluded the urine analysis this time. All the tests came negative again. The HIV tests were fourth-generation combo test both the time. I am on the eighth month post exposure. Still, I feel tenderness hear and there. Recently, I am developing small red blood vessel like dots just underneath my skin on my hand and feet which is staying for 5-7days and going away leaving faint black spots. I again showed it to the same doctor. He is confident and repeatedly asked me to stop worrying. He also gave me anti-anxiety, anti-OCD, anti-depressant drugs.

I am also taking sessions with a psychologist. But still, my mind is not free from the fear of HIV and also fear that my wife and child might get infected by me.

My questions are, do I need to repeat any test to out rule the probability of HIV? Are there any probability of error from lab test given the fact that I took the tests twice? Do I need to worry about the window period as there is conflicting information available on the internet? Do I need to worry about the phenomenon of delayed seroconversion? Do I need to opt for the tests from a different lab? Do I need to worry about HIV 1 or 2 anymore? How to unroot the fear from deep inside my mind? Any other opinion on my history?

Thank you doctor,

What is the reason for tenderness here and there? I have also done complete blood analysis where no severe deficiency found except lack of Vitamin B12, high cholesterol, and liver function problem. My eosinophil level was 7 and lymphocyte was 19. These tests were also done on 74th-day post exposure. Why one painful swollen lymph node occur almost two months after exposue in the underarm? One pea-sized lump I felt twice during these eight months post exposure on my upper abdomen, where the lump was not painful itself but tenderness felt around the area of the lump. It lasted for 5-7days. Why is that? Is there any chance of error (technical, medical or human) in the tests done by the lab (twice on 74th and 110th day post exposure)? The fear of HIV is killing me. Please help.

Hello Doctor,
Thanks for your clarification. It helped me a lot. I am trying to accept the fact but everytime I started to overcome the anxiety something is triggering the fear again and again.
This time new red rash over my thighs and forehands and chest. First one rash appeared on my chest. Then under my right thigh and a few tiny one on the upperside of both thighs. This time it is bit swellen like insect bite. Today again I found smaller one on my forehands. Appearence wise it looks a bit different from the one I have on my chest . The rashes on the thighs and forehand have a faint itchy sensation. Now I have thesemany! I am attaching photos of them. I am frightened again. Please guide.

Doctor, although I have used condom (95%sure that it was intact)and my reports are non reactive twice, one thing I wanted to know is, what are the chances of female to male transmission from a single exposure?
Thanks a lot.

Doctor Can I be 200 %sure about my HIV status? Can I continue my normal conjugal relation with my wife without any fear or anxiety of transmission? I have a breast feeding baby as well. Your re assurance is a bliss for me.
Thanks

Doctor, please take a look at the pictures. These type of small red dots are appearing intermitently on my hands and feet for quite some times now (approximately 2/3months after the exposure) Generally these itch-less or irretation-less dots are staying for 5/6 days and fading away by leaving very faint black spot on the skin like any other cut,sores, allergies, infections etc. on the skin. Another feature of them are, they are not exactly on the surface of the skin but just beneath the upperlayer of skin. And if I stretch the sikn the red colour can not be seen. Please see the pictures carefully.These are some of them taken at different times. What are these?Why are they appearing? Is there any co-relation with HIV? What can be done for treatment? Is there anything to worry about?

Thank you Doctor. Here are some more pictures for your examination. Please see these. The the thought that triggers my fear is why all the things that I told you , occuring after the incident! These dot are appearing in a few numbers for some days, then is going away. Again coming back after few days. Dictor please drag me out of the fear!!Once and for all.Also I saw some videos where the women says they areHIV positive but inspite of years exposures to their husbands unkowingly, still they did not infect their husbands or partner. Meaning that they are saying that female to male transmission is highly unlikely or a myth. All in all please help me to get out of the fear.

Hello Doctor
Thanks for guidance.
Again new complication arises. Look at the pictures attached. Its a bleeding gum or sore, dont know what it is exactly. I read in some websites that these are one amongst the acute symptoms of HIV. I brush regularly nicely, scrap my tounge, use mouth wash some times. Over all I try to maintain good oral hygene. I am also taking Vitamin C. Still it happend. Please help.

But doctor I am not taking not much stress or anxiety now a days. Besides I am taking anti OCD, anti depressant medicines for few months now and also taking sessions with psychologist. I am constantly trying to make mind free of anxiety. The venereologist I visited is also repeatedly nullified my negetive thoughts. But still these things are occuring which can be seen by eyes without any plausible reason. I am attaching my test reports this time. Please open the second file with password 8015. My encounter happend on 21/09/2019. Why all these are happening? It is really bothering me. Please opine doctor.
Thanks

Hello Doctor. Hope you are doing well. Hope you also remember my history.
I am feeling tenderness in my right armpit from yesterday. I can also feel a smaller than a pea sized lump there. I am feeling it from yesterday. Today the tenderness is there but it has come down. The lump is almost gone today. On my left armpit I can not find any lump but faint tenderness is there today.
The same happended almost 6 months back on my left armpit, which I described you earlier.
There is no rash, injury or fever.
What is the reason for this? What should I do? Is there any chance of wrong diagnosys?
Thank you

Hello Doc.
I am writing to you again. As you advised I am trying to lead my normal life. But some bodily behaviour triggering the anxiety intermittently. As I told you in earlier queries that small red dots have been occuring on my hands and feet the same phenomenon is still appearing. Its is appearing in a few numbers with few days gap in between. This time it has appeared in quite a few numbers on my hands and feet.17 in total to be exact. It has no itchy feeling, neither it has any other sensation. It is just appearing on these areas and going away with a faith brownish mark on the area. It have showded the pictures to the Dermetologist & Venereologist whom I met after the incident. He said it is happening because of weather change or due to dryness of skin and gave me NMFE lotion to apply. I am using the lotion since then almost everyday. But still it is appearing. As I told I have send you the pictures of the same phenomenon previously to you. Again I am attaching the pictures of them. It is taken today. Pls have a look at them once againgand advise me how to deal with it. Does it have anything to worry about? Does it have any co-relation with any disease? I am worried again.
Thank you.

Hello Doc,
The red dots are appearing everyday on my hands and feet. This time in larger numbers unlike previously when it was appearing in a few numbers. Everyday I can find new dots on my hands and feet. Each dots are taking 5/7days to heal and turning brown colored. It is not itching. Neither it has any other sensation. As I have sent you photos earlier, it look like small red dots just beneath the upper layer of the skin. Coincidentally as far as I can remember it is appearing a few months after the incident. I cant remember these things happening before. As you and the Doc. whom I met in person told, I am applying moisteriser even cocount oil on my skin, but still it is appearing. As I said, this time in more numbers. Please help, guid, advise.
Thank you.

Hello Doctor,
The red dots on my hands and feet are still appearing in large number than before. Every night I can find new dots on my hands and feet. As I told earlier these are not causing any itching or other sensations. These dots are started appearing after a few months from the incident. Which is causing great anxiety and fear in my mind. It has not happened before. As you advised and the I am applying NMFE moisturising lotion, coconut oil all over my body including the affected areas. I observed whether any friction or food alergy is causing the same, but I could not find out any. I am taking the same food which I was taking almost from my childhood. For you reference again, the incident took place on 21st September last year and I took 4th Gen test from SRL after 74days and 110days post exposure.
I could not find any reason for these. Why are these appearing? Please help. Your advise will help me in great extent.

Hello Doctor
Contacting you after long. As you can see from the history, I was suffering from HIV phobia even after negative 4th Gen test after 3 months of exposure.
That id a history now. Thank to Almighty I am now doing well with my life.
But just need your opinion about something, I tried anal sex with my wife today without condom for a while. She is 100% faithful to me, I also never had any sexual exposure other than my wife since I last tested. We cleaned our private parts thoroughly soon after the act with detol, betadine etc. Is there anything to worry, since we both trust eachother? Is it ok to have anal sex without condom between loyal husband and wife?

Can we have anal sex without condom? We use antiseptic moistuerizing cream as lubricant.