Q. I had unprotected oral sex with a CSW. Should I be worried about HIV?
Hello doctor,
My concern is that I engaged in unprotected oral sex with a CSW (Community Sex Worker) a few months ago. Since then, I have experienced recurring lymphadenopathy up to the present date. I underwent an HIV (Human Immunodeficiency Virus) TRI-DOT test after a month, which returned a negative result. Additionally, an HIV ELISA (enzyme-linked immunosorbent assay) test was performed within the same month, ten days after the incident, yielding a negative result. Subsequently, in the first week of the previous month, I underwent an HIV-1 RNA (ribonucleic acid) PCR (polymerase chain reaction) test, which also came back negative. Both HIV-2 RNA PCR and Western blot tests were conducted in the same month, both yielding negative results. Toward the end of that month, I opted for an HIV duo test, which again returned a negative result. In the current month, I underwent a Western blot test, and once more, it showed a negative result. Should I remain concerned about the possibility of HIV, and do you recommend any further testing? Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and understood your concern. Engaging in unprotected oral sex carries a relatively low risk of contracting HIV (human immunodeficiency virus), particularly if bleeding gums or active oral ulcers are absent. Given that the last exposure occurred several months ago without subsequent exposure, your HIV test results can be considered conclusive. Current guidelines advise undergoing testing between four to six weeks after the last exposure. If the outcome is negative, a confirmatory HIV antibody test should be conducted three months after the previous exposure. Further testing is unnecessary if there have been no subsequent exposures. Regarding the lymphadenopathy, it would be helpful to know the size and location of the affected lymph nodes. I suggest you refrain from pressing the lymph nodes firmly, a gentle palpation to estimate their size is sufficient. Lymphadenopathy can stem from various causes and is not necessarily indicative of HIV. HIV cannot be diagnosed based on specific symptoms or signs alone. The definitive method for HIV diagnosis is through testing, which, as per your case, has yielded negative results. I hope this has helped you. Kindly follow up if you have more doubts.
Thank you.
Hello doctor,
I have attached my reports. Kindly review it.
Hello,
Welcome back to icliniq.com.
I read your query and understood your concern. Your HIV test results have returned as negative. The blood count report also appears to be normal. The image showing a suspected lesion is also acceptable. As long as there have been no additional exposures beyond the one you previously mentioned, there is no need for further HIV screening tests. However, if there have been subsequent exposures, I suggest you undergo a confirmatory HIV antibody test three months after the last exposure. The symptoms you have described are nonspecific. Even an eight mm lymph node size is too small to hold clinical significance. I suggest not to excessively manipulate the lymph node. Frequent pressing can alter its size and texture. For throat symptoms, consider using saline water gargles. Regarding aphthous ulcers, I recommend taking a multivitamin B-complex capsule once daily for a period of ten days. I hope this has helped you. Kindly follow up if you have more doubts.
Thank you.
Hello doctor,
I have not experienced any additional exposure. Have you come across or encountered cases where individuals tested positive for HIV even after the window period had passed? Sometimes, when certain symptoms arise, my mind tends to associate them with HIV. Kindly help.
Hello,
Welcome back to icliniq.com.
I read your query and understood your concern. No, such instances have not been observed in my clinical practice. I hope this has helped you. Kindly follow up if you have more doubts.
Thank you.
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