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Hello, I Hope All Is Well. I Recently Was Involved

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Posted on Thu, 1 Oct 2020
Question: Hello,
I hope all is well. I recently was involved in a high risk sexual activity. I was the receptive anal partner with a transworker. Since this was my first time I was in pain(anus torn and bleeding for several days afterward). We started out with protection and lubrication and at some point after switching positions I was unsure, if the protection has been removed but there was no ejaculation involved. I am extremely paranoid/panicking most of the time that this might be hiv.

So for the first week immediately after possible exposure these are my symptoms for about a week:
-70% diarrhea and rest soft stools
- No blood in stools but a decent amount of blood when I wipe. Possible puss(clear)
-slight burning sensation in rectum

10 days after exposure(lasted about 7 days but kept progressing everyday) :
-i woke up with a dry mouth(i assumed at first it was due to the temperature drop over night from 80⁰f to 62⁰ and waking up with no blanket).
-lymph nodes on the neck light swelling(no pain)
-diarrhea like 2 XXXXXXX 3 times a day for 4 days which processed to soft stools
-constant urge to urinate
-loss of appetite(for 3-4 days)
-occasional dizziness feeling(possible from dehydration)
-slight burning in rectum
-muscles slightly sore(maybe slower recovery from weight lifting)
-minor discomfort in stomach

18 days after exposure to present(11 days already) feeling much better but still some symptoms:
-lymph nodes in neck still feel slightly swelled a little less(no pain)
- progressed but still minor discomfort in stomach
-minor sore/warm sensation on anus still
-mixture of normal stools and occasional diarhhea out of nowhere

Additional notes:
-10 panel test with hiv rna early detection taken from stdcheck.com(healthlabs) 10 days post exposure: all results negative except hsv-1(range= 30.9h) which i had as a kid.

-another standard std test using the hiv 4th generation test with reflex taken from urgent care(with rectal swab) 17 days post exposure= all results negative.

-Soo how reliable is the hiv rna early detection test if taken at 10 days, followed by the 4th generation duo test at 17 days?

-possible causes of my symptoms?
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Follow up: Dr. Dr. Kakkar (0 minute later)
Hello,
I hope all is well. I recently was involved in a high risk sexual activity. I was the receptive anal partner with a transworker. Since this was my first time I was in pain(anus torn and bleeding for several days afterward). We started out with protection and lubrication and at some point after switching positions I was unsure, if the protection has been removed but there was no ejaculation involved. I am extremely paranoid/panicking most of the time that this might be hiv.

So for the first week immediately after possible exposure these are my symptoms for about a week:
-70% diarrhea and rest soft stools
- No blood in stools but a decent amount of blood when I wipe. Possible puss(clear)
-slight burning sensation in rectum

10 days after exposure(lasted about 7 days but kept progressing everyday) :
-i woke up with a dry mouth(i assumed at first it was due to the temperature drop over night from 80⁰f to 62⁰ and waking up with no blanket).
-lymph nodes on the neck light swelling(no pain)
-diarrhea like 2 XXXXXXX 3 times a day for 4 days which processed to soft stools
-constant urge to urinate
-loss of appetite(for 3-4 days)
-occasional dizziness feeling(possible from dehydration)
-slight burning in rectum
-muscles slightly sore(maybe slower recovery from weight lifting)
-minor discomfort in stomach

18 days after exposure to present(11 days already) feeling much better but still some symptoms:
-lymph nodes in neck still feel slightly swelled a little less(no pain)
- progressed but still minor discomfort in stomach
-minor sore/warm sensation on anus still
-mixture of normal stools and occasional diarhhea out of nowhere

Additional notes:
-10 panel test with hiv rna early detection taken from stdcheck.com(healthlabs) 10 days post exposure: all results negative except hsv-1(range= 30.9h) which i had as a kid.

-another standard std test using the hiv 4th generation test with reflex taken from urgent care(with rectal swab) 17 days post exposure= all results negative.

-Soo how reliable is the hiv rna early detection test if taken at 10 days, followed by the 4th generation duo test at 17 days?

-possible causes of my symptoms?
doctor
Answered by Dr. Dr. Kakkar (45 minutes later)
Brief Answer:
Regarding HIV transmission

Detailed Answer:
Hello and welcome to ask a doctor service. I have gone through your query and noted your concern.

If the sex was protected then you can feel reasonably safe but if you aren't sure if it indeed was, then you must (in any case though) follow up with a 4th generation HIV screening test at 4 weeks followed by another antibody test at 12 weeks. As far as early testing is concerned, HIV RNA PCR can detect infection as early as 9-13 days (approximately 2 weeks later, to be safe) and fairly reliably but even if negative one needs to follow up with a HIV antibody based test at 4 weeks and 12 weeks for a conclusive result.

Hope I have answered your query. Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding HIV transmission

Detailed Answer:
Hello and welcome to ask a doctor service. I have gone through your query and noted your concern.

If the sex was protected then you can feel reasonably safe but if you aren't sure if it indeed was, then you must (in any case though) follow up with a 4th generation HIV screening test at 4 weeks followed by another antibody test at 12 weeks. As far as early testing is concerned, HIV RNA PCR can detect infection as early as 9-13 days (approximately 2 weeks later, to be safe) and fairly reliably but even if negative one needs to follow up with a HIV antibody based test at 4 weeks and 12 weeks for a conclusive result.

Hope I have answered your query. Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Kakkar (1 hour later)
Are my symptoms common ars symptoms?
I will follow up with an another test this week(will be the 4th week), but when you say fairly reliable, does that mean i can be a little more confident with my negative result? rei spoke with stdcheck.com rep and they state their test is 95% conclusive using their fda approved rna naat early detection test which they say is 99.9% sensitivity for my case?(I just wanted to follow up with a 3rd party on their answer)
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Follow up: Dr. Dr. Kakkar (0 minute later)
Are my symptoms common ars symptoms?
I will follow up with an another test this week(will be the 4th week), but when you say fairly reliable, does that mean i can be a little more confident with my negative result? rei spoke with stdcheck.com rep and they state their test is 95% conclusive using their fda approved rna naat early detection test which they say is 99.9% sensitivity for my case?(I just wanted to follow up with a 3rd party on their answer)
doctor
Answered by Dr. Dr. Kakkar (14 hours later)
Brief Answer:
Regarding STDs

Detailed Answer:
hi.

RNA pcr is highly sensitive (more than 99%) so it doesn't usually miss an infection provided it is done after 14 days..however it also has a 5% chance of being false positive. Nevertheless, an antibody based test result at 12 weeks is considered to be the most reliable for a conclusive result in case of a high risk exposure.
Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding STDs

Detailed Answer:
hi.

RNA pcr is highly sensitive (more than 99%) so it doesn't usually miss an infection provided it is done after 14 days..however it also has a 5% chance of being false positive. Nevertheless, an antibody based test result at 12 weeks is considered to be the most reliable for a conclusive result in case of a high risk exposure.
Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Kakkar (7 hours later)
Thank you. Are my symptoms, specifically talking about diarrhea 2x a day with a normal stool and slightly swollen lymph nodes a common symptom of acute hiv(ars)?
default
Follow up: Dr. Dr. Kakkar (0 minute later)
Thank you. Are my symptoms, specifically talking about diarrhea 2x a day with a normal stool and slightly swollen lymph nodes a common symptom of acute hiv(ars)?
doctor
Answered by Dr. Dr. Kakkar (14 hours later)
Brief Answer:
Regarding STDs

Detailed Answer:
hi.
These are non specific symptoms. They are not definitely attributable to any cause, in particular but yes they do occur as part of symptoms of acute HIV infection.
Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding STDs

Detailed Answer:
hi.
These are non specific symptoms. They are not definitely attributable to any cause, in particular but yes they do occur as part of symptoms of acute HIV infection.
Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Kakkar (2 days later)
Hello again, soo I have some new test results. The hiv 4th generation Elisa test took at 28 days post exposure came back negative... so considering that and my hiv rna NAAT test(9-11 day window period) being negative at 10 days, is this enough for me to relax and rule out I am hiv free?
default
Follow up: Dr. Dr. Kakkar (0 minute later)
Hello again, soo I have some new test results. The hiv 4th generation Elisa test took at 28 days post exposure came back negative... so considering that and my hiv rna NAAT test(9-11 day window period) being negative at 10 days, is this enough for me to relax and rule out I am hiv free?
doctor
Answered by Dr. Dr. Kakkar (8 hours later)
Brief Answer:
regarding STDs

Detailed Answer:
Hi.
That's good news. That is almost conclusive since you have tested negative on 2 separate tests, and almost certainly rules out HIV, however a 12 week HIV ELISA test is the most conclusive.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
regarding STDs

Detailed Answer:
Hi.
That's good news. That is almost conclusive since you have tested negative on 2 separate tests, and almost certainly rules out HIV, however a 12 week HIV ELISA test is the most conclusive.
Take care
Note: For further follow up on related General & Family Physician Click here.

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

Dermatologist

Practicing since :2002

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Hello, I Hope All Is Well. I Recently Was Involved

Hello, I hope all is well. I recently was involved in a high risk sexual activity. I was the receptive anal partner with a transworker. Since this was my first time I was in pain(anus torn and bleeding for several days afterward). We started out with protection and lubrication and at some point after switching positions I was unsure, if the protection has been removed but there was no ejaculation involved. I am extremely paranoid/panicking most of the time that this might be hiv. So for the first week immediately after possible exposure these are my symptoms for about a week: -70% diarrhea and rest soft stools - No blood in stools but a decent amount of blood when I wipe. Possible puss(clear) -slight burning sensation in rectum 10 days after exposure(lasted about 7 days but kept progressing everyday) : -i woke up with a dry mouth(i assumed at first it was due to the temperature drop over night from 80⁰f to 62⁰ and waking up with no blanket). -lymph nodes on the neck light swelling(no pain) -diarrhea like 2 XXXXXXX 3 times a day for 4 days which processed to soft stools -constant urge to urinate -loss of appetite(for 3-4 days) -occasional dizziness feeling(possible from dehydration) -slight burning in rectum -muscles slightly sore(maybe slower recovery from weight lifting) -minor discomfort in stomach 18 days after exposure to present(11 days already) feeling much better but still some symptoms: -lymph nodes in neck still feel slightly swelled a little less(no pain) - progressed but still minor discomfort in stomach -minor sore/warm sensation on anus still -mixture of normal stools and occasional diarhhea out of nowhere Additional notes: -10 panel test with hiv rna early detection taken from stdcheck.com(healthlabs) 10 days post exposure: all results negative except hsv-1(range= 30.9h) which i had as a kid. -another standard std test using the hiv 4th generation test with reflex taken from urgent care(with rectal swab) 17 days post exposure= all results negative. -Soo how reliable is the hiv rna early detection test if taken at 10 days, followed by the 4th generation duo test at 17 days? -possible causes of my symptoms?