Dear doctor, Under a lot of alcohol, I had vaginal intercourse with a lady. I was wasted but I remember that I was protected with a condom. The condom did not break nor leak but maybe was not put perfectly. I did not manage to cum, removed it and masturbated in a very aggressive way with my bare hands for some minutes. She spit twice on my dick, that is all. Since then, I had major symptoms starting from day-2 with burning sensation and painful urination for some days and my genital organ was tender and painful. I took Ceftriaxone and a short course of Ciproxen on my own assuming I had gonorrhea/chlamydia without any test. On day-5 started a very weird tingling numbness in all the limbs which continued for a week or a bit more, sores in mouth on and off starting from the first week including a huge one in the roof of my mouth, headache, low appetite, weakness, and myalgia. Later on, I started to realize changes in the nails after one month, joints pain still ongoing, no fever nor lymphadenopathy, most importantly I lost a lot of pounds and lost appetite and lost weight especially in my face - around the eyes and mouth. I want to mention that I never stopped crying from the very first day of being horrified of HIV. I got psychological and psychiatric consultation several times with no help. Combo fourth generation lab test and syphilis test were performed in a very reliable center and were negative. After eight weeks, the second combo fourth generation test at almost 16 weeks in another major hospital also negative. Can I be a case report of late seroconversion? I am scared to death. Gonorrhea, syphilis, chlamydia, and PCR negative as well. Nowadays, I am almost asymptomatic apart from the joint pain that might not be related (got examined by orthopedic who suspects a particular problem) and of course my shrinking face and the changes in my nails which are still there. It seems so far that nothing could reassure me. I admit that there is a psychological or perhaps psychiatric element because of the huge persistent stress. But I must tell you that I always had a big round face and since the event, I lost a considerable amount of facial volume, facial wasting indeed and this was confirmed by a dermatologist. I managed to regain my body weight but not my face. I read online about HIV causing apoptosis of facial fat cells. What is your opinion in that regard? I am only four and a half months from the event. I am really confused. Should I do an HIV viral load test? What are the chances for the duo test to miss twice after the window period? Have you ever heard of or seen a duo turning positive after such a long period? I do not feel like becoming an international case report you know. Thanks in advance. These facial changes what I am experiencing are simply driving me crazy. I want so much to move on with my life but I am "losing my face" which is my social ID. I do not know how to explain. My relationship with my wife, my social life, and my career are already destroyed and a total mess cause this "thing" had taken a huge toll on me. So, I am desperate. Again, I am talking about shallowness around and under eyes, temporal wasting, maybe a prominent change in my face contour, much smaller cheeks and some empty holes in my forehead and in my skull just behind my ears. It is just weird. It was not there before, it is advancing and I cannot find any explanation for it apart from the potential relationship with that one-time unfortunate exposure. I asked a couple of national HIV experts and also got a consultation from a doctor. All of them are pretty sure I am HIV negative. The doctor was a bit mad at me even. Please help me. In my country, negative duo test at 12 weeks or after is considered conclusive and definitive.
Hello. I have noted your concern. Protected sex is safe as far as the risk of HIV is concerned. Spitting on bare penis is not a risk for HIV as saliva is not infectious. The virus cannot survive in saliva because it contains enzymes inhibitory for the virus. Moreover, a fourth generation antigen/antibody HIV screening test is considered conclusive at six weeks and beyond by most sexual specialists. Therefore I do not think you need to worry about HIV. However, you may take an RNA PCR test for HIV in order to reassure yourself. Regards. For more information consult a dermatologist online -->