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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18201
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I had unprotected 5 weeks ago in Spain with someone in

Customer Question

I had unprotected sex 5 weeks ago in Spain with someone in the stripper industry. I had a 4th gen test at 4 weeks which was negative for hiv. I also had urine test for other sti's which was negative. For the last 3 weeks though I have had a sore throat, dry mouth, feel very run down all the time (normally very active) feel unbalanced and woozy when on my feet and fatigued. I had some flat red dots on roof of mouth for 2 weeks which are now beginning to go but a red dot on my tongue bled the last two nights. I also have sore ears.
I am a professional and my job and personal life is suffering at the moment.
I woke up today with a headache also.
Please help. What's wrong with me?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Have you had any evaluation for these symptoms beyond the tests for HIV and STIs that you mention?

Customer: replied 3 years ago.
Before my hiv test the doctor just said I was anxious about the test and I only had the sore throat for a week so it would go away? Which it hasn't. I got the negative result 8 days ago and I'm not worried now but still feeling very poorly. I couldn't go to the docs this week as was away with work which is why contacting yourself.
Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There are two perspectives in this situation - what is most likely and what is possible and should be checked.

The most likely cause of the symptoms that you describe is a generic viral infection. The fact that the symptoms have persisted for this length of time also raises the possibility of a specific viral infection, infectious mononucleosis (or more commonly called mono). Most generic viral infections last a few days to a week or so, but about 10-15% will last at least 2 weeks, so can still cause symptoms that last 3 weeks. Mono commonly causes symptoms for several weeks and may cause symptoms that last several months.

It is still possible that this could be symptoms related to an acute infection from HIV, although this is not as likely. A fourth generation HIV test is very sensitive and the average time to a positive test is 22 days, so most people will be detected by a test at 4 weeks. But the 22 days is only an average, and some people are more or less than average, and the test is not considered reliably negative until it is negative after 3 months.

The symptoms of an acute HIV infection are common viral infection symptoms, so it is difficult to differentiate these infections based solely on symptoms. Statistically, though, generic viral infections affect everybody at multiple times in their lives and almost everybody gets mono at some point in their life, whereas the vast majority of people engage in heterosexual sex do not get HIV (even if some of that sex is with a sex worker).

Even though it can be said that it is statistically less likely to be an HIV infection, it is appropriate to continue to test for HIV, because it is very important to identify the few that do develop HIV. I realize that there is anxiety associated with waiting for the test to be done at 3 months, but that is the time that is necessary for the HIV test to be reliably negative.

It is also true that anxiety can exaggerate any symptoms that may be due to whatever condition is causing the anxiety. It can be considered the opposite of the placebo effect (the resolution of symptoms when a person is given a placebo that the individual thinks may be an active drug).

Therefore, it is most likely a generic viral infection or mono, although an HIV infection cannot be completely excluded as a possibility until the HIV test is repeated at 3 months after exposure.

If I can provide any further information or clarification, please let me know.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18201
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and 2 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Thankyou for your response. Couple if follow up questions if ok

Is the fact I never had a rash or a very high temperature a good sign I don't have hiv? What is the accuracy of 4 week tests? What should I do to help me get over this potential virus I have? Is exercise ok as I haven't exercised in 3 weeks.
Customer: replied 3 years ago.
Thankyou for your response. Couple if follow up questions if ok

Is the fact I never had a rash or a very high temperature a good sign I don't have hiv? What is the accuracy of 4 week tests? What should I do to help me get over this potential virus I have? Is exercise ok as I haven't exercised in 3 weeks.
Ps.
I have red dots on roof of mouth toe wards the back. Is that a virus sign?
Expert:  Dr. D. Love replied 3 years ago.
Since a fever is the most common symptom of an acute HIV infection (occurring in about 95% of patients), the absence of fever is a good sign. Since a rash is not as common (only in about 70% of patients), the absence of a rash is not as meaningful. However, since no symptom occurs in 100 of patients, the absence of any specific symptom does not preclude the possibility of an acute HIV infection.

At 4 weeks, the HIV test will detect about 60-65% of people that will contract the HIV infection.

There is no specific medicine or supplement that has been shown to help accelerate recovery from a virus at this point. The usual recommendation is supportive care, such as rest and fluids, such as you have been doing. Taking medicines to ease symptoms is fine, but does not result in a quicker resolution of the infection. Exercise does not help get rid of the virus, and whether exercise may resume depends upon how you feel. If you are still feeling run down, it is generally better not to exercise. But as you start feeling better, you can gradually start increasing activity level as tolerated, and ultimately to the level of exercise being done prior to the illness.

The red dots that you describe can occur with a viral infection.

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