your CBC or "complete blood count" should not alert people to the fact that you are positive. Sometimes when people have longstanding HIV that is not treated properly, a component of the white blood cells called the "lymphocyte percentage," which are usually the CD4 cells that HIV attacks, becomes lower. Usually, however, if you are treated and "healthy," your CBC should be fine, and only a very trained medical eye would be able to suspect anything being wrong. And even that is only when the HIV has really progressed. Otherwise, don't worry about that my friend... live your life and take good care of your health... the CBC will follow!
It's possible but not likely since your last test was negative like you said. What may be better for you to do is go see your primary care provider, as there are many common things that can cause stomach pain, but the negative endoscopy is reassuring that nothing is going on. Stomach "issues" could be a sign of many things, including HIV, but HIV is probably the least likely of a long list of other problems it could be.
Again, its hard to diagnose you over the internet, I can give you suggestions on what to do - but I don't think HIV should be your main worry here.
There is always alot of discussion about how risky oral sex is when it comes to HIV. To keep it simple, let's keep a few facts in mind:
1. HIV has to get into the bloodstream to establish an infection
In order to begin to reproduce in the human body, HIV MUST get in the bloodstream. So any behavior that can get HIV in the blood easily will be considered "higher risk." That's why IV drug use is the highest risk or transfusions used to be before we started screening blood - putting a needle with HIV directly in your vein or having HIV+ blood transfused into your vein will be the most risky exposures. Right after those would be unprotected anal or vaginal sex, for the person being penetrated. The reason there is that the skin lining the anus is very sensitive and can bleed easily, even if you cannot see blood - so HIV can get into the bloodstream easier that way. The skin lining the vagina doesn't bleed as easily, but can. With oral sex, the mouth is meant for chewing, so the skin inside the mouth is used to trauma, changes in temperature, etc. So even for the person giving oral sex, it would be difficult to contract HIV from that.
2. You have to have sex with someone with HIV to get HIV!
This may sound simple and logical, but HIV doesn't just spontaneously emerge when someone has unprotected sex with another person. In the general population in the United States, less than 1 out of every 1000 people are HIV+. This number may be higher or lower depending on the city you live in, but the point is, the majority of people in the US are HIV negative. If you don't know the status of the sexual partner, find out - and if you can't because it was anonymous and you won't see them again, assume that they may be and get tested and checked out for HIV and STDs about 1 month after the exposure.
Remember also that if you do have sex with someone who is HIV positive - if they are on medication and have their virus under control, it reduces your risk by 96%! So there is a differences between someone who is HIV positive and NOT on meds or in care (they may be more risky to have sex with), and someone who is HIV positive, is in care, on meds and taking care of themselves. Risk with someone who is HIV positive is not all the same.
3. HIV is not an easy disease to catch The conclusion one can come up with given alot of these facts is that HIV is not an easy disease to catch. It is not airborne, so you can't cough it on someone, and if it was transmitted by oral sex, it would be much more common than it is now. In other words, while I would encourage everyone to get routine HIV testing, at least once a year if you are sexually active (yes, even if you are in a "monogamous" relationship) - I would also suggest that instead of thinking that every rash or symptom IS HIV, think about the more commone things that can cause rashes, fevers and other symptoms. This includes most common STDs, which are all way easier to contract than HIV.
The link below is the CDC's official report on oral sex and HIV. While I don't necessarily agree with all they say (I haven't seen these studies that demonstrate documented cases of HIV from oral sex), the information there is similar to what I am telling you.
Remember you can never go wrong in getting tested regularly and taking care of yourself, but don't let fear get in the way of logic. Educate yourself, protect yourself and enjoy yourselves as sexual beings. You can't enjoy sex if you are always worried about HIV, so just take precautions and live your life!!!
Second let me commend you on doing a lot of things right - getting tested with a partner together, taking precautions with condoms with the friend with benefits. I think you should take time to acknowledge that you are doing the right thing on several levels!
Finally, I don't think you're risk is high at all. Oral sex is really extremely low risk, if not no risk at all. Of course the receiver is less at risk, but even the giver isn't at any risk, unless they have a large cut in their mouth and there's a good amount of precum or semen that gets in the open wound, from a partner who is hiv positive, and NOT on medications. In other words, a lot of conditions would have to be met for oral sex to be a risk at all. And can you imagine if HIV was easy to catch through oral sex? Almost everyone would have it if that was the case.... the vast majority of people do not use condoms or dental dams with oral sex, so just logically, one would have to understand that you have to do more than oral sex to put yourself at risk for HIV.
That said, oral sex can transmit gonorrhea, syphilis, warts and herpes - so don't think that you have no risk for everything because you just do oral sex. Get checked up regularly regardless, just a good idea - like getting your blood pressure, cholesterol and yearly physical exams done.
yeah, you can really get carried away with "if" scenarios when it comes to HIV, but it really just increases your anxiety level and fear, and isn't productive at all.
I can't speak for the CDC person who spoke to you - but what you described was not high risk at all. And I hope you went to see a medical provider as I had suggested previously. Its just not a good idea to give medical advice or make a diagnosis about a rash over the internet. There's absolutely no way I can reassure you what the rash is or isn't without taking a look at it in person.
There are many reputable studies, not just the CDC, that have demonstrated that HIV doesn't live long outside the body, as in less than 1 minute. and unless she leaked a large amount of vaginal fluid or bled into an open wound of yours, there is no way this contact put you at risk for HIV.
Now, if you're not telling us the whole story, that's a different thing altogether, and you should see a provider in person and do so if there's you did something more risky, such as have vaginal sex without a condom with this sex worker.
Finally, think of it this way - if HIV could be transmitted by the contact you described, millions of more people would have it.
Hope that helps. Enjoy your holidays as best you can...
The T cell "percentage" you refer to tell you what % of all your white blood cells are T cells. That number should be between 31 and 57. That alone would be bad even if your T cell count was way over 200, which it is not. Long story short, your numbers are close to meeting the definition of AIDS, not just living with HIV - I would definitely recommend you revisit trying to:
1. Address your major depression so that you don't sabotage your physical health because your mental health is suffering.
2. When you are in the right state of mind to restart, do so with your meds.
3. Talk to you doctor about taking a daily antibiotic to prevent what's called PCP, a type of pneumonia that is common when your % is that low or your T cell count is under 200.
Let us know if you have any other questions - if you think the meds worsened your depression, bring that up with your doc... there are many options that don't have that side effect.
your question is a good one - in the past many people would say that with your numbers you don't need to be on medication - but there has recently come to light a bunch of evidence suggesting that even if your numbers look good, your immune system is at a heightened state, or always fighting against the virus in your body. This high state of inflammation, over time, can put folks living with HIV at early risk of heart attacks, arthritis, thinning of bones and other chronic medical problems, much earlier in life than those who are HIV negative.
The decision to start or not start meds is a very personal one and a big choice. Get another clinical opinion in person, and two sites I can refer you to: one is an HIV treatment site that gives fact sheets that should be able to help you think this through. The second is the American Academy of HIV Medicine website, which has the only certification process in the US for HIV clinical providers, and you can do a search on the site for a certified HIV clinician near you!
Hope that helps... Your numbers look great off meds, so I can see why many would say wait, but if you notice your CD4 going down and VL going up, it sounds like that's making you anxious enough to start, so do what YOU are comfortable with. Most people are split as to whether to start people with CD4 counts over 500 on meds - the benefits long term are getting control of the infection and keeping the immune system from being always hyped up and causing damage to your body. Cons include mainly side effects and committing to meds for life.
So think it through carefully... but definitely seek a 2nd opinion in person - you would do similarly for a car by taking it to another mechanic, so treat your body like the gold it is!!!
sorry for the late response to your questions... here's what I think:
- your CD4 count looks great, but the viral load at 376 copies, which is very low, but not undetectable, is something you should talk to your doc about. If it was undetectable before, sometimes stress, other illnesses, missing a couple of doses here and there can cause "blips" where the viral load goes up a little bit - but DOES NOT NECESSARILY MEAN THE MEDS ARE FAILING. However, what we typically do is repeat the viral load to make sure everything is ok. Ask your doctor or provider about that. For the meds to be considered fully "working," the viral load should be less than 40 copies, or 20 copies by some testing sites.
- your RBC count is slightly low, but your hemoglobin is not (14.1) - this could be caused by a bunch of things, so again, make sure you discuss that with your doctor... but its not uncommon that with HIV, even when treatment is effective that the RBC or the hemoglobin may be low, which means you may be what's called "anemic."
Overall, your numbers look very good - just check in with your provider about the small "blip" in the viral load, but understand that it may not mean much, but should be looked at closely.
You don't know the HIV status of the sex worker, so you can't assume that she has HIV - and even if she is positive, the risk from her giving you oral sex is close to zero if not zero, so do not worry. Your HIV test at the 52nd day should be fine and long enough to be accurate.
Regarding your symptoms, its hard to tell what those are, as they can all be caused by several conditions - I would seek out a medical provider to take a look at you to see what's going on, as it would be hard for me to diagnose you on the internet.