Q: I have had some regular encounters with commercial sex workers (CSW) in the past but did not have intercourse with any of them. I have indulged in masturbation with them. My last such encounter was 3 months back. I have observed a tiny lesion over my penis, which made me worry. I tested by Capillus at 8 weeks, and also by DNA PCR. Both the tests were negative, though, I tested positive for syphilis. How is this possible? I am terrified to get tested for HIV again and so have become a mental wreck imagining all the symptoms of HIV infection. Please help me.

A:Firstly, you should get treated for Syphilis. Secondly, I will like to know: a) How long ago have you been exposed last to a commercial sex worker? This is important to suggest the type of investigation you should undertake to confirm the diagnosis of HIV (in case you have!). If your exposure was within 12 weeks (but more than 2 weeks ago), you should get yourself tested for HIV pro-viral DNA. This is performed on the DNA extracted from the peripheral blood lymphocytes. b) If your exposure has been beyond past 12 weeks, you should get yourself tested for HIV antibodies in serum/plasma by standard techniques. However, please keep in mind that even a negative HIV antibody test even after 12 weeks may not rule out HIV infection, though chances of having HIV infection are very slim. In such an event you should be tested for HIV proviral DNA test by PCR or better by Real-time PCR.