[Question #10365] HIV Rash Only Symptom
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23 months ago
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Hi Doctors! Thank you as always for your service! My question is related to a vaginal sex exposure I had a few weeks ago with my ex boyfriend and long time casual partner. It was protected but the condom broke! I saw it was still on technically covering the head of his penis but ripped along the shaft. My concern is possible pre cum that could have leaked out. We both recently tested negative (3 Months ago) but I’m concerned because after this encounter with him, I had unprotected sex with my current boyfriend. About 6 or 7 days later, my boyfriend developed an itchy rash on his back that no one could explain. He had no other symptoms that he expressed. A few days later, maybe day 10, my voice went hoarse, I felt extreme sinus pressure in my nose and head, mild nausea, sneezing, kinda dry throat, and extreme congestion. No fever, sore throat, aches pains, rash or diarrhea. It felt like sinusitis to be honest. This lasted about 3 or 4 days and went away. Now, neither my boyfriend nor my symptoms alone sound like classic ars in my opinion but coupled together, I’ve now started to worry. My question to you is does this combination of symptoms sound concerning for Ars? Can an itchy rash be the only symptom ? Was I at any reasonable risk as a result of the exposure I described with the semi broken condom?
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Edward W. Hook M.D.
23 months ago
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Welcome back to the Forum. Thanks for your continued confidence in our service. I'll be glad to comment.
The exposure you describe was relatively low risk. The condom break you describe is hard to assess. With the head of the penis still covered it is more likely than not that the condom did its job however as you point out it is difficult to be 100% sure. Even if it did, it is unlikely that your ex had acquired HIV in the three months since he last tested - acquisition of HIV, particularly among heterosexual men and women is quite an uncommon event. If anything I'd be more concerned about more common STIs such as chlamydia or gonorrhea than HIV.
Irrespective, I am confident that the symptoms experienced by your boyfriend and a few days later, you, were not due to HIV. His rash occurred too soon to be a manifestation of the ARS and an isolated rash would not be characteristic of the ARS. Similarly, I would not expect your sinus symptoms to be a manifestation of the ARS from the interaction with your ex. Isolated sinus symptoms are not a characteristic of the ARS either.
I hope this information addresses you concerns. If you, please use your up to two follow-ups for clarification. EWH
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23 months ago
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Thank you for your reply! Just to be clear, his rash presented too early and a rash would not be the only symptom if someone was in a seroconversion period?
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Edward W. Hook M.D.
23 months ago
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Correct. Be confident that this rash was not the ARS. EWH---
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23 months ago
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Hi Dr. Hook,
I decided to test using the Oraquick Test. The result was negative but it’s only been about 7 1/2 weeks. I will likely test again but the question is even with the less sensitive test like Oraquick, would it be positive now if my symptoms last month were HIV ARS related? If so, why does the test suggest a wait time of 12 weeks to be conclusive? Is it because some people never have symptoms? I’m just trying to find the rationale here and stop worrying. Thanks so much!
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Edward W. Hook M.D.
23 months ago
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Thanks for your follow-up and the additional information. The fact that your OraQuick was negative absolutely PROVES that your rash was not due to HIV. The 12 month recommendation for follow-up is out of date and overly conservative. When tests for HIV are definitive varies with the type of test and has evolved with time and experience. OraQuick and other tests which test only for antibodies are conclusive any time more than 8 weeks following an exposure. Further, I should tell you that if you test now with a standard, combination HIV antigen/antibody test, your results will be entirely conclusive at this time. Combination HIV antigen/antibody tests provide definitive results any time more than 6 weeks after an encounter.
Given the already low risk nature of your exposure, I am confident that you did not get HIV and testing at this time will certainly prove it.
This completes this thread. Take care, please don't worry. EWH
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