[Question #10400] sore throat and rash

23 months ago

I worry about hiv ars symptoms. I am a man and had an exposure with a woman, a friend, who told me repetitively she is clean. She rubbed my penis against her vagina for several minutes and maybe, not sure, the top of my penis may have enter a little bit her vagina for a few seconds. I had vaginal secretion on top of my penis. I worried because 13 days later I got a pharyngitis (throat a bit red and painful to swallow; but no enlarged tonsillitis). It lasted 2 or 3 days and disappeared. The day after I noticed about 10 well defined small red raised bumps localized near the diaphragm at the center (just under sternum), only there not in other area. It disappeared after 4 days. It seems I lost about 5 or 6 pounds during that week but regained it right after. I did not have any other symptoms (no fever at all, not tired, nothing). I worry this to be hiv ars?

H. Hunter Handsfield, MD

23 months ago

Greetings and welcome to the forum. Thank you for your confidence in our services.

You symptoms are less suggestive of HIV than you seem to think. It usually is a mistake to look at symptoms of acute retroviral syndrome (ARS, i.e. new HIV infection) and assume, because one or two are present, that it makes it likely someone has been infected. Almost always it does not. It is the combination/pattern of symptoms and their timing, all taken together, that once in a while indicate ARS -- and yours do not even come close. For example, onset of ARS usually is 8-10 days after exposure, so your started late; sore throat or other symptoms of ARS last at least a couple of weeks, so clearing in 2 -3 days doesn't fit; and your description of skin spots is not typical for the rash of ARS.

You also describe a near zero risk of HIV from the sexual contact described. The chance your friend has HIV is extremely low; but even if she does, the exposure itself carried little or no risk.

But the big question here, it seems to me, is why you haven't been tested. Maybe because you understand (correctly) that it can take 4-6 weeks for tests to become positive? However, it is impossible to have ARS symptoms with negative blood tests for HIV. A negative HIV blood test (of any type) at this time will show you do not have ARS, and therefore that you probably don't have HIV. Additional testing will be required to prove you weren't infected -- like an AgAb ("combo", 4th generation) test -- but at least a negative result now would be highly reassuring and prove your symptoms have some other cause. Almost certainly they have nothing at all to do with the sexual exposure you describe.

Contrary to popular beliefs, symptoms almost never are useful in judging whether or not someone has HIV. The problem is that even the most typical symptoms of a new HIV infection (which you do not have anyway) occur much more commonly in other medical conditions; and half or more of new HIV infections cause no symptoms at all. Testing is the only way to know.

So my advice is to be tested. I'd be happy to comment further if you'd like to let me know the result. Let me know if anything isn't clear -- but it is doubtful I'll have anything more to say until you know your HIV test results. In the meantime, don't worry. You can expect negative test results. I hope these comments are helpful.

HHH, MD

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23 months ago

Thanks for the answer. I scheduled a test next week as it will be 6 weeks since last exposure. I wanted to ask about this other exposure with the same woman. As I mentioned she told she was clean and then even texted it to me. So I had another exposure with her which was unprotected vaginal sex. This was exactly 5 days before the symptoms I described in the first question. So what I understand from what you wrote is that in this case the timing of symptoms would be to early, 5 days from exposure being to early for ars symptoms to show up, correct ?

H. Hunter Handsfield, MD

23 months ago

As I said above, the symptoms you mention do not suggest HIV; and indeed 5 days is too soon. I remain confident you do not have HIV.---

23 months ago

Thank you for your answers

H. Hunter Handsfield, MD

23 months ago

You're welcome; I'm glad to have been of help.

That concludes this thread. Best wishes and stay safe.

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