From both these questions and your previous ones, it seems you're more worried than necessary about the risks of HIV and syphilis, and perhaps other STDs. Despite all the media attention, you should be aware of how rare both infections are in sexually active heterosexual men and women in the US and other industrialized countries. You describe a partner very unlikely to have either infection -- although you're obviously aware that if he has sex with men as well as women, the chance of either infection is higher.

As for your symptoms, four weeks is much too long for onset of acute retroviral syndrome (ARS, i.e. initial HIV infection) (always starting with in 10-14 days of exposure) and they don't fit at all with syphilis or other STDs at all. Almost certainly you acquired a garden variety respiratory virus -- influenza, covid-19, or just a bad cold. Or maybe even strep throat, given the apparent response to antibiotics. And of course we're right smack in the middle of the colds/flu season.

But there's a mystery here:  I find it rather surprising you don't report any test results! No HIV or syphilis blood test? No testing for gonorrhea or chlamydia (for which you were at far higher risk than syphilis or HIV)? My advice is that you get tested now. As you likely know, you can be tested either through a doctor's office or clinic (usually ideal because of comprehensive examination etc, in addition to lab tests themselves); or directly by a commercial lab. Either way, I would advise you immediately be tested for HIV (ideally with a lab-based AgAb test, i.e. 4th generation), a syphilis blood test, and urine or vaginal swab testing for gonorrhea and chlamydia. It's nice your partner has agreed to testing, but you still must do it yourself!

I'll be happy to comment further if and when you report your test results. But I really cannot have anything useful to say until then. Stay mellow in the meantime:  you are at extremely low risk (at least for HIV and syphilis) and can expect negative test results.

Good luck in the meantime. Let me know if anything isn't clear.

HHH, MD

I know, I’m long overdue for testing especially for the more common ones like chlamydia and gonorrhea. It’s been a year since I’ve been tested for everything. I have anxiety about doing it, but I have an upcoming appointment this week for a full panel. I definitely am getting it done. I just wanted to have some statistical reassurance and insight on my symptoms with my situation. 

I hate that I had the symptoms I had during that sickness as the swollen lymph nodes, horrible sore throat, and intermittent fevers have me questioning it, but I’m hoping it’s completely unrelated to HIV. A lot of references say 2-4 weeks for ARS which is why my anxiety skyrocketed, but I trust your expertise that 4 weeks is a lot longer than usual. I did not have any symptoms during 10-14 days, I can only recall a small rash behind my ears at 3 weeks post exposure that went away within a day or two. No full body rashes on trunk, chest, or arms, and no prolonged fevers. The sore throat, while excessively painful, lasted 3-4 days and responded to antibiotics so I’m hoping it was something bacterial. 

I appreciate your help, I know that getting a test is the only way to know! Thank you again.

I'll be happy to comment one more time when you have your test results, but won't have more to say until then. In the meantime, perhaps it will further comfort you to know that in the nearly 20 years of this and our preceding forum, with thousands of questions from people worried about HIV, not one has yet informed us they eventually tested positive. If and when it finally happens, surely it will be from a truly high risk exposure, not one like yours. (Think unprotected anal in an MSM with 20 partners a week, or with a known infected partner.)