[Question #10720] Rashes without any other symptoms

20 months ago

Dear Doctor,

Around 22 days ago, I engaged in condom protected sexual activity with a Sri Lankan individual in a massage spa at uae, condom protected vaginal sex lasting about 5 minutes no other activity of high risk. she was a massage professional, not a high-end escort. I am not sure about condom breakage because I didn’t check at the time.

On day 20 post-encounter, I noticed rashes on my upper chest, shoulders, and stomach. Currently, I don't experience any symptoms other than these rashes, which have been present for about 3 days. Given these circumstances, would it be advisable to undergo testing for HIV or other STDs? If recommended, when would be the appropriate time for testing?

I was really confidant regarding the std till the rashes appeared. but i am a bit worried now

H. Hunter Handsfield, MD

20 months ago

Greetings. Welcome to the forum.

Congratulations on your wise decision to use a condom for this event. As you apparently know, condoms are highly effective in preventing HIV. It seems very likely the condom remained intact: usually ruptured condoms are easily felt and recognized.

As for your symptoms, they really don't suggest acute retroviral syndrome (ARS, i.e. symptoms of a new HIV infection). Rash alone would rarely if ever be the only symptom; and ARS symptoms usually start 8-10 days after exposure and almost never later than 14 days.

Since you're concerned, I suggest you have an HIV blood test, ideally an antigen-antibody (AgAb) test, i.e. 4th generation. If the symptoms are due to HIV, it will be positive; if the result is negative, it will prove HIV isn't the cause. (It isn't possible to have ARS symptoms with a negative blood test.) Be clear: I'm not recommending testing because I think you were at serious risk or think you have HIV; I do not -- I suggest it strictly for reassurance.

I hope these comments are helpful. Let me know anything isn't clear; and also feel free to let me know the test result when you have it. In the meantime, stay mellow: you can expect a negative result.

HHH, MD

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20 months ago

Dear Doctor,

I received my HIV test results today, and they came back as non-reactive. Thank you immensely for your recommendation and support. It's brought me great relief.

I wanted to inquire whether you'd recommend any further testing at a later time, and how conclusive the test is at 22 days(4th Gen Test) Your guidance has been invaluable, and I truly appreciate the work you do for individuals like me who experience anxiety around these concerns.

Thank you once again for your assistance and expertise

H. Hunter Handsfield, MD

20 months ago

Glad to hear of your negative results; it's what I expected. It takes 4 weeks (rarely up to 6 weeks) for the AgAb tests to become positive. Your negative result proves your rash is not due to HIV, but does not conclusively prove you do not have HIV (without symptoms); at 3 weeks it's around 90-95% conclusive. On the other hand, you had a zero risk exposure for all practical purposes, and your original inclination -- that you had no cause for worry and didn't need testing -- was correct. But if having now gone this far, and your self description as anxious about it, you might find yourself worrying. If so, another test at 4-6 weeks would make sense. It's your call. If you do it, don't worry in the meantime. I've never heard of a person with an exposure like yours who acquired HIV.---