Hello Doctors. Thank you for your really useful service.

I recently had a potential exposure to HIV and the symptoms I had after few days got me really worried.

I am from Italy and last weekend I spent a couple of nights with a woman I am currently dating but whom I met only recently.

Timeline of events:

- Sat 06/01: (during the night) I received oral sex from her several times, and I penetrated her vagina without a condom (the ones I purchased didn't fit) in two separate acts but only staying inside max 15-20 seconds each, without ejaculation.

- Sun 06/02: I received oral sex from her once

- Tue 06/04: in the evening I started feeling a sore throat

- Wed 06/05: I started having temperature, which rose up to 38 degrees Celsius

- Thu 06/06: still having temperature, severe sore throat, and mild muscle pain (it resembles a flu)

Given that:

- I got flu vaccine last October

- I had COVID last August

- the woman I mentioned started having stuffed nose and moderate to severe sore throat from Mon 06/03

- she told me last time she had unprotected sex was roughly one year ago with her partner at the time (I guess it was a mid-long term relationship)

- she has had an active sexual life in the last few months but she assured me she always used condoms

Should I be worried about HIV and can this be a potential ARS?

It seems like I started having those symptoms a bit early for a potential ARS but still wanted to ask you.

Moreover, I am planning to have a quick fingerprick test once I'm feeling better as well as a proper 4th gen test in a month or so.

Thanks in advance for your time and extremely valuable advice.

Best regards

The exposures you describe are low risk.  There has never been a case of HIV proven to have been acquired from receipt of oral sex and in the unlikely circumstance that your partner had HIV (HIV is rare among women- present substantially less than 1% of the time among women in Europe and even if she did have untreated HIV, the likelihood of transmission from your two brief unprotected vaginal exposure would be less than 1 in 1000.  Further, as you point out, to experience the onset of HIV symptoms 4-5 days after an exposure would be distinctly unusual.  Most typically symptoms of recently acquired HIV occur 10-20 days following an exposure.  I suspect that your symptoms may have been due to either a common exposure with your partner or one of the all-too-common, non-STI upper respiratory syndromes we all get from time to time.  I am confident that your symptoms are not due to HIV however, if you wish to prove it, you could test.  If you test at the time with a 4th generation, combination HIV antigen/antibody test, your test would be positive if the symptoms you experienced were due to HIV.  When symptoms are due to HIV, tests are always positive and remain positive thereafter.  

Alternatively, if your partner were to test at this time, that too would prove that your symptoms were not due to HIV.  Persons with negative tests cannot transmit HIV.

I hope that this information is helpful.  EWH