Since our last interaction I have developed a mild sore throat, runny nose and cough with phlegm 10 1/2 days post exposure and on day 9 of PEP.I don’t have fever. Can these symptoms be related to ARS or no?

When STDs increase the risk of acquiring HIV from the infected partner is it because of the symptoms they cause or is there another reason? I have not experienced any symptoms for an std up to this point so can I assume that it was not part of my risk?

(Getting tested in a day)

I also read that in your many years of running this and another such forum not a single person has tested positive is this true?

Finally would you say that my exposure can lead to a positive HIV test (under 10 sec of unprotected vaginal sex with a csw picked up from a bar in bali Indonesia. Uncircumcised and on pep at 35 hours) I know you can’t know the answer for certain just looking for some reassuring words. 

Thank you once again for your help.

Given the low risk nature of your exposure, as well as the fact that you are taking PEP it is very unlikely that the symptoms you are experiencing are due to the HIV ARS.  ARS symptoms are the same as far more common every day viral illnesses including COVID 19, influenza, and the every day viral infections that most people get from time to time.  If you are worried that your symptoms are due the ARS, you could test with a 4th generation test- when persons experience the ARS, tests are always positive.   If you test I anticipate you will find that you are not experiencing the ARS.

STIs increase risk for HIV for several reasons including the persons who get one STI are more likely to get others as well as the inflammation which accompanies some STIs seems to increase vulnerability to HIV by making it easier for the virus to enter the body.

Dr. Handsfield is correct, we have not seen a client become positive.

As Dr. Handsfield has already told you, your risk for HIV from the brief exposure you described was very, very low.  I urge you not to worry.  EWH

Would you say that my unprotected vaginal sex exposure was low risk in nature? I had a confusion with Dr Handsfield because he thought I was talking about unprotected oral due to my typing errors. 

After I posted this question, my sore throat and cough worsened, and now I’m also experiencing wheezing. My family doctor has prescribed Zerodol Sp twice a day ( aceclofenac 100mg, serratiopeptidase 15mg and paracetamol 325mg) and betadine gargles twice a day. I could not find any interactions online with TLD Pep, so do you think taking it is okay? I cannot share that I’m taking PEP with my family doctor.

When my exposure happened, I was on treatment for a yeast infection, which had subsided, but I was on my last few days of medicine, and I applied two drops of momate lotion, which is a topical steroid, right after my exposure. Can this have any effect on my risk? 

I know some of these question are stupid, but I think I would rather know the answer than not ask 

Thank you once again for your help and for running this forum.

Taking the medication you mention will have no effect on the effectiveness of PEP if you even needed it.

As I believe, Dr. Handsfield has already told you, the topical steroid that you were using would have no effect on the effectiveness of pep, in the unlikely circumstance that you needed it

As was my sense in reading Dr. Handsfield‘s reply, I think you are worrying far more than you need to. I hope you have found my replies reassuring. You have one follow up after this following which there should be no need to return to the Forum.  EWH

After my last question I also developed a fever which reached 101 and resolved in 24 hrs with 2 doses of paracetamol. Overall all my symptoms others than the cough resolved in around 48 hours. 

I read in another post that ARS symptoms usually all come at the same time, are quite severe in nature and last around a week or more. Do you think my symptoms resolving quickly is a sign that it is not ARS?

 Do you think in case of PEP failure one can experience ARS or a milder version of ARS while taking PEP or does it delay ARS regardless of failure?

If PEP has such a high success rate (near 100% if started within 48hrs as said by Dr Handsfield) why isn’t it used more often in areas with high HIV prevalence like Africa?

I’ve gotten tested for gonorrhoea and chlamydia and if I get a negative result can I assume that an STD wasn’t a part of my risk i.e risk being 1 in 1000 instead of 1 in 500.

As this is my last follow up is there anything else I should look out for. 

Finally what do you think is the chance that I’m HiV negative. 

Thank you to both you and Dr Handsfield for you detailed replies and running this forum 

The ARS likely dies cause symptoms varying in severity however your symptoms do not suggest the ARS.  If you wish to prove to yourself that your symptoms are not the ARS, then test.  When symptoms are due to HIV, tests are ALWAYS positive.  I am confident your symptoms are not due to HIV.  

I am confident this is not HIV.  I will leave the thread open for a few days in case you test and wish to post the result.  There will be no further answers.  Please don't worry.  EWH