[Question #11805] Followup to question #11745. ARS symptoms

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12 months ago
Hi doctor,
I know I mentioned I wouldn't worry about this, but I wanted to follow up as I got sick. I am currently on day 21 of pep. On day 12/13 post exposure mentioned in question #11745, I had an ulcer on my inner cheek. I have gotten ulcers at the same location before long time ago. On day 20/21, I had a fever. I went into work today (21st day), and in the evening I was feeling unwell and took my temperature orally (under the tongue). I tried it 3 times. First time 99.9 degrees, then 101 degrees and 100.7 degrees. Maybe because I was at work and it was a hot day, it elevated my fever. I have have leg pain as well. Joints and bone. I also wanted to give more context. I contacted the woman the condom broke with and she mentioned she gets tested every 3 months and was willing to share med status but would not say her medication status (like prep). However I mentioned about the condom breaking and how I was concerned and she said it was getting weird and blocked me. So she didn't have a chance to confirm her status. To be fair, it might have been her boyfriend answering the messages. I also forgot to mention in my previous post that the condom broke when I changed positions. I moved from missionary after 15 mins to doggy style. While inserting my penis, it broke while inside her vagina and I pulled out immediately.  Questions:
1. Can this be ars or is it a pep side effect? To be fair two days ago, my colleague mentioned his wife and baby tested positive for covid, so maybe it is that. I did talk to him that day and met with him, but not a lot of interactions
2. If it is ARS, would an oraquick test detect it as early as this?
3. I had contacted my doctor for follow up testing. During the interaction, I asked whether I should take pep beyond 28 days(since I have 30 pills for each type), he said, just take it for 28 days. It contradicts with what you said doctor. So I was not sure about the dosage. 
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H. Hunter Handsfield, MD
12 months ago
Welcome back, but I'm afraid we are the wrong source for further information. You are under the care of the doctor or clinic where your PEP was prescribed. That should be the source of any and all information about your symptoms. I'll just say that it is not possible to have ARS symptoms while taking anti-HIV drugs.

1. Oh good grief. You were exposed to covid and have typical symptoms. Get tested for it. And no, it is not possible you have ARS.

2. Yes, if you had ARS an HIV antibody test would have to be positive.

3. Taking PEP drugs for 2 days more or less makes no difference. Dr. Hook's advice to complete 30 days treatment was just common sense advice to take it as prescribed. It doesn't matter if this is slightly different than your doctor's advice to stop two days earlier. 

Follow your doctor's advice about your current symptoms, PEP duration, and future testing. This forum does not provide medical care or direct medical advice.

Good luck--   HHH, MD
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12 months ago
Thank you doctor. 
I talked with the clinic I got the pep and they don't think it is related to the medication and asked me to continue my pep regimen.
Also thank you for saying that it is not possible to have ARS symptoms while taking anti-HIV drugs. I heard conflicting information on the internet that it could happen. So that puts my mind at ease.
I got tested for covid twice and it is not covid. Must be the flu I will continue with the clinic's suggestion of continuing the 28 day course.

I just had one question. In my last question, my scare was latter that I found out the person I had sex with did bareback sex quite often. Does the fact that I pulled out almost immediately after the condom reduce the risk a lot along with the fact that she told me she gets tested every 3 months? I don't know the results of the test though.


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H. Hunter Handsfield, MD
12 months ago
Yes, the very brief exposure after the condom broke made your risk even lower. In addition, you can safely assume your partner tested negative for HIV. Otherwise why would she even tell you she was tested? These are among the reasons PEP is not necessary. However, at this time that's up to you and the doctor who prescribed it.

That concludes this thread. Please note the forum policy against repeated questions on the same topic. This being your second about this exposure, your risk of HIV and PEP, it will have to be your last. Thank you for your understanding. I do hope the two discussions have been helpful.
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