[Question #11971] Protected sex HiV query

11 months ago

Hello again Doctors,

Just wanted to ask this question for assurance purposes as I have a slight concern about the exposures I had but you can be the better judge

Exposure Multiple CSWs/massage therapists (about four within the span of three weeks) protected sex with a good condom and unprotected oral lasting about 10 minutes each.

Yesterday, I had severe sore throat in the left side, it's hard to swallow and fever and muscle pain, no sinus or runny nose. No rash either. Took some cold medication and I feel much better but the sore throat still persists, this would be day 2.

I took the round of tests for everything except syphilis and HIV all clear.

My question is this has come exactly two weeks after the last exposure and seeing what the ARS symptoms are , I'm very concerned that this could be HIV.

What do you think? A viral cold or HiV a possibility?

11 months ago

Sorry again doctors, left this bit, by feeling a lot better on day 2, I meant the body aches have reduced but I feel a general sense of malaise which I gather is the meds wearing off.

Just wanted to include this to get your assessment.

Edward W. Hook M.D.

11 months ago

Welcome to our forum. Thank you for your questions. I’ll be glad to comment. From your questions. It is not clear to me whether you were performing oral sex on your CSW partners or receiving it. If you were receiving oral sex, your encounters were no risk events. Condom protected sex is safe sex as long as condoms are worn throughout the encounter and there are no proven cases in which someone has acquired HIV from receiving oral sex. You will not be the first.

I should acknowledge that the timing of your illness, about two weeks after your last encounters is within the timeframe in which the ARS occurs. The ARS is a combination of symptoms which include sore throat, high fever, and muscle or joint aches, as well as occasionally diarrhea or a skin rash. The ARS most typically occurs between 10 and 20 days following an exposure with all symptoms starting at about the same time. The ARS does not occur more than 30 days after an exposure .

Despite the resemblance of the symptoms you describe, the fact that your encounters were virtually no risk, the low rate of HIV in commercial sex workers, and the fact that you have improved so rapidly make it unlikely that your symptoms are the ARS. FYI, when persons presenting with ARS-type symptoms have been a evaluated for recently acquired HIV over 99% of them have something other than HIV, most typically one of the common every day upper respiratory tract infections that we all get from time to time such as Covid or influenza

If you wish to prove that your symptoms were not due to the ARS, you could test at this time. While testing is not absolutely conclusive until six weeks following an encounter, when persons experience they ARS their 4rh generation, combination HIV antigen/antibody tests are positive and remain positive from there on.

I hope this information and perspective is helpful to you. Please don’t worry. EWH.

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11 months ago

Hi Doctor Hook,

Apologies for the late response as I'm currently travelling in Europe and just got internet to post this response.

Thanks for the clarifications, I was the receiver in all the exposures I had mentioned and the condom stayed on till the end for all of them.

it's the third day and I feel relatively fine save for the last thing sore throat that has gotten milder after a round of cold and flu medication.

Based on your assessment, my past questions and experience along with the other questions I've seen on the forum, I looked through for similiar stories, my gut reaction tells me that this isn't HIV but a very coincidental viral throat infection that did cause enough of a scare for me to write to you again.

I will be testing eventually as part of my routine health testing, just wanted to make sure, in your opinion of what you thought. That is I'm assuming you're only asking me to test for peace of mind.

Thank you, I don't have any further questions.

Edward W. Hook M.D.

11 months ago

Thanks for the additional information. I agree with your sense that this is not HIV or, for that matter, any other STI. I see no reason for testing before your routinely scheduled testing other than possibly if it will provide peace of mind. EWH---

11 months ago

Hi Doctor,

Realized the thread was still open, and thought I can give a final update to see if there's a change in assessment and for other users on the forum like me with similiar circumstances.

Day 4, the sore throat has intensified and my uvalva is swollen and I am spitting out chunks of dark brown phlegm. No body aches or fever.

I read in an earlier thread you had written to another forum user that this is not characteristic of the ARS symptom, is that correct?

Thanks for giving me the final follow up. You can close the thread.

Edward W. Hook M.D.

11 months ago

Thanks for the additional information. I am sorry that your sore throat is persisting. My assessment in terms of HIV or other STI is unchanged. Your course of illness is not suggestive of these problems. The presence of Brown phlegm suggests that there may be a bacterial process present and that antibiotics may help. This illness is not suggestive of an STI or HIV and maybe something you acquired in your travels. A trip to a healthcare provider might be helpful at this time.

We provide up to three responses to each clients question. As this is my third response, this thread will be closed shortly without further responses. I hope you’ll be feeling better soon. EWH

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