[Question #12530] ARS Symptoms?

7 months ago

I am very nervous and would like some advice on the risk level and whether what I am experiencing are ARS symptoms. 2 weeks ago I, male, had sex with another male 3 times. we used condoms once, but it broke. the other 2 times we didn't use condoms as he told me that he was on PEP after a potential exposure that he had, and he was almost finished his pep regime. I went to two clinics and requested PEP for myself. HOWEVER, both providers refused to prescribe me pep as she said that my risk was extremely low, since the other guy was on PEP there was no need for me to take PEP. Now it's two weeks later and I am experiencing the following symptoms: headache in the back of my head/neck, tightness when I swallow. pain in my ears running down the sides of my neck, and overall tension in my shoulders and back. I also have a mild sore throat that hurts only sometimes when I swallow.

7 months ago

1. Were both of the clinics wrong by not prescribing me PEP for this encounter?

2. I stayed in contact with the other male, who finished is PEP and he told me that all of his HIV tests came back negative. Does this mean that I could not have been infected?

3. Are the symptoms I'm experiencing now ARS symptoms?

4. I got a 3rd generation rapid HIV Insti test done today and it came back negative. If these were ARS symptoms that I'm experiencing, would the Insti test have picked them up? I'm on day 3 of the symptoms.

Edward W. Hook M.D.

7 months ago

Welcome to our Forum. Thanks for your questions and your implied confidence in our service. I'll be glad to comment. Like the other clinicians you spoke with, I would have declined to prescribe PEP for you. While the timing of your encounter is about right, the symptoms you describe are those of an upper reparatory tract infection, not the ARS. The classic definition of the ARS is high fever, severe sore throat and widespread muscle or joint aches, all occurring at about the same time. Headache, ear discomfort and back/shoulder tension are more suggestive of anxiety than the ARS. Further, if your partner was on PEP, he could not have transmitted HIV to you. Thus, in reply to your specific questions:

1. Were both of the clinics wrong by not prescribing me PEP for this encounter?

See above. Even if he had HIV, your risk of infection, depending on the activities you participated in, would be quite low.

2. I stayed in contact with the other male, who finished is PEP and he told me that all of his HIV tests came back negative. Does this mean that I could not have been infected?

Yes

3. Are the symptoms I'm experiencing now ARS symptoms?

No, see above.

As an antibody only test, a 3rd generation test adds to the very, very low likelihood that your symptoms of HIV however, you would have been more sure if you had a 4th generation tests. During the ARS, a small proportion of infected persons would have negative tests for HIV antibodies but tests for the combination of HIV antibodies and antigens (i.e. 4th generation tests) are always positive.

I hope that this information is helpful. EWH

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7 months ago

Thank you. That gives me some reassurance. I took a 4th gen test, but won’t get the results back until tomorrow so I will know for sure by then.

The risk was anal sex with me as the receptive person. The guy did show me proof that he tested negative at 6 weeks post his pep treatment.

1. Since his tests are negative 6 weeks post him finishing pep is it impossible for me to have hiv and these to be ars symptoms? I’m nervous that he probably didn’t adhere to his pep regime when we had sex, so there could have been hiv in his system.

2. I’m not having a fever, or severe sore throat. Just a lot of neck tightness, and pain in my neck. Can this be swollen lymph nodes or are swollen lymph nodes usually painless?

I will also come back with an update once I get the results of my 4th gen test.

Edward W. Hook M.D.

7 months ago

Thank you for the additional information. Your partner’s negative test results provide assurance that you were not exposed and that you were symptoms are not due to the ARS..

1. His negative test results prove to you that he did not have HIV and that there was no possibility of him infecting you.

2. Swollen lift notes are very nonspecific finding which can result from any number of oropharyngeal infections. Swollen lymph nodes are best diagnosed by a trained clinician. I do not have a good explanation for the discomfort you were experiencing in your neck.

EWH

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7 months ago

Ah I see. So while he’s taking PEP, he did not have particles of hiv in his system to transmit to me? What if he missed his pep dose on the days we had sex?

I don’t feel the lymph nodes, only pain where lymphnodes are. Would this type of pain be associated with hiv ars?

Edward W. Hook M.D.

7 months ago

If he showed you negative test results for HIV following completion of PEP he could not have transmitted HIV to you.

There is internet misinformation that persons on PEP have HIV virus in their system. That is incorrect.

As I said above, the pain/discomfort you describe does not suggest ARS

We provide up to 3 responses to each client's questions. This is my 3rd response and therefore the thread will be closed without further replies. Please don't worry. EWH

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