Hello Doctor,

I am from Brazil (please excuse any mistakes, English is not my first language).

I am a 30-year-old heterosexual male.

Twenty days ago, I had protected vaginal sex with a friend of mine. We have known each other for 9 years. During the night, we had three instances of vaginal intercourse. The first two times, there were no issues with the condom (I always checked it after finishing). However, during the third instance, the condom broke, leaving my glans fully exposed. Because of this, we had unprotected sex for approximately two minutes. Based on my friend's history, I know she is quite promiscuous, but she always uses condoms.

I am very worried about HIV.

What triggered my anxiety is that on the 17th day after this risky encounter, I started experiencing a sore throat, especially when swallowing saliva. I have no other symptoms. In fact, I have been going to the gym regularly, lifting weights, and doing heavy physical work. I do not have headaches, fever, or body weakness.

Could this sore throat be a symptom of Acute Retroviral Syndrome (ARS)? Does a sore throat need to be accompanied by other symptoms to be considered ARS?

Lastly, Doctor, do you think I should get an HIV test given the details of this story?

Can I move forward without worrying, Doctor? What would you do?

Thank you for your time and service.

You describe a near zero risk event in regard to HIV risk. Assuming you are confident your friend is not a sex worker or otherwise at high risk, the chance she had HIV probably is very low. And even if she has it, the average risk of an unprotected vaginal sex exposure with an infected woman is under one chance in 2,000. As for you sore throat, of course that can be a symptoms of new HIV infection, but usually not by itself:  if it were due to ARS, you would expect fever, enlarged lymph nodes, and maybe skin rash. And of course we're in the middle of the season for colds, influenza, and other common viral infections -- which are thousands of times more common than HIV, even in people at much higher risk.

Should you test for HIV? From a medical/risk perspective, I see no need and I would not be tested if somehow I were in your situation. However, testing is always a personal choice, and even when there is no risk, persons worried about HIV often are more reassured by negative test results than by professional opinion, no matter how expert. A negative test now would prove your sore throat is not due to ARS. (Although the seroconversion time for HIV tests is 2-6 weeks, depending on the test, the results always are positive when symptoms are caused by HIV.)

Or maybe you should discuss this with your partner friend. You might find she is just as worried about HIV as you are. (In general, women are at higher HIV risk in such situations as their male partners.) If you both were to be tested, you would know for sure neither was at risk. Also, assuming both you and her have otherwise been sexually active in recent months, other STDs are much more likely -- especially for chlamydia

or gonorrhea and conceivably for syphilis. 

Be clear:  I am not advising either you or your partner be tested for HIV because of significant risk. Either or both being tested for HIV would strictly be for reassurance. The chance of other STDs is far higher, although still probably quite low, especially since you have had no symptoms to suggest any STD at all.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Hi Doctor,

Thank you for your detailed response. It was very helpful and reassuring.

I understand that a sore throat alone is very unlikely to be related to ARS, especially without fever, swollen lymph nodes, or other systemic symptoms. Based on your explanation, I feel much calmer knowing that my risk was extremely low and that my symptom is most likely due to a common viral infection or another benign cause.

By the way, I’m not sure if this information is relevant, but my sore throat ended today after five days. I only took a cold medicine two days ago, but nothing else. During these days, I felt a little phlegm and a very mild cough. No other symptoms.

Would you say that I can move on with peace of mind and put this behind me?

Again, I truly appreciate your time and guidance.

Thanks for the thanks. I'm glad to have helped.