[Question #12924] ARS question

3 months ago

Hello. I was looking for info on ARS and found this site. A couple weeks ago, I met a girl and we drunkenly exchanged oral sex on each other without protection. no vaginal/anal sex. I usually don't do this because I have a fear of STDs. I got her number the next day and we spoke about meeting up again and I asked if she had been tested for STDs and stated that I had a full panel done by Quest since the last time I hooked up with anyone. She said she hadn't tested in a long time and had hooked up with other men, but she went to Quest and got a STD panel done at 1 week after we hooked up. She was negative for everything. In the last few days I've developed a terrible headache and have noticed what appears to be a ringworm rash smaller than a dime appearing on the back of my left hand. I made the mistake of googling and got it in my head that it could be ARS symptoms. Here's my questions:

1. Are the headache and the (what appears to be) ringworm rash on the back of my hand symptoms of ARS? (it seems like there are a ton of symptoms and I have no idea how/when it works)
2. I know there is a window period for HIV testing so is it possible that she tested negative while still able to transmit the virus? She took it through Quest and her results she showed me said it was a 4th gen test, which is the same as the last one I took a few months ago.

It looks from other responses on here that this isn't anything to really worry about, but I wanted to be sure. Thanks.

H. Hunter Handsfield, MD

3 months ago

Welcome to the forum. I'm also glad you found us and I'm happy to address your concerns.

You describe a sexual exposure with little or no risk of HIV and it is exceedingly unlikely you have it. First, in the US and most industrialized countries, HIV is rare in even the most sexually active women, so even before your partner was tested, it was statistically unlikely your partner had HIV. And with her negative test a week after exposure, it is certain she doesn't have it and could not have infected you. Second, even if she was infected, oral sex is safe: there has never been a proved case of HIV transmitted oral to penis or by performing oral sex (cunnilingus) on a female partner. That doesn't mean it isn't possible and probably it has happened, but with no know cases it obviously is exceedingly rare. Third, your symptoms are not at all suggestive of ARS.

As you have discerned from looking at other discussions on the forum (thank you!), "this isn't anything to really worry about." To your specific questions:

1. Headache and the sort of rash you describe don't fit with ARS, especially in the absence of more typical symptoms: widespread rash (all over the body), sore throat, fever, enlarged/inflamed lymph nodes. And even with these typical symptoms, usually it turns out HIV isn't the cause: there are several more common causes of these sorts of problems. As a general rule, symptoms are pretty much useless in judging possible new HIV infection. As just noted, most with typical symptoms don't have HIV; and many with new infections have no symptoms at all. Testing for HIV is far more reliable than either presence or absence of symptoms.

2. In theory it is possible to become infectious with HIV, i.e. able to transmit the virus, before testing positive. But it's very rare: most of the standard tests like PCR/RNA and the antigen-antibody (AgAb, "4th generation") tests detect the virus itself, in addition to antibody; and negative results mean there's not enough HIV in the infected person's blood or genital fluids to transmit to sex partners. Her negative test result is very nearly 100% proof you could not have been exposed.

From a medical/risk perspective, you don't need HIV testing. If somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry about infecting her. That said, reassurance alone is a valid reason for testing, even when the risk is nil. So feel free to test if you would like the additional reassurance of a negative result. You could have valid PCR/RNA test 11 days after the event, or an AgAb test at 6 weeks. If you'd like to include other STIs, you could have a valid urine chlamydia/gonorrhea test now (any time 4-5 days after exposure) and a syphilis blood test at 6 weeks. If you decide to test, stay mellow until then: after 21 years, there's never been anyone on this or our preceding forum who tested positive for HIV and you certainly will not be the first!

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

HHH, MD

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3 months ago

You responded quick! I didn't think to check back until around now. Thanks!

Your response is very reassuring and I appreciate it. I spoke with her again last night and she admitted she'd hooked up with a few other people a very recently before me and that she went and got the same tests from Quest again. No idea if those recent tests are conclusive with her other partners, but it seems kinda sketchy so I don't plan on anything else with her. Anyway, you had stated that the symptoms weren't ARS (and I don't feel sick, I ran 7 miles earlier today) and that her negative HIV test a week means she really couldn't have transmitted that. Well, her most recent quest HIV test was negative at (I think) 18 days after we hooked up. I'm assuming that means there's even a less chance of her having somehow been able to transmit anything, but it was new info so I thought I'd run it by you and see if it meant much. Please let me know if it changes anything.

I'll get tested for stuff myself in another few weeks, but I feel fine and have no other symptoms so I think I'm good. Thanks!

H. Hunter Handsfield, MD

3 months ago

Yes, your partner's second test renders the chance she was infected and could have infected you to absolute zero. You were not at any risk of HIV. Glad you're feeling better about the situation: you have every right to be completely confident! (If somehow I were in your situation personally, I wouldn't be tested again. But feel free if you would like the additional confirmation.)---

3 months ago

well then, that's certainly welcome news. Thanks! Just to clarify, even if she had somehow had HIV introduced into her body (which I sincerely doubt she had) the negative test 18 days after the event makes it conclusive that she couldn't have passed anything? Only asking for clarification because I have no idea how many/how recent other partners she had was. I think that's my final question, so thanks for the help!

H. Hunter Handsfield, MD

3 months ago

"even if she had somehow had HIV introduced into her body". Irrelevant. Her test shows that is impossible. And yes -- if somehow that happened, the negative test results prove she did not have transmissible virus, no matter how many other partners she had recently.

It's time to ignore any and all further "yes but" or "what if" thoughts that come to mind. Even if they do, please to not return with a new question to ask again. Thanks. I do hope the discussion has been helpful and allows you to suck it up and stop worrying. Good luck.

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