[Question #12950] HIV worry

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3 months ago
Hi drs

Thanks for putting up a great forum. 

So the situation is, I had protected anal with a guy, who, said he’s neg and has no “reports of anything” I have no reason to think he’s lying it was just a very relaxed answer. Anyway I was the insertive partner. I never finished as I lost my erection, it’s must have been about 15 mins sex in total. But when I pulled out, the condom had broke. Which I think must have been when I went soft; as it was in tact a few mins before when we changed positions so maybe max 4-5 mins with the break max. 

I’m just a bit worried as 5 days after, my guttate psoriasis has really really flared and now I’m covered all over. 
I originally got it at Xmas after being prescribed beta blockers for anxiety,  which after stopping them, it’s been gradually disappearing , although not totally cleared. 
So it just worried me that have I contracted hiv and my immune system has reacted and gone into overdrive causing it to flare ? There’s so much conflicting information I just wanted to ask someone who has the knowledge. 

I will admit though, I was worrying in the days after about the condom break, and then when I started noticing the spots coming up, my stress and anxiety went through the roof,  and so did the psoriasis, which I know stress is a major factor with psoriasis. 

Sorry I don’t mean to ramble on i just can’t get my mind clear, and I know the more I worry the worse it will get. 

Thanks again 
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Edward W. Hook M.D.
3 months ago
Welcome to our Forum.  Thanks for your questions.  I’ll be glad to comment.  I’m not clear on the timing of your encounter but it sounds like it was recent and it was your psoriasis that was diagnosed around Christmas.  If that’s incorrect, please let me know.

I would also presume that your partner was telling you the truth about his status.  Most people tell the truth.  Unfortunately, condoms break about 1% of the time.  I hope this event will not keep you from using them in the future.

Overall this was a relatively low risk encounter.  If your partner had untreated HIV, the estimated risk of infection from a single unprotected insertive encounter is less than 1 infection in 200, I.e. chances are 99.5% you would not be infected.  Your risk for other STIs, which are somewhat more common is slightly higher if he had one of them ( gonorrhea and chlamydia are most common)

HIV can make psoriasis more severe but anxiety which appears to be present here can do that as well.  If HIV were making your psoriasis more severe, an HIV test would be positive.

I hope this information is helpful.  If I have the dates wrong or anything is unclear please use your up to 2 follow ups for clarification.  EWH
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3 months ago
Hi, thanks for the reply
So the psoriasis was at Xmas originally and started to go after stopping propanol but it still had some active up to the point of the encounter.  So it hadn’t actually gone into remission. I forgot to mention I’ve had it years before from medication too.
The encounter was on the 18th of April and my psoriasis started flaring on the 23rd slowly and the this week more so.  Given the timing of being 5 days after, my anxiety has gone into overdrive as I keep reading that psoriasis getting worse/flaring can be the first sign of infection. Is that correct ?   With every patch I’m worrying more. And now at 2 weeks post encounter. I’ve had no other ars symptoms, had a slightly sore throat, nasal congestion and headache, which I think could be hayfever in hot weather. But that was only on the 2 days of hot weather.  Do you think this could be hiv ? Even though I know 90% was protected 
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Edward W. Hook M.D.
3 months ago
Thanks for the additional information.  If anything, it makes me more confident that your psoriasis flare is NOT due to recently acquired HIV and is likely a reflection of your anxiety.  Five days is to  quick for even recently acquired HIV to cause symptoms  and your current symptoms are too mild to be the typical ARS.  That said, I would encourage you to test, in part to address your anxiety.  At this time an HIV RNA PCR test would be 100% conclusive.  A 4th generation, combination HIV antigen/antibody test, while not entirely conclusive would PROVE that your psoriasis flare is unrelated to HIV

One follow-up remaining.  EWH
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3 months ago
Thanks dr, in my area testing is only put on once a month and is next on in 3 weeks. I’ve just started dating someone new. I’m petrified incase they want to move the relationship forward. As I don’t don’t to pass anything on. Which again Is a huge source of worry.  Based on the above, which I know you can’t diagnose from symptoms, do you think I’m ok ? I’ve made myself so much worse for anxiety after reading psoriasis flares can be the first sign of hiv, is that a typical sign of acute infection/ars? 

Thanks again 
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Edward W. Hook M.D.
3 months ago

Final responses.  I’ve done my best to tell you why your psoriasis flare is not due to HIV.  please re-read my responses.  Again, a psoriasis flare is not a sign of the ARS.

I’m not sure where you are but it’s hard to believe that testing is available only once a month and there are no home tests (OraQuick) available. I’m confident that if you look around you can find testing if you want it

This completes this thread.  Please don’t worry.  EWH
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