[Question #13353] Ars question

1 months ago

Thank you for providing this wonderful service. On August 11th I had unprotected vaginal sex with a friend of mine. I have known her for quite some time and know she does sex work. I asked her if everything was good and she said yes. A week later I started to have a bad hacking dry cough a mild sore throat and muscle aches and pains that I still have now. Temperature was never higher than 99.4. Also, there are a couple of people in my office as well as 2 roommates who are also sick. I know symptoms are notoriously unreliable for diagnosis. My questions are:

Does this sound like ars as far as symptoms and timeline?

Would you recommend testing?

If so, the health dept in the next county offers free ab/ag finger stick tests. How long would it have to wait?

H. Hunter Handsfield, MD

1 months ago

Welcome back. I see you had a question over 8 years ago: thank you for your continuing confidence in our services.

First, this was a low risk exposure in regard to HIV despite your friend's sex work. Most such persons are accurately aware and honest about their sexual histories, especially in regard to HIV -- so it seems very unlikely she has it. Second, although you are correct about symptoms being a poor guide to judge possible new HIV infections, your symptoms do not fit well with ARS, which does not cause cough. They also started too soon, since ARS onset typically is 8-20 days after acquiring the virus. As you apparently suspect yourself, almost certainly you have a common cold or other garden variety upper respiratory viral infection, which fits with your nonsexual personal contacts having the same sort of symptoms.

Those comments start to cover your specific questions, but to be explicit:

1. No, neither the symptoms nor the timeline are good fits for ARS.

2. From a medical/risk perspective, HIV testing isn't really needed. On the other hand, you were anxious enough to take the time to ask these questions, and probably you would be reassured by negative test results. In other words, it makes sense to be tested simply for the reassurance you will experience.

3. You can test now. A negative AgAb result at this time would not entirely rule out HIV, since it takes a couple of weeks before this test to start to become positive. However, it isn't possible to have ARS symptoms and test negative. That is, a negative AgAb result would prove your symptoms are not from ARS. You could then have a second test 6+ weeks after exposure, expecting another negative result. You also could ask the health department about having an HIV RNA PCR test; those results are conclusive 11 days after exposure and you're there. Another option is to ask your sex working friend to retest (and perhaps pay for it): if she is AgAb negative, you will know you were not exposed to HIV.

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

HHH, MD

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1 months ago

Everything is clear. Thank you for your help.

1 months ago

Just out of curiosity, what are symptoms of ars and how long do they last?

H. Hunter Handsfield, MD

1 months ago

Typical symptoms are sore throat, lymph node enlargement in several areas, body wide non-itchy rash, and fever, onset usually 8-20 days after exposure, lasting 2-4 weeks. But even with these, most people with these symptoms have something other than HIV; and nearly half of newly infected persons have no symptoms at all. Therefore symptoms are a very poor predictor either for or against a new HIV infection; only testing is reliable. For more detail try an AI search, like chatGPT.---

1 months ago

I took an RNA test 15 days after my exposure and it was negative. Would that result alone be proof that I am in the clear?

H. Hunter Handsfield, MD

1 months ago

Yes, that negative result is conclusive proof your didn't have HIV and ARS is not the cause of your symptoms.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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