As a male I had a protected encounter with a female csw in Thailand. It was very brief, around 30 seconds and oil was applied on the condom. So not sure it broke or not, didn't notice it, worried since oil was applied.

Have done 6 4th gen duo tests on 16th, 22nd, 28th, 36th, 42st and 60th day after exposure on Abott Alinity Platform. All came out negative.

After 80 days had slight sore throat, fever with nasal congestion and phlegm, muscle aches. Fever and sore throat resolved in 1 day, the cold took a few days more.

I was completely okay post this.

After 100 days had 2 nights of sore throat (that became better during the day), cough, very mild fever for a day and loss of taste and smell. These symptoms resolved in 2 days and did Covid test because of the smell issue, which came out negative.

- Do these symptoms indicate delayed seroconversion? Especially as they came back to back in a gap of 20 days?

- Can symptoms start this late? Can they be this short? (~ 2 days each time)

- Is there a possibility of Hiv 2 infection, having a longer window period?

- Do I need to test again or are my tests 100% conclusive?

You were at little or no risk for HIV. The large majority of female sex workers in Thailand to not have HIV and you had a zero risk encounter anyway. It seems you misunderstand the issues about latex condoms and oil based lubricants. They increase the chance the condom will break -- but if it does not, there is no risk. Oil does not permit HIV/STI transmission through intact latex.

Equally important, your test result prove for sure you did not acquire HIV. That means your symptoms cannot be caused by HIV. Also, acute HIV infection does not cure cough, nasal congestion, or phlegm.

"Do these symptoms indicate delayed seroconversion?" No, not possible.

Settle down and don't be worried. You caught a cold, nothing more.

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

HHH, MD

1. My main concern was falling ill twice within 25 days. Especially the 2nd one had a brief loss of taste & smell. Do both of these episodes, look like something consistent with cold and not HIV? And is it natural to have 2 colds so close together (immune suppression being the concern)?

2. The  window for onset of symptoms? How long do they last?

3. Is delayed seroconversion even a thing with duo tests? Given materials around Elite Controllers and conservative 90 day window periods (my sickness around the 80th day fuelled the anxiety). Essentially, is it correct to assume that duo test beyond 6 weeks is a catch all for all infections (even HIV 2) and marginal cases like ECs?

2. ARS symptoms typically start 10-20 days after exposure and last 2-4 weeks.

3. Delayed seroconversion never occurs with the AgAb (duo) tests. That term relates only to the earlier antibody-only tests and even then was exceedingly rare. The AgAb tests detect 100% of HIV infections (usually including HIV2) by 6 weeks.

Since you mentioned that 'usually including Hiv 2' in the third question, when can we consider Hiv 2 testing to be conclusive? Is my 60 day's result beyond that window/can be considered final?

Thank you for your response and clarifying my doubts so elaborately!