[Question #1601] Potential HIV exposure, all ars symptoms. Very scared. Toronto
94 months ago
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Edward W. Hook M.D.
94 months ago
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Welcome to our forum. I will try to help. From your description there was no meaningful risk for HIV from this encounter. First, most commercial sex workers do not have HIV or other STIs. Further, in the case of the exposure that you describe, there was no unprotected penetrative sex. The sort of rubbing you describe (frottage) is a form of masturbation with no risk for HIV. Similarly, condom protected sex is a virtually no risk event. When condoms come off as a man is withdrawing form a sex partner, they have done their job and protected for HIV and other STIs.
At the same time however, the flu-like illness you describe is consistent with the symptoms of the ARS (Acute Retroviral Syndrome) and occurred at a time after your exposure when it might occur. While I remain confident that if your activities were as you described, you did not get HIV however, at this time my recommendation would be to go and get a 4th generation, combination HIV antigen/antibody test to prove that your symptoms were not due to HIV but were a badly timed, coincidental, non-HIV viral infection of the sort that most people get every once in a while. If your symptoms were due to HIV, the 4th generation test will be positive at this time.
I should also point out that when at risk persons (you were not) have flu-like illnesses, over 98% of them do not have HIV but have other illnesses (non-STI). I point this out to indicate just how low the odds of infection are for you. Testing will provide you with peace of mind. when your test in negative, be confident that you did not get HIV from the encounter with the CSW yu have mentioned. I hope these comments are helpful. Please let us know the results of your test. EWH
94 months ago
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Edward W. Hook M.D.
94 months ago
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I was not aware that Canada had not adopted use of 4th generation, antigen/antibody tests and would urge you to verify this. The rest of the world has shifted to these tests, from the U.S. to most developing nations. Even if the tests available to you are antibody only tests, you will get much useful information by testing at this time, more than 4 weeks since your possible (unlikely) exposure since over 90% of persons will have reactive antibody tests at this time and the proportion would be expected to b e higher still if your symptoms were due to the ARS.
As far as whether your symptoms match the ARS or not, they certainly do not match perfectly. As you point out, cough, nasal congestion, and sputum production are NOT part of the ARS. On the other hand, the other flu-like symptoms you report - sore throat, fever or feverishness, transient rash and severe muscle aches are often seen in the ARS and they do tend to overlap in terms of when they appear (i.e. they do not occur sequentially over time).
Perhaps I over interpreted the level of concern that led to your questions. As I said above, when all is considered, it is quite unlikely that your symptoms are due to HIV (and even less likely to be acute hepatitis B or herpes) but I also thought (perhaps reading between the lines) that you were concerned. If this is the case, a negative HIV blood test would be strong evidence that your recent flu-like illness not HIV or related to the exposure that you describe and would allow you to confidently move forward without concern. I hope that this rationale makes sense. I am trying to address what I perceived to be your concerns. EWH