[Question #2487] ARS question / final 4th gen ab/ag test

44 months ago
Hello Doctors, 

I asked a question last weekend and it was well answered. However I wanted to ask a question about ARS. 

About two months ago I was prescribed Ativan after I had quit smoking marijuana and had some bad withdrawal symptoms that caused anxiety (never had it before). 

4 weeks ago I had a very low risk encounter (received ora sex from an upscale TS escort).

14 days after the encounter, I did an HIV RNA test and it came back negative. 

I was finally reassured that everything was fine until I started getting a sore throat after 24 days and I started reading online about ARS symptoms (I asked Dr. hook and he said it was unrelated to my fears since my encounter was close to no risk and the HIV RNA test was negative -non reactive-).

I was smoking cigarettes for the first time in years due to my excessive stress and the sore throat started in my sinus behind my nose and slowly (2 days) made its way in my neck. It was hard to swallow for a day and I had mildly swollen lymph nodes right under my jaw for one day as well. I also had a runny nose for a day or 2 and it all started getting better after. I did not have any body pain, rashes, vomit nor diarrhea. 

The problem is that most online resource are very vague and from what they write, it seems that ARS symptoms could be just like a cold/sore throat.

Can you please shed some light on what generally happens? Is is possible to have an acute HIV infection that manifests as just a sore throat like the one I described?

What's keeping me somewhat calm is the fact that two of my colleagues at work also had a sore throat so it may just be a summer cold.

Also, The reason why I am writing again and asking another question is because 2 weeks ago I had already ordered online another 4th gen ab/ag test (I know it may be redundant) and it has been waiting for me at the clinic. It's now been  30 days since the encounter. When would you suggest I do this final and conclusive test for my peace of mind?

Thanks in advance for your help. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome back. But sorry you find it necessary after the reasoned, science based reassurance you had from Dr. Hook.

You symptoms do not even hint at ARS. They are, however, typical for both the effects of smoking and of a garden variety minor viral respiratory infection. They also are almost certainly being magnified by your anxieties over a regretted sexual decision and your fear of HIV. While I am not a believer in anxiety creating symptoms out of the blue, for sure anxiety can magnify minor symptoms and normal body sensations that otherwise would be ignored or not even noticed. As for "what generally happens" in ARS, I would encourage you to google "ARS symptoms" (spell it out). However, my stronger advice is to stop search the web or this forum for any more information about it. Like most anxious persons, you are already being seduced by posts and statements that reinforce your fears and missing the ones that would be reassuring with any objective review.

Your planned 4th generation test will be virtually conclusive at this time; around 98% of newly infected people have positve results by 30 days. If you feel compelled to have a final test at a truly conclusive time, do it again 6 weeks or more after the event.

Really, mellow out. You are seriously overreacting. From a medical/risk standpoint, you didn't need HIV testing at all. Whatever additional tests you do will remain negative.

Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV or other STDs will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand. 

I hope these additional comments are helpful.