[Question #2518] Anxiety. ARS question.

43 months ago
Hello Dr. HHH.
A few days ago I made the exercise of assessing any risk behavior by my part. I always, always play safe. 
However, I recalled one particular experience exactly 4 years ago (King County, Latin) in which during a drunk night I had sex with other man, me bottoming. 
Being drunk is playing with my mind here. I totally recall asked him to go for a condom, he going to the car and getting it and coming back. When I woke up I remember seeing part of the opened envelope in my bedroom and throwing it away. Asked him later if he used a condom, said yes 2 times.
29 days later I got sick, low fever, muscle pain, lack of appetite (I can't remember if respiratory symptoms). This lasted only around 36-48 hours. Is the timing and duration consistent with ARS. Too late, too short maybe? 4 years later I have never got sick (maybe 1 or 2 colds a year). I'm also worried because this was end of July, could I really have caught a flu or cold in that time?
I think I'm just paranoic from reading things, and I'm scared as hell to take a test, I have visualized myself getting a positive and I can't even sleep or think of anything else.
43 months ago
I also want to add, I never thought of this one of being a risk situation. It just came to my mind after reading about ARS and remembering getting sick after that experience. I know symptoms are no way to diagnose, but in my case, I was pretty sure I did things right. It is the timing of the flu like thing that made me worry. Also, nothing really bad, no rash, could go to work those 2 days, had energy to walk to pharmacy and buy some ovc flu/cold meds. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Welcome to the forum Thanks for your question.

It is unlikely you have HIV, but you owe it to yourself to be tested to know for sure. More about that below.  As for the exposure and your symptoms:  First, even in the highest risk scenarios, HIV transmission is uncommon. For example, being on the receiving end of unprotected sex with a known infected partner, with ejaculation in the rectum, an average of only 1 in 100 events results in actual transmission of HIV. In this case, a condom probably was used, so the risk is markedly lower than that. And you don't know your partner had HIV; if he said he did not, probably it was truthful:  most people don't lie about it when asked directly. As for your symptoms, some aspects could go along with ARS, but as you suggest yourself, they started too late and cleared up too soon. Onset is always 10-20 days and duration typically at least a couple of weeks. Finally, the notion that colds or influenza are rare in the summer is just plain wrong:  they are somewhat less frequent than in wintertime, but not all that much.

You must be tested, and I have no patience with not doing it because of fear of the result. It isn't the test that makes someone infected; you have it or you don't. Probably you don't, but if you do, you have to know, both to protect partners going forward and to get life extending treatment. Also, research and day to day experience show that when people are worried about testing and finally do it, anxiety and stress always decline, even with a positive result. In other words, knowing for sure is less stressful than the pre-test uncertainty. (The same applies to all testing for potentially serious conditions, e.g. mammography for women with breast lumps, colonoscopy for those at risk for colon cancer, etc.)

So just do it. Assuming no exposures more risky than the one described above, you can be confident in a negative result. I'll be happy to comment further after you post a follow-up comment with your test result. OK? In the meantime, I hope this information has been helfpul.

HHH, MD
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43 months ago
Thanks, I'll post again when done.
Just to clarify I didn't ask if he was neg, I asked if he used a condom he said yes and that is consistent with what I remember. I know this doesn't change any of your comments.
Only one question remained unanswered: Is 36-48 hours too short for ARS.
Thanks so much for your answer. Those are some peaceful yet objective words.
43 months ago
Sorry doctor, didn't read the too soon part. Thanks!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Glad to have been of help and looking forward to hearing about your negative test result. Please do it fairly soon:  threads are closed automatically if no activity after 4 weeks.

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