[Question #3888] hiv assesment

32 months ago
hello doctors, about 16-18 days ago was the last time i had unprotected sex with my ex girlfriend of almost a year. during that year we had unprotected sex almost on a daily basis probably 3-4 times a week. I never worried about stds or hiv while i was with her. i know that before me she had 5 boyfriends of which she has told me so i assume that before me she had unprotected sex with 5 other men one of which was a month before she met me. about a week ago on around day 9 postsex i developed a slight discomfort in my throat and some heavy congestions and nasal drip, i still have the discomfort in my throat at times when i pass saliva so i went to the doctor yesterday she gave me some anti flu pills and said it seemed like it was something viral and my throat was red and irritated, as of this morning i cant feel the discomfort in my throat but it comes and goes.  could this be ars? i have not had fever just a drenching night sweat one day but i uncovered myself from the heavy blanket and it stopped. i have not had a rash or swollen nodes no fever. im worried maybe she cheated on me before this last time we had sex and i am going through ars at this point. what are my odds of contracting hiv from a partner like this? we are from the U.S and are both of hispanic background. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome to the forum. Thanks for your question.

HIV is extremely rare in women with your ex-GF's sexual lifestyle. If she is likely to be an injection drug users, or to have had frequent sex with IDUs or gay/bisexual men, she could be at risk for HIV. Otherwise, it is exceedingly unlikely. Also, when a woman has HIV, the average risk of transmission to a male partner is around once for every 2,500 episodes of unprotected vaginal sex. (That's why many spouses of HIV infected persons never catch it -- which maybe you didn't know.) So even if your ex-GF in fact had HIV, the odds still are very high that you did not catch it. However, the risks of other STDs are higher, and you should consider testing for gonorrhea, chlamydia, and syphilis.

As for your symptoms, they are not alarming. I cannot say with 100% that you don't have ARS, but it is extremely unlikely. Even with symptoms typical for ARS, usually something else is the cause. In particular, standard respiratory viral infections, are far more likely with symptoms like yours. Also, ARS doesn't cause nasal congestion or drip. (Influenza also is unlikely in absence of fever.)

Should you be tested for HIV? The conservative approach says yes:  in today's world, anyone having non-monogamous sex with unexplained symptoms should be tested. In addition, since it's on your mind, you should consider testing strictly for reassurance:  most anxious people are more reassured by negative test results than by an expert's opinion based on probability and statistics. Also, all people who are sexually active outside mutually committed monogamous relationships should be tested for HIV from time to time, such as once a year, so maybe this is a good time, while it's on your mind. 

Don't get me wrong:  the chance you have HIV or that your symptoms are ARS are almost zero, and on this basis testing really isn't necessary. But the simple fact that your worried about it is a good reason to be tested for reassurance, along with syphilis, gonorrhea and chlamydia testing as well. 

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

HHH, MD

---
32 months ago
I have one more questio Dr.Hansfield, about one or two days after we had sex, i remember that day our sex was a bit forced and somewhat not well lubricated, i developed some redness, chafing and itchyness on the head of my penis it lasted about a week then stopped. Its happened before whenever we have dry sexual intercourse. Is this some sort of yeast infection?
32 months ago
And my final question is, i have heard that ars symptoms don't come alone that I would not have just sore throat but also fever or swollen lymph nodes as well. How true is this? Because as of now all i have is some slight discomfort in my mid section of my throat when i pass saliva and some nasal congestion nothing else what so ever
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
The penile problem sounds like simple physical irritation from vigorous sex.

There is a very wide spectrum of symptoms with ARS. Half of all newly infected people have no symptoms at all, and mild forms of ARS may have some but not all symptoms. As explained above, it is exceedingly unlikely you have ARS. The most important part of your symptoms is that nasal congestion doesn't fit with ARS. Presence or absence of fever and rash doesn't mean anything one way or the other.
---
32 months ago
I dont know if this can be answered but all in all what would you put my odds having hiv at?
32 months ago
Can i expect negative results?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
The chance you have HIV is under one in several million. All my comments make it crystal clear that you can expect negative test results.

You're reacting emotionally and not thinking objectively. Really:  mellow out, re-read all my comments with care, and go on with your life without worry, whether or not you choose to be tested.

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