Dear Doctors,

I am posting this on behalf of a friend for language reasons. Please ignore my previous post.

Following an episode of unprotected vaginal intercourse as the insertive partner, I started to 

experience the following:

5 days later I started getting sick, first a mild chest infection, I could feel the mucus in my chest, got worse after 2 days and still have it after more than 2 weeks now. Been coughing a lot also for around 15 days but most of the time I cough, I feel I am clearing the mucus so probably not a dry cough. Also for the last 2 weeks, have had several episodes of headaches and aching eyes, and a few times burning eyes. Overall it seems like a very mild flu. During this time my body temp never went over 37.2 (99 Fahrenheit).

One night I noticed 3 pimples very close to my armpit, all within a 3-4 cm radius. Never had them 

show in the same area at the same time before. Yesterday I also noticed that a large area of my tongue had a different, a beige-ish color. Upon brushing my tongue, it completely came off. Also yesterday, in my left armpit, I had a rash, looked like a cluster of 4 very small spots, and the area around them very red and painful. I applied Bepanthene , and after 12 hours, it seems to be disappearing. However, I believe now I might be getting another one in my other armpit. It started hurting but not yet visible.

I know you cannot diagnose hiv by symptoms but could you kindly answer the following;

1 – Do any of these symptoms seem consistent with hiv? Or can any of these be safely disregarded as being related to hiv?

2 – Do we have enough data as to how soon after the first symptoms show, an ab/ag test turns 

positive? If these were indeed hiv related symptoms, and I have had them for 2 weeks, how reliable a 4th gen test would be at this point? (21 days after the exposure)

Best regards

1) Neither HIV nor any other STD causes symptoms like these. It sounds like you caught a cold -- perhaps from your partner (close enough for sex obviously is high risk for colds, influenza, etc if a partner is infected). But in any case, not HIV or any other STD. Same for pimples in the armpit and rash. An antiseptic cream like bepanthene cannot clear any infection in 12 hours; the quick response means the skin problem was an irritation, allergy, or something other than an infection.

2) Yes, we have plenty of data on this. If symptoms are due to HIV, the AgAb test is always positive within a week or so. A negative test at this point really isn't necessary, based on the exposure or symptoms, but a negative result would prove that your symptoms are not due to HIV. And as I said, they don't sound at all like HIV/ARS symptoms anyway.

Having had unprotected sex with a partner you don't know well, I would suggest you have a urine test for gonorrhea and chlamydia, and after 6 weeks, a blood test for syphilis; in addition to a final AgAb HIV test. Or in the absence of symptoms that suggest STDs or HIV, perhaps stop worrying about individual exposures and just getting periodic STD/HIV testing, e.g. once a year.

I hope these comments are helpful. Let me know if anything isn't clear. But also please don't get in the habit of asking about STD/HIV risks and testing after every new sexual exposure. You should know enough now to make your own decisions about whether and when to be tested.

HHH, MD