I did not have any sex for 4 months. I met a girl on a sugar dating site 09/01. We dated for the next two weeks and we went in for complete STD testing on 09/15. We both came back negative on HIV. We then had our first and only unprotected sex on 09/28. 

I asked the girl twice and she has said that she has not had any sex from August until our first sexual encounter. She is sexually adventurous. I trust her, but being afraid, my mind tells me one never knows.

I had a painful bump under my left armpit on 10/03. I went to urgent care center, diagnosed as furuncle, prescribed Augmentin (875 amoxicillin 125 clavulanic acid) twice a day.  Started the medication on the evening of 10/05. Noticed my gums being extremely sensitive and painful to brushing the evening of 10/06. I stopped brushing. Noticed subtle bleeding in my gums on 10/08. If I put a tissue on my gums for a few seconds, I see subtle red spots. So they stopped the medication, prescribed me another antibiotic. Stopped taking medication evening of 10/08. Its 10/09 morning and my gums still bleeding. My tonsils are swollen/painful, but that happens often as I get nasal allergies/drip and swallowing that I believe causes it. I do not seem to have any other ARS symptoms at the moment.

Are my symptoms, 10 days after sex, related to ARS at all? Do amoxycillin and clavulanic acid, may cause bleeding gums individually or as a combination medication in Augumentin? Some internet websites state that both components in Augumentin may cause gums to bleed.

I/We tried to do everything right. Shall I we go for the RNA test? I am afraid for RNA as I have heard that it may give false positive. Would it be better if I go for RNA and HIV combo test for peace of mind? If yes, when? I would ask her if she may come too, but don’t know if she would.

I talked to the girl about this and she vehemently denied having had sex since July. My gums are actually bleeding more after I brush my teeth. I see blood after I spit the toothpaste. As mentioned earlier, this started when I took Augmentin. But I have stopped taking the medication since 2 full days now and still the bleeding gums issue would not resolve. My gums never bled like they are now. So my worry is this may only be happening either due to Augmentin or ARS. What else could it be?

Q1] Do you think the components in Augmentin may be causing this? As I said, some websites make a mention of that. If it may be because of that, how long it may take to resolve itself?

This is freaking me out. I have read that gum issues start late into HIV infection.

Q2] You say bleeding gums is not typical of ARS, but does it happen at all, though atypical? Does ARS start just 10 days after exposure (today is day 12)?

Q3] I do not yet have any other symptoms. Just swollen and painful tonsils that I get often. But could it be related to ARS this time around?

Q4] I was thinking of doing a duo test after 3 weeks since it is more accurate then. I have read it is conclusive at 6 weeks. But given everything that is going on, would you recommend I do a duo test right away?

Since this is not a normal dating/relationship, I don’t want to ask the girl if she would come with me for testing. I would go do it myself if and when needed.

I really appreciate your help in navigating this tough situation. I would be grateful if you may address my four questions above.

Hello Dr. Hook,

From the bottom of my heart, thanks for your advice. I still have a couple of questions for you and I would be grateful for your advice.

 So I think the gum bleeding issue I was harping on, must have been thrush after all. I get white/creamy coating on my tongue and the bleeding is not around teeth but on the soft tissues below the gums. This is resolving by itself now. I noticed the bleeding on day 10 and white/creamy layer on my tongue on day 15 after the exposure.

 Q1] I am hoping this might have happened as a result of the strong antibiotic I took for 2 and a half days and not ARS? And if it was the tests I describe below might have caught it?

 I went in and did HIV RNA and IV generation combo test 12 days and 18 hours after exposure at quest diagnostics and both came back -ve. I know everywhere it’s said that the gold standard for conclusive result is after 6 weeks on a combo test. However, I am anxious and would be grateful to know your opinion on how good an indication these test results are on my status regarding HIV. Dr. Handsfield seem to suggest that the RNA test by itself may be a pretty good indication, albeit more than 5 years ago on a post below:

 https://www.medhelp.org/posts/HIV---Prevention/RNA-and-oraquick-swab-test-/show/1891685?li_source=LI&li_medium=default-widget-bot

 Q2] Is that advice still valid or not anymore as I understand things change with more information becoming available in the following years? I would still do the 6 week combo test if you recommend. I might even do one combo test at 4 weeks.

 I do not seem to have any other symptoms at the moment. I am in a sugar dating relationship for the first time, and I think in addition to everything, I am experiencing guilt for some reason of having unprotected sex. On second thoughts, I am not sure how trustworthy these relationships may be. I hope it is just that and nothing serious. Hopefully this would be the last and I would not have to come here again for this episode. I also know that I am not allowed any further follow-ups.