[Question #4934] Risk assessment

26 months ago
Hi Doctors, 

First can I say what I wonderful service you provide, it's helped me out for answers in the past and I'm annoyed at myself for having to come back. 

I had been seeing a girl (we're both from the UK) this January  and about 10 days ago our condom broke whilst having sex.  We didn't realise for some time and then continued on (stupidly)  as we were sort of caught in the moment.  Obviously before continuing I asked her had she been tested and she said quite recently at the start of December and all came back fine. 

So with that reassurance in mind we ended up having unprotected sex one more time, as my own status has also been checked about a year ago with a strictly monogomous relationship in between. I did press her again on the issue and checked has she been with anyone since and again she said no - but obviously I can't be 100% sure - not everyone would say if they'd had recent partners.  In fact asking about it has sort of put her off me as she messaged me saying that she doesn't lie about that stuff but that I over asked about it. She also said that she had worked in West Africa and had received a biting incident whilst working in education but that had also been checked since - about a year ago. 

Obviously I didn't know her for that long, as this was our 4th date and there will be no more.  Despite this I've now got a sore throat, which burns and have some (about 5-6) red raised spots on my abs/chest cavity - obviously reading about the early symptoms of HIV on the NHS website has spooked me as well.  I have no other symptoms spare for some dry/abrasians/red mark on my penis which I put down do friction from the sex. 

Not sure what my next course of action should be here. I didn't think it meritted PEP the day after and it's too late now anyway. 


Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Welcome to the Forum and thanks for your confidence in our service.  I'll try to help.  The exposure that you describe was low risk- you both report hat you were checked relatively recently and most people, even most people who have NOT been checked do not have HIV or other STIs.  In general I agree with your partner and understand how repeatedly asking questions regarding having been checked for STIs and recent partners would be off putting.  If she was willing to discuss this, there should be little need (or benefit) from further questions.

I can however also understand how your sore throat and possible rash might concern you under the circumstance.  Your symptoms however represent only part of the symptoms which would be expected if you had recently acquired HIV.  Typically the signs of recently acquired HIV (the so-called ARS) include not only a sore throat and sometimes a rash but also high fever and severe muscle and joint aches, neither of which you report.  Thus I find it unlikely that your symptoms related to recent STI.  I nonetheless understand that you may want to be checked.   The symptoms I mentioned above occur when persons have VERY high circulating levels of the HIV virus.  Thus, if you had acquired HIV and your symptoms were due to HIV, a HIV RNA PCR test would be positive at this time, as probably would be a 4th generation, combination HIV antigen/antibody test. 

If you choose to get tested, I would also advise a urine test for gonorrhea and chlamydia which, although also unlikely, are far more likely than HIV.

I hope this information is helpful.  I doubt that you have any STI, including HIV from the encounters you have described.  EWH 
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26 months ago
Hi Doctor Hook,

Thanks for your prompt reply.

Would the low number of these tiny red bumps be reassuring?  Obviously it's hard to tell, if you look hard enough around the body, what counts as a "red dot" could be a heat spot? I read that it's a whole body thing if/when it happens and would be quite obvious? 

Also is any of this at the 9-10  day mark concerning?  

The sore throat isn't particularly bad either, just a slight burning sensation - again I've read that you'd have all these symptoms together and that the sore throat would be very bad. Temparture as of a few minutes ago was 37.3 C?

Again, she was willing to discuss this and was open and happy about being tested in December, she said they tested for everything and all was negative. 

Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
The rash associated with the ARS is typically generalized.

The 9-10 day time is typical timing of the ARS but my suspicion is that it is coincidental.

Your temperature is in the normal range and you are correct, the sore throat of the ARS is typically severe.

I think you are overly concerned.  EWH

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