[Question #5769] General symptoms

20 months ago
Hello Dr Handsfield,

I was hoping to get some knowledge and clarification on a few things.  Mainly if flu symptoms could be a sign of HIV exposure or I guess it would be called ARS?

The symptoms were fever and a chest infection. So no sore throat but a cough and mucus build up in the chest. Symptoms were 98% cleared up by 1 week except still a small cough that happens only rarely but has persisted in the couple weeks since being better. The symptoms started pretty much exactly 6 weeks from exposure.  

The other part which I know is that the exposure is a low or maybe no risk exposure. Heterosexual one night thing but without sex. Only hand and male to female oral.  I of course can't be positive that penis wasn't around and in contact with wet outside of vagina.. but no sex. 

The last part is that blood work just from regular yearly was done and HIV was negative then.. but that would have only been maybe 10 days post that exposure. Given I read these forums I considered that a clear from any other past exposures and the one in question a no risk so I have since continued normal sexual life.  I'm just worried now if your recommendation is I should go get tested again for blood work? Or any test for other STI which would not have been done since that exposure? 

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Welcome back to the forum, but sorry you found it necessary.

As already discussed with Dr. Hook, there is no realistic chance you caught HIV during the exposure on your mind, for the reasons you learned from Dr. Hook (and correcly summarize here).

Second, you're misinterpreting advice about "flu like" symptoms. It's actually not a very accurate term, because physicians and other experts use it only for the systemic symptoms of inluenza, like fever, headache, muscle aches, and chills. These can occur with ARS (although of all people with such symptoms, under 1 in thousands has ARS) -- they're called "flu like" because most cases occur in people with--   ta-daaa  --- flu (or colds). In any case, ARS does not cause cough, nasal congestion, and mucus from the chest. Also, 6 weeks is too late:  ARS symptoms start 1-2 weeks after exposure.

You do not need HIV testing. Do your best to stop worrying about this.

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

HHH, MD
---
---
20 months ago
That was clear Doc, Thank you!

I did want to get some clarification for future reference on the real risks for STI's from oral activity both ways as the information you get from some doctors these days seems to play up the risk much more than years ago? And if you would recommend testing without symptoms after an oral exposure? I was also a little unclear from my question to Dr Hook on what effect the 10 day(two 100 mg pills/day) of Doxy would have had on any possible exposure to Syphilis, clymadia, gonhorrea etc?  If I remember right I had been 2 days taking prior to exposure and then 8 days after.. 

Thanks again
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
I agree there has been more media attention recently to STI risk from oral sex, and some legitimate debate among experts (e.g. about chlamydia risk). But it remains a fact that for all STIs the risk from oral sex is much lower than vaginal or anal, and the risk is zero for all practical purposes for some, including HIV.

Being on doxycycline is 100% protective against syphilis and chlamydia, and probably nearly so for nonchlamydial NGU. Protection from gonorrhea probably is good most of the time, but would vary widely depending on local prevalence of doxycyclien resistance. Exact duration of protection unknown, but probably good at the doses and times you describe.
---
20 months ago
Thanks Doc.  That is all good to know. 

Last question for general knowledge. What are the current statistics around HIV contraction from a one time unprotected heterosexual encounter in North America? From the guys perspective that is.  And I think i've read that duration would play a role there(so only being inside for 10 seconds or something), is this true?

Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
An anlysis by CDC several years ago estimated the average risk for the male partner for a single episode of unprotected vaginal intercourse with an HIV infected (and untreated) parter was 1 chance in 2,500. I stress average -- it's zero in some situations (infected partners with low viral loads), higher in recently infected persons and those with high viral loads. Logically the risk would be lower with only a brief exposure, but there are no data.

That completes this thread. I hope the discussion has been helpful.
---