Dear Doctor. I had sex with a "sugar babe" about 8 weeks ago. Based on what she told me, she is effectively an escort (somewhat exclusive but not high priced). The condom came off towards the end of the vaginal intercourse, which had lasted a long time. I do not know for certain how long the condom was not covering my penis. Maybe a few seconds; maybe a couple of minutes. I do remember thinking that it felt different and then looking and finding that I was no longer wearing the condom... She said she is tested at least every year (but not for some months at the time) and has never had any STIs... I thought nothing of the incident and I figured the risk was very low. I am also tested every year and haven't had any STIs... About 8 weeks later I developed the following symptoms: Fever, night sweats, sore throat (no cough, no phlegm), ulcers in mouth, nausea, and headache. No rash though. Very mild joint pain. It isn't the worst sickness and all the symptoms didn't start at once. I didn't measure the fever at its peak but it certainly wasn't very high. I was sweating a lot during the day while just sitting. The symptoms are mostly gone after 5 days. Mouth ulcers and mild fever remain (just measured at 99 under the tongue). From what I've read on here, I'm guessing you'll say the risk of hiv infection from one exposure is very low (and she probably doesn't have HIV). And that my symptoms started too late, are too mild and didn't last long enough to be ARS. However, I've been in isolation for the last 6 weeks with my wife and kids. They haven't been sick and aside from trips to the supermarket, I've had no contact with anyone outside my family. I'm struggling to see how this could be the flu or some other garden variety virus. Do my symptoms fit ARS? How significant is my risk? I live in New Zealand. HIV rate here is extremely low among women from what I understand, although the lady in question does use drugs like weed and mushrooms. Doesn't inject drugs as far as I know.

Welcome to our forum and thanks for your question. Thanks as well for your confidence in our service. I appreciate your detailed description of the events and your recent illness. In reading your post, I found myself thinking that this client has answered his own question and it is my job to validate his thinking.  To summarize the facts:---

I've ordered an OraQuick oral antibody test from the local Aids Foundation. It should arrive in a few days. I've read these tests are good but have a higher false negative rate than blood tests. What do you think of the test? With the covid-19 rules, I'm trying to avoid going to a doctor's clinic for a blood test. 

The OraQuick test for HIV on oral fluid is an antibody only test which is slightly less sensitive than standard blood tests.  By the time you get the test it will be more than 9 weeks after your low risk encounter and will provide useful information.  If your continuing symptoms were due to HIV, which I am confident they are not, the test will be positive. 

As I explained earlier,  this is really too late to be ARS.  The figure regarding persons who would develop ARS by now is not 99% but virtually 100%.  Further, I will add that in research studies in which at risk persons with flu-like ARS symptoms were evaluated, only 1% of them turned out to have HIV.  The remainder had other causes such as community acquired, non-STI viral illnesses.  Thus, yes, I agree, you are focused too much on symptoms. 

I hope my comments are helpful.  I anticipate that your test will be negative.  When it is, it is my hope that combined with the facts I have provided above, you will be able to put your fears aside and move forward.  EWH

---