The exposure dsecribed was very safe in regard both to HIV and other STIs -- congratulations on a wise approach to such an encounter. And your symptoms really don't concern me. Minor sore throat occurs all the time in entirely healthy people, and in any case it was too late to be very suspicious for HIV:  the symptoms of initial HIV infection (acute retrovirual syndrome, or ARS) ueuallly start within 2 weeks of exposure; and almost always there are multiple symptoms in addition to sore throat. As for the burning sensation in your toes, I imagine you have found an online source that speaks of neuropathy as an HIV/AIDS symptom -- but that's almost entirely a symptom of advanced HIV infection months or years in duration, and always in association with multiple other health problems. Finally, neither of these symptoms suggests an other STI either.

From a strictly medical standpoint, you don't need testing for HIV or anything else. If somehow I were in uour situation, I certainly would not be tested and would continue unprotected sex with my wife without worry that I might infect her with anything. On the other hand, many or most follks who sseek this sort of advice are likely to be more reassured by negative test results htan by professional opinion, no matter how expert. If that describes you, then by all means get tested for reassurance. You could have a valid urine test and throat swab for gonorrhea and chlamydia at any time; and 100% conclusive tests for HIV and syphilis 6 weeks after the event. (For HIV, make sure it's an antigen-antibody (AgAb, "duo", "4th generation") blood test; (You could be tested for HIV earlier, e.g. now i.e. about 1 month: the negative result would be highly reassuring, but only about 98-99% conclusive.)

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

HHH, MD

1) I am considering starting PrEP as an additional protective measure, but would please like to know how long (in days) it takes to develop 99% protection? Is it true that it takes 7 days for full protection and 20 days to reach the anal tissue(s)?

2) If I am fully protected on PrEP and catch HIV due to unprotected sex - how long does HIV live in the body before the immune system kills it? And during this period, can I pass the infection on to others?

3) If I miss a dose of PrEP, do I double-dose the next day?

4) If I am on PrEP and want to stop to take a break, do I just pause immediately or keep on taking it for a while longer in case I may have HIV in my body? How long after potential infection/unsuspecting exposure should I keep on taking it? Can you please explain how to correctly take breaks on PrEP?

Sorry for the many Qs -- I am very interested in bettering my knowledge and understanding of safer sex and appreciate your help. I have an additional two Qs remaining after this post on another subject and that would be it for this thread. Many thanks.

1) Assuming your future exposures are reliatively infrequent and of similar risk as the description above, I would recommend against PrEP. If you do it, look into PrEP on demand, which requires only 3 doses of anti-HIV drug starting a few hours before exposure -- i.e. no need for ongoing daily treatment.

2) Very complex -- anywhere from several weeks to several years.

3) Not if you use PrEP on demand.

4) Also not an issue with PrEP on demand.

1) What is the risk level for unprotected frottage between two males?

2) Is it rare to have HIV and be asymptomatic?

3) In terms of the mechanics of infection: Do STIs and HIV infect the host when bodily fluids get into the urethra, or should there be cuts/injuries/lesions on the penis that directly lead to the bloodstream?

Thanks again for your time, patience and efforts. All my best.

2) No, very common -- at least in the first few years after becoming infected.

3) Direct bloodstream access is not required. Inflammation caused by STIs is sufficient to elevate the risk. However, the sort of exposure described above carries little or no risk of HIV even in the presence of other STIs.

That concludes this thread. I hope the discussion has been helpful.