I know I was here a few months ago over a risk and I’m back again. I’m recently single this month and I went on a bit of a bender to compensate I suppose. In the last month, I’ve had two encounters with massage CSWs in which only a hand job was performed or condom protected oral sex  with me on the receiving end. On other occasions I’ve had condom protected intercourse with two different woman I met at the bar. They were all around the same age as me, between 25-30 years old and normal regular woman as far as I know. But a condom was used.

On one occasion though I met and had unprotected intercourse with a 30 year old school teacher who was recently out of a relationship herself at a bar after a night of drinking. She told me that night she didn’t have anything as I was the first person she has had intercourse with in a long time after being in a relationship and insisted we could continue intercourse even though I didn’t have a condom and was hesitant without one. My intoxicated state flared my judgment.

My issues though are now approximately 16 days post that incident, I have a bad cough that’s producing clear phlegm at the moment with a sore throat, larynx pain and a raspy voice and chest congestion. No fever at the moment and negative for Covid-19 and vaccinated. I’m concerned this could be the ARS. But I was told by urgent care there is a cold going around.

1.) Would you quantify my risk high with these symptoms?

2.) Should I go ahead and test again for these incidents? I’m trying to chill out a little with the drinking and slow it down. 

Thank you again for your help and have a great weekend.

The most recent event, even though it was unprotected intercourse, was obviously little or no risk for HIV, for the reasons you state yourself.

Most important, your symptoms are not at all suggestive of ARS, which does not cause cough, chest congestion, or sputum (phlegm) production. I'm glad to hear you tested negative for COVID-19; that would have been my biggest concern. But for sure this isn't ARS.

1) Zero risk, based both on the exposure and your symptoms. You caught a cold.

2) From a strictly medical or risk perspective, there is no need for HIV testing. But if you remain concerned, by far the best approach is to talk with your partner and ask her to be tested (and maybe pay for it!). If negative, of course you could not have been exposed. If you cannot contact her or she declines testing, you still don't need testing -- and if somehow I were in your situation, I wouldn't be tested. However, many or most anxious persons are more reassured by negative test results than by professional opinion, no matter how expert. (We don't take it personally!) If that applies to you, and if your partner isn't tested, by all means feel free to do it. If you do so, you definitely can expect a negative result.

Your follow-up question doesn't change my opinion or advice. These are not likely symptoms of ARS.

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

HHH, MD

You’re right my anxiety is getting the best of me. I’m 26 years old, I can’t be scared of this everytime I go out and live my life like we’re supposed to. I suppose I just read too much and see the stories on the internet of what people claim happen to them. I’m sure most normal people my age don’t have these fears.

Everything was clear from what you said. I can’t get her to test but I did reach out to her and she came back to me with a “I was recently out of a 10 year relationship prior to us hooking up. I’m clean as a whistle.” So obviously I hope she’s not lying but still.

And sure, I have a sore throat that’s being caused from a post nasal drip and a small oral ulcer on tonsil/roof of back of throat. I woke up yesterday feeling better. Today though I woke up feeling as if I took a step back and everything is breaking up as I do in fact have a good cough that’s breaking up green phlegm occasionally in the morning and late at night and now feel congestion in my left nostril building with pressure. So I have a cold. 

I appreciate your help and all you do. I will avoid these repeated anxiety driven questions. Please be well.