[Question #8128] HIV ARS Concern
48 months ago
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Hi Doctors. Thanks for taking the time to review my concern.
7.5 weeks ago I had protected vaginal sex with a CSW in Bogota, Colombia. During the act I lost my erection and went completely flaccid. The lady was on top at this time but continued “riding” to try and reinvigorate my member. After a few minutes of this I was concerned about the fit of the condom as I was completely and did not want the condom to come off or the ring be loose enough to allow fluids to enter etc. When she got off, the condom had moved (bunched up) near the glans of my penis but was still indeed on my penis. A few weeks later I then became concerned about this incident and waited with horrible anxiety for time to pass before being tested. I have hsv2 and have taken daily acyclovir for 2 years to prevent outbreaks and to the best of my knowledge and inspection have never had another outbreak except for the initial episode. I took a 4th gen duo p24/ab/ag test at exactly 6 weeks from the date of the concerned exposure and voila, it was negative. But this past weekend (7 weeks post risky exposure) I came down with a high fever and mild sore throat and mild muscle aches. This has alleviated in 72hours but has me extremely worried because of the association with ARS. I contacted the agency of the lady I used and expressed my concerns and they say they are sending her to be tested to alleviate my worries. I would appreciate your thoughts. Thank you.
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Edward W. Hook M.D.
48 months ago
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Welcome to our Forum and thanks for your question. I happened to log on soon after your question was posted and thus you are getting a reply somewhat sooner than is typical. If there are follow-ups to this reply, they may take a while longer to get to you.
Short answer. you are in the clear and can be confident that you did not acquire HIV from the exposure you describe and that your current symptoms are not due to HIV. First, as long as the condom was worn throughout the encounter and covered the tip of your penis, the fact that it slid down does not impair its function. If your partner was infected with HIV and statistically she was unlikely to be infected, contact of infected genital secretions with the skin of your penis does not put you at risk for HIV. That you have genital herpes does not change this. Thus you were condom protected. finally, your 6 week test result provides conclusive evidence that you did not acquire HIV from the encounter you describe. All test results more than six week after an exposure are entirely conclusive.
The onset of your flu-like symptoms is too late to be the ARS which typically occurs 2-3 weeks after exposure. OTOH, they could be due to COVID-19 or influenza. I suggest you get tested for COVID and perhaps flu.
I hope this information is helpful. If there are further questions or any part of this response is unclear, please feel free to use your up to two follow-ups for clarification. EWH
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