[Question #8478] HIV RISK? ARS SYMPTOMS?
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43 months ago
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Hello doctor, firstly Merry Christmas to you and your loved ones. I would like your advice on the below
2 weeks ago i had sex with a sex worker We engaged in the following : protected oral and protected vaginal sex. however during the vaginal sex the condom broke and I was unprotected inside her vagina for about 1-3 minutes . she changed the condom and we started having sex again . A couple of minutes later the condom tore again and we immediately stopped having sex . I asked her if she had any diseases and she replied that she didn't and was clean.She also says that she tests every 3 months and that she always uses condoms.
I also went to see my std doctor who after hearing the case, said that he personally would not prescribe PEP due to the nature of the exposure. He advised me to take a duo test at 28 days.
Symptoms:
-7days post: Pain in the right elbow that comes and goes and happens in certain positions. It is not constant. Today it is has become a little more than previous days. If i press the muscle right above the elbow it hurts and this is where the pain is originating from through out the right arm.
- 11 days post: I have a slight head ache which is momentary for the last 3 days. that too comes and goes.
- I am also having neck pain on the left side that is not constant but come and goes at random positions and when i turm my head to the left it is noticable but slightly.
- 12 days post: Pain in the left ear and feeling of it being blocked. The pain is there at random times of the Day, is not there every day and is not constant it comes and goes.started on Thursday and was there for about 2 hours then went away. I didn’t have this over the weekend. It usually gets worse when I’m in a cold environment like in my office as it is less when I’m at home with the ac off and only fan on.
I have not had any fever,sore throat, rash as yet. Today my temperature is 37.1 which is the highest it has been as it usually is 36.5-36.7
What is my risk of hiv?
Are the symptoms that I experienced and am experiencing a sign of ARS as I have read that they can also be very mild.
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Edward W. Hook M.D.
43 months ago
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Welcome back the Forum. Your risk for HIV from two brief encounters in which the condom broke is very low. Remember, most commercial sex workers do not have HIV and the testing regimen your partner described was a good one. Most people do tell the truth when asked about testing. In the unlikely situation that your partner had untreated HIV there is a still greater than 99% chance that you were not infected. Remember, the risk for infection following a single unprotected exposure to an untreated, infected partner is less than 1 in 2000, thus with two exposures, the risk if less than 1 in 1000 or, in other words, there would be a 99.9% chance you were not infected. If you had asked me about PEP, like your doctor, I would not have been willing to prescribe it either.
Regarding your symptoms, none of the symptoms you describe suggest the ARS. Further, when the ARS occurs, symptoms tend to all occur at about the same time and do not come and go as the symptoms you describe have done. I suspect that given your condom mishap, you have been more watchful than usual, leading you to notice mild symptoms and then wonder about their relevance.
I would not worry. If my reassurance is not sufficient, had your symptoms been due to HIV, a 4th generation, combination HIV antigen/antibody test would be positive at this time. While I see no need for testing at this time, if you want the reassurance, your results will be reliable as to whether or not your symptoms are due to HIV. EWH
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43 months ago
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Thank you doctor for your words and apologies for the late reply.
If i was to take a 4th gen test, in your opinion and i know there is no guarantee to this effect but can i expect my results to be negative? I am nearing the test date and I am literally splitting hairs at the moment over this whole episode.
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Edward W. Hook M.D.
43 months ago
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If you choose to test, I anticipate that your results will be negative, proving that your symptoms were not due to HIV and providing further evidence that you were not infected. EWH---
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43 months ago
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Hi doctor as a last thing, if you dont mind.
Today i have started feeling a tingling/pulsating sensation near the tip of my penis. When i urinate there is no pain nor is there any discharge. Its just an uncomfortable sensation, and i would say similar to the pins and needles effect.
Can any sti cause this 1 month post exposure as this is the first time i have felt it?
I once again thank you for your advice and reassurances throughout this whole post!
Stay safe doctor!
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Edward W. Hook M.D.
43 months ago
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In the absence of lesions, the tingling that you described is not suggestive of any STI, including HIV. On the other hand it does suggest that you may be looking hard for symptoms and noticing normal sensations which you would otherwise overlook. The sensations you describe did not concern me. EWH---
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43 months ago
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Hi doctor, As a last if possible,
My std doctor had advised me to test anytime post 28 days. I did get a 4th gen test today 33 days post exposure and the results were negative. However whats confusing me is the 45 day test window? Did i test too early and can i take my 33 day result as being conclusive and move on?
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Edward W. Hook M.D.
43 months ago
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Final answer. The official recommendation regarding the time it takes for fourth generation HIV test to be conclusive is six weeks (42 days). By four weeks well over 95% of persons with HIV would have positive tests so your test results, while not conclusive, are very strong evidence that you were not infected. EWH ---