[Question #8572] Possible HIV ARS Symptoms
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42 months ago
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Hi Dr. Hook.
I had condom protected vaginal sex with a man about 1 month ago. Details are fuzzy because alcohol was involved. I can remember him assuring me that the condom was on and I saw it in the beginning and the end but not in between. I don't know how realistic this is but at one point I think he may have briefly taken it off and put it back on without my knowledge. I can remember him messing around with it and showing me it was still on when i questioned him. Around day 27 I woke up feeling achy and nauseous. This lasted for about 2 days. Then I started having a dry sinus and slightly scratchy throat. That lasted 2 days. No other symptoms. Just a very mild flu type feeling. It was so strange. Question is assuming that a portion of the encounter was unprotected, does this sound like ARS? I also suffered from a terrible yeast infection 2 weeks after and was tested negative for Chlamydia Gonorrhea and Trich. It seems like my body was working hard to get rid of the yeast infection so I decided to make sure it wasn't an STD to be on the safe side. I hope I'm over reacting here but the timing of the symptoms have me questioning the encounter. Thoughts? P.s. if my symptoms were due to ARS would any test be positive at this time? I'm thinking about Oraquick for convenience and privacy.
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Edward W. Hook M.D.
42 months ago
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Welcome to our forum and thanks for your question. I’ll be glad to comment. The encounter you describe was low risk. Despite any questions you might have about whether the condom was removed during the encounter, this is most unlikely. It is quite difficult to remove a condom and then put it back on in the midst of a sexual encounter. You noted the kind of person place at the beginning and at the end of the episode making it almost certain that the condom was also present throughout. In addition to addressing your questions about the condom, let me also remind you that HIV infections are very, very uncommon amongst heterosexual men and, that even in the unlikely circumstance that your partner had untreated HIV infection the risk for acquiring infection from a single encounter is about one in 2000 episodes. Putting this together this was a very, very low risk and encounter making it unlikely that you acquired HIV.
While I understand your concerns about the timing of your recent symptoms, they really are not too suggestive of the ARS. The symptoms of the ARS are severe with a severe sore throat, high fevers, and very uncomfortable muscle and or joint aches.
With regard to testing, if you choose to test, I would encourage you to seek a fourth generation, combination HIV antigen/antibody test rather than testing with The Oraquick assay which only tests for antibodies to the virus. The fourth generation tests are more sensitive than antibody only tests and if a fourth-generation test is negative, you could be completely sure that your symptoms are not due to HIV.
I hope this information and perspective is helpful to you. Your encounter is was very low risk and not something I would worry about. If there are further questions or any part of my response is unclear, please don’t hesitate to use your update to follow ups for clarification. Please don’t worry. EWH
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42 months ago
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Thank you for the thorough reassuring reply. One last thing, is 4 weeks long enough for a valid result on the bacterial STDs? And would a new HIV infection make it difficult to overcome a simple yeast infection? I'm going to get the 4th generation test as soon as possible as you recommended. I wouldn't even be questioning the encounter if i hadn't got sick. The internet is the devil. Lol. One last thing, is a fever always present with the ARS? I did not have a fever just felt achy and nauseous for a couple days.
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Edward W. Hook M.D.
42 months ago
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You are correct, when it comes to topics like this, the internet is not your friend.
Testing for STIs such as gonorrhea, chlamydia, and syphilis at four weeks will provide reliable results.
Finally, yes, high fever (not just low grade fever) is a central part of the definition of the ARS.
Hope this helps. Please don't worry. EWH
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42 months ago
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Ok. Thank you so much. Fingers crossed!
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42 months ago
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I'm not able to get a doctor's appointment until next week so i decided to take the oraquick for some sense of reassurance. It was negative at 6 weeks. I think this is my last follow up. I know statistics are not 100% but I read that by 6 weeks, 50% of people would test positive by oral swab. How true is this? Also, if my body aches and dry sinus and itchy throat were due to ars, would even a less effective test like oraquick be positive at this time?
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Edward W. Hook M.D.
42 months ago
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At 6 weeks I’d estimate the accuracy of the Oraquick assay as around at least 80-90% and perhaps higher. If the Oraquick is negative, you can be confident that your body aches and sore throat are unlikely to be due to HIV.
Hope this helps. EWH
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