Following up to my last question which was so kindly answered by Dr. Hook, I've been having some real HIV anxiety after a risky encounter with a trans female CSW. The condom broke during anal, which was noticed by her almost instantly, making the exposure time around 1-2 seconds at most. 

My main concern here is that I've noticed what's called a "cobblestone throat" yesterday on day 3 after exposure. I have a sore throat and small red blisters on the back of my throat, with some thrush on my tongue. It says on the internet that ARS symptoms start after 2 weeks minimum yet there are some sources that say it starts as early as 4 days. 

Also have been having some muscle aches from time to time and some minor fever ranging from 37.4 to 37.8 as the machine is showing different figures every time I test. Only the tonsils in my throat are enlarged.

I failed to mention on my last question that she was quite sick as in coughing during our encounter. Maybe it's due to this but I still would like to get a professional opinion. There was an entry a while back from Dr. Handsfield where he said HIV ARS symptoms don't start that early, but this is giving me some nasty anxiety and there's still some time till testing. 

At this time my main fear is HIV, this was a one time exposure and I regret it deeply, I just want to come out safe from this tbh. No PEP was used as I was unable to acquire it.  

Looking forward to your reply. 

Day 3 is too soon for the ARS to begin.  The ARS occurs when both virus and antibodies to the virus are present and interact.  Three days is too soon for antibodies to appear and too soon for the ARS to occur.  The ARS would not be expected until at least a week following exposure and most typically occurs between ten days and three weeks following exposure.  FYI and if you want to prove to yourself that your sore throat is no due to the ARS, you could seek testing with a 4th generation, combination HIV antigen/antibody test at thsi time- when the ARS is present, these tests are virtually always positive.  Should you test, the negative test thatI am confident you will see is proof that your sore throat is not the ARS.

The information that your partner will il and coughing during the encounter is helpful.  She may have had the flu, COVID-19 or some other "routine" viral respiratory illness of the sort that is far more common than the ARS and for you to have developed symptoms just three days after contact is typical of these illnesses.  

I hope this additional information is helpful  Did you get PEP?  Please feel free to use your up to two follow-ups for clarification.  EWH

Thanks for taking the time to answer. I'm relieved to hear ARS does not present so soon. Ofc this does not mean it may not show up later on which is still somewhat of a worry for me. 

I will take your advice on testing to make sure this is not ARS. Please correct me if I'm wrong, if I test with a 4th gen test now to prove this is not ARS, how accurate will the result be in general to find whether I contracted the HIV or not? I know these tests don't usually give viable results before the 12 day mark so as far as testing goes, should the result of this test done at day 6 put me a little more at ease, or does it mean very little and that I'll have to wait for day 12 for accurate results?

She definitely had an upper respiratory infection so I could have very easily contracted that. It is indeed typical in 3 days. 

Unfortunately, I was unable to get the PEP on time so at this point I believe my only option is to wait it out with patience and with as little anxiety as possible. 

I just have a couple of follow up questions;

1. It may be an obvious answer, but have you or Dr. HHH in your practice ever come across an HIV+ case which occurred from such a brief exposure as mine? If so, how often do you reckon this happens?

2. I had gotten tested about 3 months ago for HIV as part of routine bloodwork, negative results with 0.12 value for antibody result. My question is, in the test done at 6 days, if my test is negative but antibody amount is increased to say 0.17-0.20, should I take this as a possibility that I might test positive in the next tests. (FYI anything above 0.25 is considered positive...I think)

3. Does the fact that I had an exposure with a Transexual CSW as opposed to a regular CSW increase my risk? Or does it remain the same for insertive rectal intercourse regardless of gender/sexuality?

Thanks once again for all the help and I appreciate your detailed responses, fingers crossed, hopefully I'll come out unscathed from this one time exposure. Will definitely be a lot lot more careful practicing safe sex from now on. 

1. It may be an obvious answer, but have you or Dr. HHH in your practice ever come across an HIV+ case which occurred from such a brief exposure as mine? If so, how often do you reckon this happens?

Never