[Question #9648] Risk Assessment ODDS

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30 months ago
Hello Doctors, I’m curious to know the statistical odds of a past situation which occurred two weeks ago and I briefly discussed before. I initially practiced safe vaginal sex with a woman. (Unprotected oral) At one point of unsuccessful attempts of her being on top, I believe the condom fell off because I don’t recall penetrating. Now my question is in regards to the hypothetical if in fact she sat on me and i was inside her briefly unprotected. Does non penetrating offer the same odds .. what are the odds of infection if that was the case? When penetrating i was protected but there’s a gray area of her being on top of me and us trying to resume where I cannot recall penetration. I just removed her off of me and seen condom off. Wasn’t ripped or teared. Also most of the time after penetration, i wasn’t fully erect and condom was still in place. I just can’t figure out how the condom fell off. 
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Edward W. Hook M.D.
30 months ago
Welcome back to the Forum.  I'm sorry you felt the need to return with these "what if" questions.  As I've already indicated, the encounter was a no risk event.  If you penetrated your partner (unlikely) and IF she had untreated HIV infection (even more unlikely), your risk for infection would be less than, on average, less than 1 in 1000.  In other words, if the unlikely circumstances you describe occurred, there is a more than 99.9% chance you would not be infected.  

As I also explained, friction alone could have resulted in the condom coming off.

I urge you to put these concerns behind and move forward without continuing concerns.  EWH
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30 months ago
Thanks Doc for the reassurance..one of the reasons i felt to return back was the fact that I had got a sore throat Sunday night into Monday. (Now to admit i did attend a big event the night before with ton of ppl)
 I don’t know what warrants a “severe throat” but i know I seen one of the docs on here (not sure if it was you) say that was a symptom of ARS so that really concerned me. Aside from the symptoms i had earlier so it built my anxiety. Even though you said the symptoms i had before (hands and feet rash) couldn’t have been a symptom because it occurred so quickly within a few days. After taking some otc medicine once my sore throat seems to be fine now but again reading that caused HIGH ANXIETY. 
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Edward W. Hook M.D.
30 months ago
When the ARS occurs, persons tend to be quite sick with a combination of HIGH fever, SEVERE sore throat, and muscle or joint aches.  Some persons may have a generalized rash or diarrhea as well.  In careful scientific studies which tested at risk persons with a flu-like illness, 99% of persons with flu-like symptoms of the sort I describe had something other than the ARS, including influenza, COVID, and other community acquired, non-STI viral infections.  Given the low risk nature of your encounters, I would not be worried about the ARS.  If my assurance is insufficient, when persons have the ARS, 4th generation, combination HIV antigen/antibody tests are uniformly positive.  If you choose to test, when the test is negative as I'm confident it would be, you can be sure that your sore throat was not the ARS.  EWH---
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30 months ago
My last question Doctor is do I ignore the persistent hand rash that I am having ?? (which as we discussed began with the first encounter in December) but has persist now and the recent sore throat?? which occurred this past sunday/ monday with the encounter I had in January. The csw I seen in December said she got tested in January so that somewhat eases me with her yet the encounter with the woman in January (who is not a csw but unknown status ) as we discussed has now made me more nervous. Thanks for understanding. 



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Edward W. Hook M.D.
30 months ago
Final Response:

The rash you are focusing on is not a manifestation of the ARS and is not typical of HIV-related rashes.  in terms of HIV it can be ignored.  If it bothers or continues to concern yo, then my advice would be to see a dermatologist and get it addressed.  

This completes this thread.  EWH
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