[Question #9676] Concerning Symptoms from 2 exposures
30 months ago
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Hello Doctors!
I have had 2 separate sexual encounters within 2 months. A month apart from each other. The first encounter involved protected vaginal & oral sex. The second encounter was unprotected oral sex and protected vaginal sex until I became flaccid. Yet in both instances I have developed symptoms that i seen are considered to be ARS. In both instances i attributed hand / feet sweats. I don’t know if it’s considered a rash (it doesn’t itch) yet in both instances the rash is persistent. Lasts well over a week. Both symptoms occurred within days after encounter Well under a week( 1-3 days ) - I’m very concerned being as though i developed these so fast yet there persistent ?
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Edward W. Hook M.D.
30 months ago
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Welcome to our Forum. Thanks for your questions. To briefly summarize my thoughts, the exposures you describe are VERY, VERY unlikely to have even exposed you to HIV and I am confident that the symptoms you describe are not due to recently acquired HIV from the exposure you describe. Bellow is a more extensive explanation:
1. You do not mention any details about your sex partners however most people do NOT have HIV and this is particularly true to women
2. Except for your receipt of oral sex, your exposures were condom protected. Condom protected sex is safe sex. Unless you noticed your condom to be broken, it was not- when condoms fail they break wide open.
3. The ARS is not just a rash. The ARS is a syndrome which includes HIGH fever, SEVERE sore throat, and muscle and/or joint aches. A small proportion of persons with the ARS have a widespread redish skin rash.
4. The onset of the ARS occurs between 1 and 3 weeks after exposure. It does not occur more than 30 days after an exposure (you do not mention the timing of your exposures relative to the rash you note)
5. You have not described your rash (location, color, etc.)
Bottom line- little you describe concerns me that this is HIV or the ARS. FYI, even when persons have classical ARS as I have described above, over 99% of the symptoms are NOT due to HIV but are due to other causes of flu-like symptoms, i.e. COVID-19, influenza, and many other community acquired, non-specific viral infections.
I hope this information is helpful. I have little concern that the symptoms you describe are due to HIV acquired from the low risk exposures you describe. EWH
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30 months ago
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Thanks for swift reply Dr. I will answer your questions in the order you asked. Apologies for not being specific.
1. My two sexual partners were women. First one was a csw. She says she test regularly and has stated she has tested after our encounter( which i can’t confirm. ) Second woman wasn’t a csw but unknown status.
2. The first encounter was fully protected. Second encounter was during penetration. At some point condom mysteriously fell off but this was more than likely due to grinding on top. I don’t recall any penetrative sex after becoming somewhat flaccid. Condom was fully intact. No tears or fully wide open break.
3. This “skin rash” is just been on feet and palms - sweaty. Not widespread over body. (But i do have VERY sensitive skin in general from skin condition eczema)
4. Both timing of rashes began within 3 days. The rash didn’t occur at or past a week.
5. Location has been on feet and hands dr.
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Edward W. Hook M.D.
30 months ago
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Thanks for the additional information. It confirms my assessment that this was a very low risk exposure.
I would add the the rash of the ARS would not begin three days after an exposure and I've never heard of an ARS rash limited to the hands and feet. EWH
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30 months ago
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Morning DR Hook & thanks for clarifying. I have one more reply so mines well use it.
Yes both sweaty palms feet symptom occurred within 3/4 days. But both well under the 1-3 week start frame. I’m more concerned now about the most recent exposure since the first exposure the other symptoms also were within 1-3 days and you say it’s too early.
Now I’m a lil over 3 weeks past exposure and I consider this one to be more of an exposure due to the fact of me not knowing if sex was fully protected. I know when i was actively penetrating it was. But there was a time of grinding and trying to penetrate but i was somewhat flaccid. The condom did somehow fall off but was intact. I seriously don’t remember penetrating but can we be hypothetical and give the chances in case i did?
Secondly out of the symptoms you related to combination of ars. Are you saying these all occur together?
Because out of the symptoms named, i can say the rash and severe throat is something i experienced. (No high fever etc) The sore throat did cause discomfort and occurred a week ago but it wasn’t severe to the point of me not being able to swallow or being hoarse and burning my throat. I took theraflu and cough drops which did help it go away after a day or so.
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Edward W. Hook M.D.
30 months ago
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My sense is that you are really overthinking this. That the condom came off during your frottage ("grinding") would not put you at risk. During such activity, even when partners get each others' genital secretions on one another without penetration, there is no risk for HIV. I really would not worry and am confident if you choose to test (which I really do not think is necessary) I am confident that the test will show that you were not infected.
In response to your other questions:
Yes, the symptoms of the ARS typically all occur at much the same time, not at different times. Further, the absence of high fever which is a usual part of the ARS further indicates that the symptoms you described were not the ARS. Finally, as I mentioned in my original reply, even when persons do experience all of the symptoms of the ARS (which you did not), in 99% of cases, the symptoms are due to something other than the ARS.
You sound concerns and if it would help to relieve your concerns, you could test. Testing any time after possible ARS symptoms would be positive if the symptoms were due to HIV; testing at 4 weeks (28) days would detect over 99% of recently acquired infections; and testing any time more than 6 weeks after an exposure would be 100% conclusive. If you choose to test, I am confident that your test would show you were not infected.
I hope this information is helpful. This completes this thread. Please don't worry. EWH
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