I’m back here unfortunately. 3 weeks ago had unprotected intercourse twice with a 24 yr old girl I met in a club in Barcelona. Next day we both went to a clinic for a rapid HIV test and both tested negative - my time was ok as I last had sex 5 weeks before. She claimed her last was 2 months ago but afterwards admitted it was 2 weeks ago so I guess her test was useless (dunno if she was lying again).

I am now in the UAE where I will be tested for HIV in a week for my residency. 2 weeks after the episode I had one strong chill/shivers episode in the morning (I don’t think I have fever as I function normally but haven’t taken my temperature). More importantly I have ulcers at the roof of my mouth - not the first time but these are unusually painful I find it hard to eat. Also unusual strong headaches but these started a week before the ulcers and the chiver episode. No other symptoms.

The girl sent me a screenshot of a test she did yesterday claiming it’s HIV + other STDs that says she is negative for ‘all collected samples’ - not sure I trust her.

My main question: Are my symptoms suggestive of ARS?

Any single symptom of a new HIV infection occurs far more commonly with other medical conditions, mostly mild and unimportant. It's the pattern of symptoms that can suggest ARS, i.e. acute HIV infection:  if there are symptoms at all, almost always there are three of these four:  fever, enlarged lymph nodes, sore throat, and skin rash, Without these, almost no other symptoms, by themselves, suggest HIV. And as I said at the start, the blood test results prove your partner doesn't have HIV.

So all is well. You do not need any further testing. I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

But what I’m saying is that when we did the rapid test following intercourse she had had sex 2 weeks before so the rapid test would no detect HIV this early.

Do you mean that if the test didn’t detect HIV and by any chance she had caught HIV 2 weeks before she would not be contagious?

Thank you

There is no realistic chance you have HIV now, but of course you are free to get tested in a few weeks to confirm you are not infected.

Your three questions indicate you tend to greatly over worry about HIV. It's harder to catch than you seem to understand. But given those worries, it is difficult to understand your choice to have unprotected sex with new or commercial partners. Please get into a consistent condom habit!

I’m still waiting to get tested for my UAE residency but in the meantime please bear with me for couple of questions

1- both you and Dr Hook insist that mucocutaneous ulcerations are not a sign of ARS - not doubting but why does every online medical journal (e.g., Canadian medical journal association) state that it is HIGHLY suggestive of acute HIV?

2-can the rash on the face appear only on one side and only on the face?

3- can an ARS symptom start a week after another?

4- would a duo test detect HIV at 2.5 weeks?

Please don’t tell me dr not to worry because of this or that and try to answer my questions, please it would be very helpful to reduce the high stress. Thank you

Re-read the part of my reply above beginning with "Any single symptom...." To expand on that comment, listings of symptoms that CAN occur during ARS is not the same as using those lists to conclude that ARS is likely. Every symptom and sign of ARS occurs far more commonly in other conditions. Even among the most typical combination of ARS symptoms -- sore throat, fever, enlarged lymph nodes, skin rash -- the large majority of persons have other explanations. Timing also is critical:  ARS just about always begins roughly 1-2 weeks after exposure; onset either before or after these times is strong evidence against ARS. The point of symptoms is that they should prompt HIV testing in persons at risk, but usually with the expectation of a negative test result. 

2. No. The rash of ARS typically is body wide, mostly on the trunk, rarely on the face. The vast majority of skin rashes are very different than the rash of ARS. And here too, rash alone almost never would be the only manifestation of a new HIV infection.

3. Typically all ARS symptoms start within a few days of each other, with all beginning within 2 weeks following exposure.

4. The AgAb (4th generation, "duo") HIV blood tests are positive roughly half the time at 2-2.5 weeks.

That completes the two follow-up comments and replies included with each question and so ends this thread. Please note the forum policy against repeated anxiety driven questions on the same topic. This being your second, it will have to be your last about the sexual exposures on your mind or about ARS symptoms. Such repeated questions are subject to being deleted without reply and without refund of the posting fee. Experience shows that repeated replies tend to prolong and reinforce anxiety rather than relieving it. Also, the forum sponsor does not wish to collect fees for questions that simply repeat previous answers. Finally, such questions have limited educational value for other users, one of the forum's main goals. Thank you for your understanding.

I do hope the two discussions have been helpful. If you remain concerned, I suggest you carefully re-read both of them. Also, you might be interested to know that in the nearly 20 years of this and our preceding forum, with thousands of questions from people concerned about HIV after a particular exposure, nobody has yet turned out to be infected. You will not be the first. If and when that finally happens, almost certainly it will be from a far riskier event than the minimal risk you have described.

Best wishes.