Any RISK involved ?

Dear doctors. Grateful for assessment.  

Exposure:

Jan 22nd - protected vaginal intercourse with csw in dubai
Jan 28th - protected vaginal intercourse with csw in dubai. Condon was durex extra safe it did slip up about half way but it remained intact and i ejaculated inside it.

Questions

1. Exactly 10 days after first exposure i had a runny nose, cough and ear nose congrstion. Could this be ARS

2. When i removed condom in second incident i noticed some white fluid at base of condom it might have been under the condom, could the vaginal fluid have crept under condom and caused hiv risk ? Note it was covering head and i came inside it.

3. When i got home 1st day my GF gave me unprotected oral , came in her mouth. 3rd day we had unprotected vaginal sex.  Exactly 2 days later she had a mild flu like symptoms and was diagnose with mastitis she is breastfeeding our baby. Could this mastitis (mild flu, lump on breast, red mark on breast only) been caused by hiv ars. Note it her sumptoms started 4 days after unprotected oral sex and 2 days after vaginal unprotected sex

Is there any real risk or medical reason to test ?


1. Exactly

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post.  I will answer each of your questions here below:

1. Exactly 10 days after first exposure i had a runny nose, cough and ear nose congrstion. Could this be ARS

NO, IT WOULD BE FAR TOO EARLY AND SYMPTOMS DO NOT CORRELATE.  THOSE ARE SYMPTOMS OF A COLD.

2. When i removed condom in second incident i noticed some white fluid at base of condom it might have been under the condom, could the vaginal fluid have crept under condom and caused hiv risk ? Note it was covering head and i came inside it.

HIGHLY UNLIKELY.  PROVIDED THE HEAD OF YOUR PENIS REMAINS COVERED, THAT IS CONSIDERED SAFE.

3. When i got home 1st day my GF gave me unprotected oral , came in her mouth. 3rd day we had unprotected vaginal sex.  Exactly 2 days later she had a mild flu like symptoms and was diagnose with mastitis she is breastfeeding our baby. Could this mastitis (mild flu, lump on breast, red mark on breast only) been caused by hiv ars. Note it her sumptoms started 4 days after unprotected oral sex and 2 days after vaginal unprotected sex

IMPOSSIBLE TO DEVELOP ARS SYMPTOMS AFTER 2 OR 4 DAYS ONLY.  HER SYSMPOTMS ARE CONSISTENT WITH MASTITIS

Is there any real risk or medical reason to test ?
NO, THERE IS NOT AS YOU DID NOT PUT YOURSELF AT RISK OF CONTRACTING HIV; A CONDOM WAS USED AND THIS REMAINED IN PLACE AND INTACT.

Best wishes,
Dr José

[thinker18]

Just to clarify last point in question 2.  The condom slipped to about half way up penis. It was definitely covering penis head and i ejaculated inside condom and there wasno breakage.  When i was removing the condom i notice some white vaginal fluid around the bottom of the condom which was half way up my penis and maybe a bit of fluid inside the beginning part of the condom ? Could the vaginal fluid gone inside the intact condom and up to head of penis an make an hiv infection ??

[thinker18]

Just to clarify last point in question 2.  The condom slipped to about half way up penis. It was definitely covering penis head and i ejaculated inside condom and there wasno breakage.  When i was removing the condom i notice some white vaginal fluid around the bottom of the condom which was half way up my penis and maybe a bit of fluid inside the beginning part of the condom ? Could the vaginal fluid gone inside the intact condom and up to head of penis an make an hiv infection ??

[thinkdub]

Thanks doc this is terrific news, i am highly reassured.... just one last question if you don't mind

1) When you say in place and intact, even if it has slipped up most of the shaft but remained covering head is this considered in place and intact?

2) If i misjudged the timing and say the MASTITIS had started 10 days after me and my GF's unprotected vaginal intercourse, would this have be a risk factor of ARS?

Best Regards

[thinkdub]

3) In your experience when is the EARLIEST you have ever seen ARS appear in an infected patient of yours ?

Thanks a lot... that will be all from me

[thinker18]

Dr jose

I just did an hiv duo test through TDL laboratory.  It came back as not detected.  I did the test 24 days after exposure.

How accurate do you consider 24 days for this test accuracy

[Dr Sean Cummings]

Hello,

The HIV DUO is designed for use at 28 days or after. A test at 24 days will be reassuring but only that. You need to test at the correct intervals to get a result you can rely on.

Best regards, Sean

[thinker18]

Hi dr sean

Thanks for your reply.

Just to confirm with you, my original exposure was protected insertive vaginal sex, my concern was the condom wentup about half way during intercourse and i was concerned vaginal fluid may have got into the condom diring sex.  

I have now done hiv duo at just over 26 days from date of incident.

The combined information of exposure and duo result at 26 days should provide sufficient indication of myself being negative. Am i correct ?