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Exposure/Symptoms assessment

Hi,

I am a male residing in a Nordic country currently and had a sexual encounter with a sex worker a bit more than 3 weeks ago. It was protected oral (without ejaculation) and first protected vaginal (with same condom) and second time protected vaginal (new condom). Both times I ejaculated inside and the condoms were intact. The sex worker was from Central Europe (Hungary to be precise). Based on reading from most resources and this site I would have analyzed my risk as zero, based primarily on correct protection usage and also low probability of the girl being HIV+ (based on WHO data Hungary has one of the lowest HIV prevalence which is even lower in Women). However, at around 2 weeks time I started feeling minor/mild pin like pains (2-5 seconds coming and going during the day) mainly in feet, hands and sometimes at other places in the body. This led me to believe in Peripheral Neuropathy which (at some resources) has been claimed as an ARS symptom (even if rare), so am totally freaked out since this has started and these symptoms have not yet subsided (1.5 weeks of PN and 3.5 weeks post exposure). I have not felt any other symptoms yet.

I would greatly appreciate your assessment given the above information (is there even a remote risk? any reason to get tested for HIV? (apart from peace of mind). I may go for a test (usually there is the Antibody/Antigen test done here, I guess that is the same as the DUO/COMBO test) after 4 weeks have passed. I presume this type of test should be 99-100% conclusive at/after 4 weeks?.

Thank you.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

You have carefully researched the situation (thank you!) and I agree with most of your self-analysis.  However, I think you misunderstood something you read about ARS symptoms, or perhaps found a somewhat inaccurate website.  While peripheral neuropathy may accompany ARS, I'm not aware of it and am skeptical.  In any case, I cannot imagine that peripheral neuropathy would ever be the only manifestation of ARS.  If it occurs at all, I would expect it to be part of a syndrome dominated by sore throat, fever, and probably lymphadenopathy (lymph node inflammation/enlargement) and skin rash.

In any case, I'm not convinced you have peripheral neuropathy anyway.  PN symptoms are generally localized, e.g. in a single leg or perhaps both legs, or an arm, or whatever -- but consistent for that area and not migrating around the body.  Your symptoms are more suggestive of the physical manifestations of anxiety, which can magnify normal body sensations that otherwise would be ignored or not even noticed.

Equally important, you are exactly correct about the safety of the sexual exposure described.  I cannot imagine you caught HIV -- for all the reasons you state very clearly.

Therefore, as you have perhaps predicted, from a strictly medical or risk perspective, I don't really recommend HIV testing at all -- i.e. reassurance is the main reason to consider it.  In any case, you correctly understand the performance of duo/combo testing at 4 weeks, which apparently is only a few days away.  So I recommend you do it.  In the meantime, stay relaxed.  You definitely can expect a negative result.

I hope this has helped.  Happy new year--  HHH, MD
Helpful - 1
Avatar universal
Thank you Dr. for the assessment and insight, helps alot. Will try to relax myself.

A Happy New Year to you too!
Helpful - 0

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