HIV - Prevention Expert Forum
Please Help. Very Anxious re - ARS
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Please Help. Very Anxious re - ARS


I had protected oral sex with a female at a (Australian) licensed brothel. 3 days later I went back and had protected oral & full sex with a different worker. Both times there seemed no noticeable breaks in the condom.

2 weeks later I developed a chronic sore throat. One week after that (& still with the sore throat) I discovered a small pea shaped node under my jaw. I have had no other ARS symptoms - rash, flu, headache, fever etc. etc., but I am going crazy with anxiety.

My doctor has put me on antibiotics and given me a shot of penicillin and says that I have pharyngitis, he also told me that nodes are extremely common with sore throats (especially under the jaw near the infection).

Should I be worried? I can't sleep & I’m obsessed with ARS.
Is a chronic sore throat & small detectable jaw nodes a symptom?
Would anxiety/lack of sleep/food/smoking be a factor in my sore throat persisting?

UPDATE - My sore throat that has been going on for a week has just started to get better (pretty much gone), then tonight I have just had diarrhea. In the last 24hrs I have taken 15,00mg of vitamin  (through various vitamin pills), had a penicillin shot, antibiotics, herbal sleeping tables, panadine extra & consumed pretty much nothing but fruit & camomile tea -which may well have caused it. Nevertheless I’m still freaking out.

My question is = Do ARS symptoms hit you at once, or can you have a sore throat one week, then diarrhea the next?

Why I ask is that I’m confused by the descriptions of ARS - When it is suggested that symptoms occur together, is that just referring to the space of the 2-3 week symptomatic period?

Or does it literally mean that symptoms hit somewhat simultaneously & not one after the other (as with my case)?

Also have there been any reported cases of transmission without condom break?

Any advice would be much appreciated as I’m terrified.
All the best.
Welcome to our Forum.  We find that, following exposures that they consider "risky" many of our clients focus all too much on symptoms.  This is a mistake.,  The symptoms of the so-called ARS are highly non-specific and even when all are present in at risk persons, less than 1% of persons with ARS symptoms turn out to have HIV.  The right way to address concerns about HIV is with testing, not worrying about non-specific symptoms that are most likely caused by other processes (most commonly community acquired, non-STD viruses of the sort that most people get through their activities of daily living).

In your case, your exposures were very low risk.  In Australia workers at commercial brothels are tested regularly for HIV and other STDs and are committed to safe sex practices- thus your risk from the exposures you describe is probably lower than if you had sex with someone you met at a bar or party.  Further, condom protected sex is safe sex, even if your partner had HIV which as noted above is most unlikely.

As for your questions-the sore throat you are describing sounds like a typical, non-STD sore throat, likely worsened by your smoking, anxiety, etc.  

My advice is try to not worry and test with a combination HIV p24 antigen/HIV antibody test at 4 weeks after your last exposure. Your results at that time will be conclusive, ruling out the possibility that you acquired HIV through the exposures you describe.  EWH
Thank you so much Doctor.

So in a nutshell - do you think that I'll be ok?

All the best . B.
Correct.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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