HIV - Prevention Expert Forum
Possible exposure
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Possible exposure

Hello Drs. I am a 29 year old male from South America.6 days ago I had sex with a CSW (woman), protected oral and vaginal. However at that time I had some semi healed redish injuries between my legs caused mostly because of a pair of tight jeans. That same CSW inserted her finger (with a condom on) in my anus, affecting the above-mentioned injuries. They were redish but did not bleed. Just a few hours later I had unprotected sex with a former girlfriend who is not a CSW.
My questions:
1. Based on this two exposures can you ***** my risk of hiv and STDs?
2. After 2 weeks I experienced some mild sore throat which got a bit worse as days passed and no other symptom. It has been 12 days since the symptoms begun and I am still feeling such sore throat. I am taking paracetamol. Does it sound to ARS to you?
3. 20 days after exposure I took a CMIA method combo test-hiv 1 and 2 us antigen p24. The test came back negative. How accurate in terms of percentage is that test at such time frame?
4. I took the above-mentioned test 4-5 days after the onset of symptoms. In the event that I had been infected, would the antigen part of the test had come positive?
5. Do ARS symptoms hit all at once?
6. Today, 26 days after exposure I developed some sort of ulcer on my left leg (far from my genitals). I am afraid it may be a syphilis chancre. It is round, approximately 1 cm in diameter. It is redish and hard on top. It is not open. It is located approximatelly 7 cm from the above-mentioned injuries. Should I worry about syphilis?
Thank you very much.
300980_tn?1194933000
Welcome to the Forum.  I will go directly to your questions and am confident that you will receive answers from me that are quite similar to those that you have already received from Dr. Jose on the Spanish language site.  The activities you describe carry no meaningful risk for HIV.  Condom protected sex is safe sex and symptoms that you have developed since that time are far, far more likely to be co-incidental than related to HIV or other STDs.  let's address your questions:

1. Based on this two exposures can you ***** my risk of hiv and STDs?
See above.  As I said, condom protected sex is safe sex and when she inserted her finger into your rectum, this is a form of masturbation and there are no STDs transmitted through masturbation either.

2. After 2 weeks I experienced some mild sore throat which got a bit worse as days passed and no other symptom. It has been 12 days since the symptoms begun and I am still feeling such sore throat. I am taking paracetamol. Does it sound to ARS to you?
An isolated sore throat is not the ARS in which people are typically far more sick than you describe.  This is far, far more likely to be a coincidental sore throat than HIV.

3. 20 days after exposure I took a CMIA method combo test-hiv 1 and 2 us antigen p24. The test came back negative. How accurate in terms of percentage is that test at such time frame? '
At 28 days these tests provide definitive answers regarding whether or not HIV has been acquired.  At 20 days, they are not quite as good.  While the answers from studies are imprecise, you can assume that this test would have detected well over 75% of recent HIV.  Further, had your sore throat been due to HIV, this test would have been positive when you took it, a few days after your sore throat began.

4. I took the above-mentioned test 4-5 days after the onset of symptoms. In the event that I had been infected, would the antigen part of the test had come positive?
Yes- see above.

5. Do ARS symptoms hit all at once?
Yes, or typically at least within a 24 hour period.

6. Today, 26 days after exposure I developed some sort of ulcer on my left leg (far from my genitals). I am afraid it may be a syphilis chancre. It is round, approximately 1 cm in diameter. It is redish and hard on top. It is not open. It is located approximately 7 cm from the above-mentioned injuries. Should I worry about syphilis?
Syphilis is quite unlikely. this is far more likely to be a superficial skin infection, perhaps related to your earlier injuries.  If you are concerned, you may wish to have a doctor look at it because if it is a (non-STD) bacterial infection it could get worse.

I hope my comments are helpful.  EWH
6 Comments
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Avatar_m_tn
It has been 26 days from the possible exposures
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Avatar_m_tn
Thank you very much for the reassurance you jiat gave me. I would like to make somw final follow-up questions.
1. As the sex was condom-protected you said that there is no hiv risk. However I am afraid that vaginal fluid may have gotten in contact with the above-mentioned injuries as I do not recall it but still consideres unlikely die to the fact that the injuries were 5 cm from the scrotum. Does this info change your your hiv assessmen?
Just a comment. I started to have second thoughts about my second poaibble exposure (unprotected vaginal) but your comments in other threads gave me further reassurance and the fact that she is someone I know and not a promiscuous girl.
3 Just came from the urologist and he ruled out syphilis or any std. As you said it was just a skin infection and he referred me to an urologist. He even said that based on my exposurea there ia no need for further hiv testong. Do you agree with him?
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300980_tn?1194933000
1.  IF vaginal fluid did come into contact with yoiu wounds, this would not lead to infection.  No reason for concern.  No change in my assessment.

2.  Yes, I agree.  I see no need for HIV testing related to this exposure.  EWH
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Avatar_m_tn
Dear Doctor: I will  appreciate one last follow-up question. You said that my negative test ruled out that my symptoms may be ARS-related. However, the test was taken 4-5 days after the onset of symptoms and in many of your threads you talk about one week after the onset of symptoms. Does this change your assessment? A fast answer will ease my nerves and it will be the last I make. Best Regards,

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300980_tn?1194933000
No, this does not change my assessment.  EWH
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