ARS Symptoms

[DR79]

Hi Doc...you do a great service to all of us out here, and I applaud your patience and knowledge. I'll try to keep it short.

On January 1st, I had unprotected sex with a woman. (I am a man). I did not ejaculate inside her. This woman and I had a discussion about her STD history before we had sex and she said she was "fine" but I guess you never really know. Additionally, the girl was on the final day of her period, and removed her tampon prior to sex. I did not see any blood on my penis after sex. (But WHAT was I thinking!!)

Now, 9 weeks later, I am as sick as I have ever been. I have a fever of 101 degrees, stiff neck, dry cough, diarrhea, chills, sweats at night - the whole thing. My doctor said it's a "flu-like" virus and I just need to grind it out, but I am worried that these could be ARS symptoms. What are your thoughts? Is 9 weeks too late for ARS to begin? If I was going to have the ARS illness, would it have happened already? Do these even sound like ARS symptoms? Any knowledge you can provide would be greatly appreciated. Thanks.

[H. Hunter Handsfield, M.D.]

First, with respect to 'What was I thinking!!':  People have sex during menstruation all the time.  Any increased risk in HIV or other STDs is too little to worry about.

I agree 100% with your doctor.  Your symptoms came on too late to be due to HIV, and they sound like a garden variety virus.  Sure some of your symptoms are similar to those of ARS, but you can say the same thing about 80% of all infectious diseases.  That is why symptoms simply never are a valid indicator, by themselves, of new HIV infection--especially in the virtually zero-risk situation you describe.  And most of your symptoms are not suggestive of HIV, especially the cough.

Have an HIV test for reassurance.  You can count on a negative result.  And otherwise follow your provider's advice.

Good luck--  HHH, MD

[DR79]

You would characterize the unprotected vaginal sex during her period as low risk?

For future reference....symptoms such as mine past the 4-5 week mark after an encounter would be too late for HIV? Is that correct?

[H. Hunter Handsfield, M.D.]

Depends on what high risk means to you.  Vaginal sex is technically high risk if one partner is infected, but even there averages 1 transmission in 2000 exposures.  For practical purposes, vaginal sex with blood exposure isn't much different, perhaps a doubling of the risk, to 1 in 1000.  And the odds are strong your partner wasn't infected, since HIV is so rare in womein in the US.

I already answered your question about timing of symptoms.