ARS Symptoms

About 3.5 weeks ago I had an encounter in NYC with a 19 year old girl I met at a bar. I fingered her and she performed oral sex on me. After about a minute of oral sex i saw her vagina was bleeding. My fingers on both hands were covered in blood also so I washed my hands. She wasnt on her period or a virgin but she had been to the doctor the previous day for stomach cramps or something and they told her if this happened she needed to come back but they didnt know what it was. The fact that blood was present worries me because i remember putting my fingers in her mouth before she performed oral sex but I dont think there was blood on them at the time or I would have noticed but if there was blood does that make the risk go up? I am showing many symptoms of ARS- not sure if anxiety related. Week 2 I developed a minor sore throat for about a week and a little headache on and off. The middle of week 2 my lymph nodes seem swollen especialy in my groin, and more so on the right side of my body. My joints hurt behined knees and hips, and got diarhea (diarrhea) 3 times in a row at week 3. 3.5 weeks i looked on my back and saw small flat, red spots on the bottom part of my neck and across my shoulders, and a few down my back.I have not had a fever when Ive taken my temp. and I havent really felt tired, just depressed from all of this.
Im wondering my risk in this situation, and an assessment of my symptoms especially the rash and lymph nodes (possible anxiety?). Thanks a lot.

[H. Hunter Handsfield, M.D.]

I agree completely with monkeyflower, who responded before me (below).  There is no risk here, and anyway, the odds that any particular 19 year old woman in New York has HIV is close to zero, especially if she isn't from an AIDS-endemic country and not an injection drug user.

HIV is a rare cause of the symptoms you describe, compared to innumerable other conditions--and most of the symptoms don't suggest HIV anyway.  'Groin nodes seem to be swollen' doesn't count unless lymph node inflammation is confirmed by a health professional; and absence of fever rules out HIV.  Your only health problem undoubtedly is your stress/depression over the event, which are entirely unwarranted.

Mellow out; you're fine.  But if your anxieties are not settled by this reassurance, have an HIV test if the negative result will help resolve your fears.

HHH, MD

[monkeyflower]

No risk at all. The bleeding is irrelevant. No one ever got any STD, let alone HIV, from fingering alone. Also, I don't know why you'd think you were at risk from putting your fingers in her mouth...

[Brah23]

Dr. H, thanks for the kind words. I know you usually dislike follow ups, but I just wanted to clarify something. The fact that blood could have been transfered to her mouth and then to my penis doesn't make it a higher risk exposure? I am only asking this because this rash I have developed looks like a ARS rash from what I have seen online and I forgot to say I had a dermatologist confirmed my enlarged lymph nodes in my neck. Also, does the fever associated with ARS last throughout or come and go because I didn't take my temp till middle of week 3. I am planning to get tested in a week, that will be 4.5 weeks, and I know I wont know for sure until then, I am just trying to get a grip here. Thanks a lot.

[H. Hunter Handsfield, M.D.]

You missed the main point of my previous response.  Realistically you could not have acquired HIV from the exposure you describe.  Therefore, if you have had not other exposures to HIV, then your symptoms--no matter what they are--are not caused by HIV.  And no, there is no realistic way you can spin your exposure to make it anything other than a trivial to zero risk.

There is no symptom that is unique to ARS.  All symptoms of ARS, including the rash, enlarged lymph nodes, etc, are identical to those of other conditions that are more common than ARS.

I don't guarantee anybody is free of HIV.  But you came to this site seeking my expert opinion and, presumably, reassurance.  Get tested if you feel like it, but in the meantime accept the good news and stop trying to talk me into agreeing with your fears.