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HIV Prevention (Expert Forum)
ARS??
by olevia_111, Oct 20, 2006 12:00AM
Dr. Handsfield - Thank you!! I know you only want facts:
I am a 28 y/o heterosexual male who had one instance of unprotected vaginal sex on Sunday October 8 (already presenting with cold symptoms on this day - pharyngitis, rhinitis, and etc). One day after intercourse, I had noticed penile sensitivity; three days after intercourse, I had noticed redness and papules/rash on foreskin of penis (uncircumcised). Presented to the ER and had cultures taken of the papules/rash on penis. Five days after presenting to ER, results for herpes were negative. However at this time, the pharyngitis, rhinitis with significant post-nasal drip had worsened and chronic fatigue had set in. No fevers (temperature had range of 97 - 99) to date. When the girl was questioned regarding her past, she stated that she was tested for gonorrhea, syphilis, and HIV (all NEGATIVE) on September 29, 2006 and that her last unprotected encounter was first week of July 2006 with her boyfriend of 4 months. My fatigue has not improved to date and pharyngitis has worsened. Prior to this unprotected fiasco, I was in a monogomous relationship of 5 years and had been HIV negative. My question:
1. Is it possible to present with ARS WITHOUT fevers? And have you seen, in your clinical experience or in case reports, LATE onset of fevers OR do symptoms usually all present all at once?
I am very worried and appreciate your opinion and thoughts. Thank you.
I am a 28 y/o heterosexual male who had one instance of unprotected vaginal sex on Sunday October 8 (already presenting with cold symptoms on this day - pharyngitis, rhinitis, and etc). One day after intercourse, I had noticed penile sensitivity; three days after intercourse, I had noticed redness and papules/rash on foreskin of penis (uncircumcised). Presented to the ER and had cultures taken of the papules/rash on penis. Five days after presenting to ER, results for herpes were negative. However at this time, the pharyngitis, rhinitis with significant post-nasal drip had worsened and chronic fatigue had set in. No fevers (temperature had range of 97 - 99) to date. When the girl was questioned regarding her past, she stated that she was tested for gonorrhea, syphilis, and HIV (all NEGATIVE) on September 29, 2006 and that her last unprotected encounter was first week of July 2006 with her boyfriend of 4 months. My fatigue has not improved to date and pharyngitis has worsened. Prior to this unprotected fiasco, I was in a monogomous relationship of 5 years and had been HIV negative. My question:
1. Is it possible to present with ARS WITHOUT fevers? And have you seen, in your clinical experience or in case reports, LATE onset of fevers OR do symptoms usually all present all at once?
I am very worried and appreciate your opinion and thoughts. Thank you.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 22, 2006 12:00AM
, Oct 22, 2006 12:00AM
I cannot comment on the penile “papules/rash” you describe, and you don’t say what the ER provider thought about it. But the onset of that symptom – at least the “sensitivity” of the penis – was too soon to suspect herpes or any other STD. Your question about fever is irrelevant, because your symptoms simply cannot be due to HIV; they came on much too soon. And they don’t sound like HIV anyway. (The only one you mention that even remotely suggests HIV is sore throat, and of course hundreds of things, all more common than HIV, do the same thing. Rhinitis etc is not a symptom of HIV. And yes, ARS always causes fever.) On top of all that, symptoms NEVER are a reliable indicator of HIV, especially in such a low risk situation as the one you describe.
Bottom line: You describe a zero-risk event and symptoms that cannot be due to HIV.
Good luck-- HHH, MD
Bottom line: You describe a zero-risk event and symptoms that cannot be due to HIV.
Good luck-- HHH, MD
He will say your risk is low, which you know since you have read other threads here. He will say have a test at about 6 weeks if only to ease your worries but don't lose any sleep over it in the meantime.
And the doc would say that people can start to seroconvert, i.e., exhibit symptoms whilst having detectable levels of HIV antibodies in the bloodstream, as early as ~10 days.
Though symptoms are never a true indicator of HIV infection, and though up to 30% of HIV infected people don't exhibit noticeable symptoms, the most prevalent among all of them is fever, regardless if it's mild, which would occur between 2 to 4 weeks.
Test results are a de facto indicator. I would get tested at 4 weeks for a 95% accuracy and between 6-8 weeks for 99% accuracy result of whether you are HIV infected.
the link is:
http://www.libchrist.com/std/facts.html
i hope this comforts some of us.
I asked her afterwards if she was clean and she said she did a test last month and she was. She did not believe that I was clean and was concerned that she might infect her man. she seem pretty concerned about the fact the condom broke, but I dont know if should think she is clean. She is a sex worker!
Right now I am panicking, I always fear something like this would happen and now it is finally happened...I am counting down the days to 4 th week after exposure to do the test. I dont know what I would do if I tested positive. I am really scared...
Even in the very unlikely event that she did have HIV, vaginal intercourse is NOT an efficient way to transmit the HIV virus. Even when the condom breaks.
Do some archive reading here. You might feel better.
I cant wait for 4 th week to do the HIV test. I need to get on with my life. I have people who love me who would not know how to begin to explain to them what I did!!
Thanks again "who_dis" for your advice
Do you have nothing better to do than sign up on , multiple boards, falsify posts and then post the link to it in other forums? Others may be naieve to see what you are doing but i am not. Grow up pal....sheesh....lol