Condom breakage

Hello, doctor:

I had sex with a young man that I met online. He said that he'd been tested for HIV in April and his results were negative. We had oral and anal sex. I performed fellatio on him, swallowed his semen, and then later I bottomed for him. It was during anal sex that the condom broke. We discontinued immediately.

It is now twelve days later and I have a sore throat, mild fever, and fatigue. Could this be ARS? I should also mention that I received the Tdap vaccine two days ago.

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to comment.

Sorry to hear of your condom failure.  From what you tell me this was a low risk exposure- your partner told you he had been tested and recently had a negative test (most people tell the truth) and you were practicing safe sex but experienced condom breakage-something that happens about 1% of the time.  If he happened to have HIV, there is no risk for HIV from oral sex, even with swallowing.  On the other hand the risk for acquiring HIV from receptive anal sex is about 1 infection for every  100 exposures.  

The timing of your sore throat and mild fever is consistent with the ARS but is most likely not.  When persons with acute flu-like illnesses (i.e. the symptoms of the ARS) are tested, less than 1% have positive tests.  

In your situation, it is worthwhile being tested.  Better yet, if you can find this person and he will get tested, you can find out.  If he gave you HIV, his test will now be positive.  If your symptoms are the ARS, a DUO (combination HIV p24 antigen/HIV antibody test is likely to be positive at this time.  If a DUO test is not available, persons who have the ARS typically have positive antibody tests within a week of the onset of their symptoms.

I hope these suggestions are helpful. EWH

[paul_abraham]

Thanks for the comments, doctor.

I will definitely get tested now and in a few weeks. Would you expect the result to be negative?

[Edward W Hook, MD]

Yes, the os are in your favor.  TAke care. EWH

[paul_abraham]

Doctor, is it possible that my symptoms are from the Tdap vaccine? The sore throat is less severe today and my temperature is normal, but I tire easily.

[Edward W Hook, MD]

Perhaps. TDap re-immunization can cause mild reactions.  EWH