HIV risk

Hello,

I'm a 27 year old male from Australia. On Saturday September 5th this year, I met a girl at a club and went back to her place at the end of the night. We engaged in mostly protected vaginal sex, however I did give her unprotected oral sex and had probably a couple of minutes of unprotected vaginal sex.

The following Monday, I had a sore throat, and by Wednesday, I still had a sore throat bad enough that I decided to go to the doctor. I told him about the encounter I had as I was scared the sore throat could be a result of a chlamydia/gonnorrhea infection due to the oral sex. He subscribed me 2 x 500mg tablets of Zithromax, which I took straight away. The sore throat disappeared by the end of the day surprisingly. however about 10 days later I started to get this feeling of swelling/pain around my neck area, which lasted nearly a couple of weeks. I can't confirm whether they were swollen lymph nodes; I didn't notice them swelling, they just felt painful/numb. I don't recall any major fevers, though I did sometimes have that feeling of being just sick.

What I'm really nervous about is that this could be a sign of ARS. I've read that symptoms usually occur about 2 weeks after infection, and appear all at once, but I can't help wondering. What are your thoughts?

Also, do you think that due to the fact that the Zithromax worked so quickly on the sore throat it proves it was a bacterial infection and not a viral one? If so, why would I get the swelling/pain around the neck 10 days later if the infection had cleared?

Thanks for your time :)

[Edward W Hook, MD]

Welcome to the Forum.  Your exposures are unprotected oral and vaginal sex.  Your statistical risk from such exposures, even before we consider symptoms is rather low.  Here are the reasons:

1. On a statistical basis it is unlikely that your partner had an STD of any sort, including HIV.
2. Even if she did. most exposures do not lead to transmission.  For men exposed to a female partner with gonorrhea the is of infection is only 1 in 5 and for HIV it is far, far lower.
3.   Your sore throat was unlikely to be an STD or related to the exposure you describe.  Chlamydia does not cause meaningful throat infections and when gonorrhea infects the throat it is typically asymptomatic.  My guess is that your sore throat was unrelated to your sexual exposure.  Whether it was bacterial (i.e. strep) or not is more difficult to say but again, the statistics say it is more likely to be due to a virus than bacteria.  
3.  You may or may not have swollen lymph nodes.  Even if they are, when people have HIV lymph nodes all over the body are swollen and in early HIV this is accompanied by other symptoms such as fever, muscle aches and a rash.  

My advice.  this was a relatively low risk exposure.  The azithromycin would have cured genital chlamydia, NGU and most cases of gonorrhea.  As far as HIV is concerned, it is unlikely and I would urge you not to spend a lot of time worrying.  On the other hand, there is no reason for you not to get an HIV test if you have not had one recently.  I would suggest however that you wait until about week 6-8 following exposure to get tested.  At that time, in your situation, the results will be quite reliable.  I am confident that they will indicate that you did not get HIV either.

Take care.  EWH

[Pete1982]

Thanks for your response, doctor. Regarding your statement concerning swollen lymph nodes all over the body, would this have been some I would have noticed over those two weeks if I indeed did have them? Also regarding the fever you describe, would this be one that persists over a long period?

Thank you.

[Edward W Hook, MD]

You would be quite aware of the fever and you may or may not have noticed the lymph nodes swelling.  Again, I encourage you to try to put this aside.  Your concern is far out of proportion to your risk.  EWH

[Pete1982]

Thanks Dr Hook, I'll try to put the incident aside. I'm gonna get tested around early December, so that it will be 3 months since the exposure. I'll post the results once I know.

Thanks again. :)

[Pete1982]

I was tested last week at the 10 week mark, and I just got the results today which have all come back negative.

Thanks for all your help :)