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HIV Prevention (Expert Forum)
ARS
Answered by
Edward W Hook, MD - HIV Prevention, stds
This forum is limited to prevention of HIV and to safe sex in general. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, this is the site for you.
IMPORTANT
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
ARS
by StressedScared, Jul 19, 2008 07:21PM
I am a male and 11 days ago I had unprotected anal sex with a male of unknown HIV status. I was the insertive and not the receptive partner. The entire event lasted less than 2 minutes. I have no fever. The only symptom I am experiencing is swollen lymph nodes/glands in the neck and groin. I already had some swelling in one of the nodes in my neck around the time of the event due to sinus allergies. I saw a Dr. 3 days ago who said she couldnt feel any swelling and ordered a full STD panel. No results yet. I saw another Dr. in the same office today who said she could feel swollen nodes in my neck and some swelling in the groin. She couldnt feel anything in the armpit but they feel puffy and I have a burning pain. I know symptoms arent a good indication. Can the beginng of HIV have only the symptom of swollen nodes? Could it be syphalis with the only symptom being the nodes? Considering the activity, what is the soonest I can test with a degree of accuracy. I will definately test again at 3 months but there is no way I will make it that long mentally without a 2nd test to help calm my nerves. Thanks Doctor.
Doctor's Answer
by Edward W Hook, MD, Jul 24, 2008 02:47PM
, Jul 24, 2008 02:47PM
What we know is that about 50% are positive at two weeks and 85-90% by 4 weeks. Thus it is reasonable to assume that about 75% will be positive at 3 weeks. EWH
1, The partner. Unknown HIV status but we both know that sex with a random partner of unknown HIV status is riskier than having sex with someone whom you know or whose status you know. Even so, odds that he was infected on a statistical basis are probably less than in 10%. Thus it is unlikely that he was infected.
2. The exposure. The odds of HIV transmission though rectal sex. if your partner was infected, are about 1 in 100 with the odds for the insertive partner (you) being lower than for the receptive partner.
3. Your symptoms. While they occur at approximately the right time for the ARS, when studied, less than 1 in 100 people with a flu-like illness characterized by the symptoms of the ARS turn out to have the ARS. It is far more likely that you have some sort of non-specific viral illness, not ARS.
Putting all of this together, while there certainly is risk associated with your exposure, the odds are still very much in your favor that you do not have HIV. A first HIV test at about 4 weeks will give you about a result at a time when 85-90% of tests that are going to be positive will be and will be highly informative. In this situation some would suggest a HIV PCR test, I do not because false postives in this test are much more common than in the antibody blood test and thus could suggest you are infected when in reality you are not.
I hope this helps. Please keep us posted on your tests. EWH
As far as causes of swollen nodes are concerned, the list is very long and includes not only many viruses but also bacterial infections, non-specific inflammatory responses due to things other that infection (i.e. medications, allergies, etc) and much, much more. Evaluation of swollen nodes should be done in the context of complete examination and evaluation with your doctor. From your post it sounds that the first thing to sort of is if your nodes are swollen (you indicate that your two doctors are not totally in agreement on this) and then go from there.
As for syphilis, the timing and findings are not right for your symptoms to be syphilis unless there is something you've forgotten to mention in your post. If you had swollen nodes from syphilis, your blood test would be positive. Good luck. EWH
I think I saw a post the other day that 3 weeks gets you to around 75%?
Is around 75% testing positive that are going to test positive an accurate figure for 3 weeks?
This thread is getting too far into "what if questions" which have little value to you. Please, no further questions. EWH