very short exposure, risk of hiv?

[malkin]

On Feb. 7 (6 and a half weeks ago) I participated in some risky behavior in the Philippines. I will tell you exactly what happened, not leaving out a single detail. It should be noted I am a 33 year old male. First, I performed cunnilingus on a prostitute, but it was only on the clitoris. The prostitute then performed oral sex on me for a lengthy amount of time, about 15 mins. Then I had an extremely short unprotected penetration into her vagina. By short I mean in and out (2-3 seconds max). I then put on a condom and finished.

In the time since then (and I hadn't thought about it until now) I have developed a small rash behind my ears of slightly raised bumps, not pimples. I should note that although I know it's unsanitary, I never scrub back there.   This area is the crest where my ears meet my head. I also had a cold sore that lasted about a week. Now,as of yesterday, I have a fever (as confirmed by a doctor) and a deep cough, not frequent, but dense flem producing cough. The symptoms seem to be subsiding a day and a half later, but are still present. This is also a seasonal change in the part of the world I live in, so I understand I could just simply have gotten sick. Is it possible to have acute hiv symptoms 6.5 weeks after the encounter? Do the symptoms usually come all at the same time, or can they be scattered as I an describing? I am worried. What are my chances here?

[malkin]

Hello Dr. Cummings,

First I should tell you I sought a second opinion on this matter from Dr. Hook, who agreed with your answer to me. Of course, no offence, Dr. Cummings, I simply did what I always do with medical issues and sought a second opinion. Dr. Hook said "no further testing is required" after I gave him the following message. Do you agree?

"I was able to take a test,but unfortunately due to the country I live in, I couldn't be choosy about the test for fear of drawing attention to myself.  To make a long story short, where I live they would strip me of my privacy followed by kicking me out of the country. So I went to a free, anonymous test and they used an SD HIV 1/2 rapid test 3.0. I looked at the test package as much as I could for more information, but that's the extent of it. It came back negative.

The test came at 7 weeks and 5-6 days post exposure (they only test 2x per month, so I had no choice). The symptoms I described as I thought to be ARS, started 1 week and 1 day ago, at the 6.5 weeks post-exposure mark. Given that these symptoms happened so late, is there still a chance the test isn't able to detect HIV at this stage?

Given my low-risk exposure risk, do you recommend further testing, or should I consider myself in the clear?"

Thanks Dr. Cummings and to Dr. Hook as well for the work you do here. You have helped me through a difficult time, and hopefully it has drawn to a close.

[Dr Sean Cummings]

Hello

Thanks for your post.

I think its extremely - fantastically - unlikely that you would acquire HIV from this lady even if she was to be HIV positive which we don't know. The only activity which might expose you to risk would be the short unprotected penetration but as you say it was so brief I think it would be of no consequence.

Seroconversion symptoms at 6.5 weeks would be unlikely.

The only way to clear this up would be to have an HIV test - preferably a 4th generation combined HIV antibody and antigen.

A negative 4th generation test at this point will establish and confimr that you are HIV negative.

best wishes, Sean