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Avatar universal


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.
14 Responses
239123 tn?1267651214
I cannot comment on the penile
Avatar universal
He will say ARS can never start that soon.....especially the SAME DAY?? of exposure! Usually 2-4 weeks and almost ALWAYS with fever.

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.
Avatar universal
Sorry, let me clarify.  I already had cold symptoms the day that I had the unprotected intercourse.  I was not implying that ARS symptoms had started the same day.  My apologies.
Avatar universal
Hey Dumbo,  you can correct me if I'm wrong, but having unprotected vaginal sex with an HIV infected person is like 1/100,000.

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.

Avatar universal
I am only repeating what the doc does and what I understand, but the odds are ~1/1000 for male to female and uncirc males and ~ 1/2000 female to male and circ males.....this is with an infected partner.  If unsure of a partners status I have heard the odds are 1/100000 or so....(i.e. chance of finding a HIV positive person, odds of transmission from 1 episode etc) though I believe the odds are really 1/1million,  i.e. 1/1000 chance person is infected, 1/1000 chance of transmission from an infected partner.... .001 x .001 = .000001 = 1 in 1 million.  This is based on vaginal sex as well. anal sex is higher, IV drug use obviously much higher as well....and they are averages only....based on years of data they now have.
Avatar universal
Fever is almost always 100% present during ARS symptoms.  It was one time, thats 1 in 2000 chance from a woman giving it to a man IF she was infected (based on one time exposure.)  You should relax b/c I would bet my life you are not that unlucky!
Avatar universal
1/100,000 is based on sex with someone of  unknow status. 1/1000 is the rate with someone confirmed HIV pos.
Avatar universal
Please read this, i found this and this in addition to Dr. HHH is so re-assuring. see my post below to Dr. HHH, too many what if thoughts making me crazy. I am anxiousally waiting for my results that will be at my docs office in 10-12 days he says. i know from my risks i don't have anything to worry about but i just hope thats true and i realy am a worried well.

the link is:

i hope this comforts some of us.

Avatar universal
After having concerns over an incident that happened to me when I was in Uganda I had been tested at 4 weeks (negative) and then told that the doc was 99.9 per cent sure I was not infected.  However, I still worried and the other day I went back and got a negative result again.  I am very aware of the terrible things that hiv/aids does to people after seeing with my own eyes when working with children indirectly or directly affected by the condition in Zimbabwe.  But what I feel is that the majority of the time talk of this hiv stuff is mostly psycholgical and if one lets it play with their head then it will.  If you are using a condom then thats the way forward but being sensible in the first place is the key.  I know that I will from hear forward.
Avatar universal
Avatar universal
I know you won't, but try to relax.  Regardless of how you are thinking right now, the vast majority of sex workers DO NOT have HIV.  The fact that this one was so concerned about you not infecting her, bodes very well that she is telling the truth.  Otherwise, she wouldn't have cared if it broke.

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.
Avatar universal
Thanks. That is what I say to myself but my mind is thinking all sort of things that are not productive to my well being. believe or not the sex worker even showed me her children pictures on her phone but mind is telling me things like its part of her scam!

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
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