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Avatar universal

Hig Risk

I had a high risk exsposure, receptive anal.  Sometime during the act the condom broke.  My partner said he pulled out prior to cumming but im not so sure, I had some leakage after words, seamon? muccus and lube, i dont know but scared to death.  He said he was tested less than 3 months ago, and I have nothing to worry about.  17 days later I woke up to find 6 red dots on my jaw line, all 6 cover the area of a quarter, kinda look like a pimple without the white center, slightly raised.  they dont icth or hurt.  Then later that day I notive a swollen lymphnode on the same side, behind the jaw bone under the ear.  its a little tender but cant say that it hurts.  I havent had any other symptoms, No fever, No flu like symptoms.

My questions are could this be a rash from ARS? would a rash from ars cover such a small area and be on the face? and would it show up without having a fever.   How about the one lymphnode? would there be more than one with ARS.   Im absolutely sick with fear, I have a 4 week test tomorrow, just cant wait any longer, then agian at 6 and 12 weeks.  Please help!!
8 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Almost certainly your partner didn't have HIV.  Yes, it's possible he had acquired it since his negative test, but statistically unlikely.  If he was infected, the chance of transmission was low.  Your symptoms don't sound at all like HIV.  I disregard your self-diagnosis of an enlarged lymph node; self diagnosis of lymph node enlargement is extremely unreliable.  Anyway, in ARS people have widespread lymphadenopathy, many areas of the body--not a single enlarged node.

Bottom line (no pun intended):  Almost certainly your 4 week test will be negative.  If so, it will be almost 100% reassurance.  A single additional test either at 6-8 weeks or at 12 weeks will be sufficient; you don't need 2 more tests.  But of course follow the advice of your own provider.

Good luck--   HHH, MD

Good luck--   HHH, MD
Avatar universal
Thank you so much for the feedback, it does help with the fear factor, you didnt address the red spots on my face, i take it those arent consistant with a rash from ARS? Ive read posts that say that the rash, if it developes would follow a fever, since I had no fever no ars rash? is this correct?
239123 tn?1267647614
MEDICAL PROFESSIONAL
What did you think I meant by "Your symptoms don't sound at all like HIV"?  As to what the cause of your rash might be, I haven't a clue and won't try to guess.

Stop looking at the internet for HIV symptoms.  It is a fool's errand.

Avatar universal
Why is unprotected (albeit) brief receptive anal course between gay men considered to present a "low risk" for transmission?  On one hand, I realize that the estimated per incident transmission with a known poz partner is 50 in 10,000; this is certainly reassuring statistically.

On the other hand--I'm hard-pressed to fully comprehend how this sexual act could be described as "low risk."  The advice on this board has gotten me through a very similar situation with much less anxiety, and I appreciate the statistical rarity of HIV transmission to some extent.

That said, I'm confounded by the fact that people--many, and many people--become infected in the gay community.  In any act of successful fornication there's only one known: there's going to be a top, and there's going to be a bottom, and therefore a *significant* portion of the gay community (I'll specify: urban gay communities) engages in the highest known sexual route of infection.  But this table says: well, if get ****** 10,000 times by a positive partner, I
Avatar universal
The Dr. (and other literature) says it is patterns of behaviour that usually determines whether someone is at true risk.  So, if a person is promiscuous, has receptive uprotected anal and/or shares needles, and does this repetetively, then the odds are significantly higher and that person will more than likely aquire hiv eventually.

I recall a statement he made awhile ago regarding his geographic area and gay males having high risk sex in bath houses where only around 25% of them are infected each year.  He said that is high on a population basis, which it is, but relatively low considering the number of males practicing this lifestyle as well as considering how many times they are practicing unsafe sex during the course of a year.

Most literature I have read, as well as read here and heard from health experts, confirm behavioural patterns as the risk, not necessarily the sex act although that does obviously play a part in the process.
239123 tn?1267647614
MEDICAL PROFESSIONAL
dumbo is right on about behavior patterns.

In addition, the stage of the epidemic makes a big difference.  Around 1980, when HIV was spreading very rapidly among gay men, a large proportion of infected people had early HIV infection with high viral load.  Therefore, a randomly selected partner not only had a good chance of being infected, but of being highly infectious.  So in the early phase of a rapidly spreading epidemic, the risk for any particular sexual exposure was much higher than it is now, with a more stable "mature" epidemic.  A similar phenomenon is being seen in heterosexual HIV epidemics in Africa.  In most sub-Saharan countries the proportion of the population with HIV rose from a couple percent to around 20% over only a few years, but in most countries that percentage has now leveled off in the past few years.  Partly that's due to behavior change, and partly to death rates balanced by new infection rates.  But much of the explanation probably relates to the maturity of the regional HIV epidemics.

HHH, MD
Avatar universal
Very interesting.  I'm not up to speed on HIV medication, however I'll presume that the overall lowering of the viral load in treated patients not only prolongues <i>their</i> lives, but has also saved the lives of many, many other people with whom they had sex but did not infect.  In growing the maturity of the epidemic, HAART has, in one sense, saved thousands of lives from actual infection.  

While I'm quite honestly not a conspiracy theorist of any kind, the controlling over the "age" of the epidemic via viral reducing meds, the CDC's conservative estimates that opt for prudent/anxiety producing guidelines instead of realistic ones, and our culture-at-large's stigmitization of the disease all seem to act in such away that suggests stopping its spread not by cure but by slow seige.  Have other diseases been approached with this long-term bleeding out of it strategy?  Ie., create an enviornment that makes the virus extremely difficult to transmit sexually; promote ONLY the use of condoms, consistently; maintain by all reasonable standards the highest amount of fear and stigma about the disease. The obvious analogy in these political tense times deals with the much reviled terrorist, who could strike  any time you let your guard down, nevermind the astronomically minute risk that the general US population has of being killed in such an event.  In both cases, the outcome of the reaction tends to be disproportionate; for terrorism we make war, for HIV we make more fear.

This isn't a moral judgement on such an approach; indeed, were it to effectively end the epidemic lest a cure by discovered, who wouldn't carry some latex and anxiety if it could save millions of lives in the future.  Furthermore, does the mutability of the virus, the limits of medicine, and an eventual intolerance for fear expressed in the population (elections!) resulting in unsafe sex condemn this hyper-controlled virus to eventual re-perpetuation? Or is the only thing that can end an epidemic a simple, massive, and timely innoculation?  

Doctor--if you're still reading this, do you recommend any book, or popular-science publication, that discusses in CLEAR and HONEST terms the current state of the virus, recent medical advances, long-term strategies and theories?  I happen to find the subject sort of fascinating from a cultural persepctive (age of anxiety, etc.), not to mention educating myself happens to be a great way to reduce my chances of slipping up ever again, because, well, I live in New York, and I'm not sure what life without propogated fear would be like.  


Thanks again!
79258 tn?1190630410
Conspiracy theories will get you nowhere. I'm sure the truth is far more sinister ;-)

As for HIV anxiety, I think it's obvious that you're not freaked because it's such a horrible disease. You are far more likely to get and die from lots and lots of equally/more horrible things, like cancer, diabetes, heart disease, or even random violence. Yet I bet you're not staying up worrying about them, are you.

So, while waiting for other suggestions on readings on the virus itself, read Marty Klein's America's War on Sex. He's awesome, and he is right on. That's what should be keeping you up nights.
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