Professional opinion required

[dmn303]

Hi Dr,

Rather than being long winded I'll cut straight to the chase. I paid for sex with a TSW and was the condom protected insertive partner for Anal intercourse, it was brief as I was quite premature (maybe 30 seconds inside). After that we tried again with a new condom however this time it didn't really go in as I was becoming soft and gave up. I showered and was on my way.

I identify as straight and maybe once a year engage in these types of transactions and I'm always very careful about wearing a condom and have no interest in being the 'bottom' partner. I was not particularly worried about my last encounter as condoms were used and to my knowledge they didn't break. However exactly 9 days after I have come down with a sore throat,  puffy swollen neck glands and a terrible head ache but no rash. I have been bed ridden the last couple of days with little appetite.  Do you think this is cause for concern, or unrelated? I'm kind of worried given the time frame and symptoms to seem to coincide with ARS or are they to early? I sent a text message to the girl posing as a potential new client and asked if she was clean and always practiced safe sex, to which she replied she did and I needn't worry.

What do you make off all this? Am I at risk, do I need to be tested after this particular event? I'm extremely worried.

Thanks for your great work here.

[Edward W Hook, MD]

Whether you respond to antibiotics or not is irrelevant to my assessment and advice.  If you do respond it is further evidence that this is not HIV but the converse is not true- even if your symptoms persist despite antibiotics I woul not worry about HIV.  EWH

[dmn303]

Hi Dr,

Thanks for your response. Just quickly, I went to the DR today and he inspected my throat and said I had a bad bacterial infection which was causing my nodes to flare up. He has put me on anti-biotics which seem to have started to work almost 5 hours after first taking them.

If the anti-biotics work does this further suggest that it is NOT hiv related?

I know you guys don't like to go back and forth so if you could just answer that I'd be grateful. Merry Xmas!

[Edward W Hook, MD]

Welcome to the Forum and congratulations on your commitment to safe sex.  The chances are that your partner did not have HIV, most people, including most transsexual commercial sex workers do not have HIV.  If she did have HIV and the exposure was unprotected, the statistical risk for infection of the insertive partner is, on average about 1% (1 in 100) and in your case the risk might be somewhat lower give the brevity of the exposure.  Use of a condom throughout the exposure reduces the risk for infection to essentially zero.  I would not worry about your condom protected exposure described above.

The symptoms you describe above began a little earlier than is typical for early HIV infection (two weeks is typically about as early as these occur) and are far, far more likely to be due to the sort of flu-like illnesses that are common at this time of year than to HIV.  

Thus, your risk if quite low and I would n ot be worried.  In this day and age, when sexually active folks present for evaluation of a flu-like illness, testing for HIV is often done along with tests for the flu virus itself but I see no reason for you to specifically seek testing for HIV related to the condom protected exposure you describe.

I hope this comment is helpful. EWH