Sore neck - ARS

[cgs40]

Hi Doctor

Had a sexual exposure with a escort 7 weeks ago which involved protected vaginal sex and unprotected oral sex (receiving) I also lick her cliterus for 4 seconds before stopping. Escort claim tested two weeks prior and all clear.

After 4 days I visited the GUM clinic and was tested for Chlamydia/Gonorrhoea, results came back 3 weeks later as negative.Was then retested for Chlamydia at the gum request (week four) and results came back a week later negative.

After 5 to 6 days (week 1) I started to have a sore patch on the left side of my neck, I visited the doctors on day 12 with this and he said my lymph nodes were not swollen, bit I had a slight sore throat.

This sore throat went away within 7-10 days, I revisted the doctors on day 24 as my neck was still sore, he again check my nodes and confirmed nothing was swollen. he did however give me some cream for a rash (shaving rash on my left hand side of neck)

Then at day 45/46 and I still have a sore neck on the left side during the day, the pain goes away at night or when laid down, I revisited the doctors and he agains checked for my neck nodes and stated they were not swollen and that my throat was also not sore.

During this period since the exposure I have:
a) NEVER to my knowledge had a fever, (beeing checking since week two and temp been around 36)  
b) NO main headaches (had two or three since exposure)
c) NO obvious rashs
d) HAVE HAD slight weakness or pain right elbow / muscle (this seems to come and go since day 30)
e) HAVD HAD a slight blood shot right eye which has been off and on since day 40
f) BUT NO other obvious ARS symptons.

My questions are:
1) Does the neck pain/tenderness seem to be  anxiety related or as a result of ARS?
2) I know the risk of receiving oral as a man is very low risk i.e.1-20,000 - But what if I am the 1?
3) Any risk associated to me licking the womans cliterus? if so what chance..
4) Do my symptoms sound like any other STD

[Edward W Hook, MD]

Sorry, I am not going to fuel your anxiety by getting into a to and fro discussion of which of your symptoms may or may not be part of the "ARS syndrome" (see above).  Bottom line, your symptoms should not make you concerned about HIV.  If your symptoms trouble you, I would suggest you see your health care provider to work through them, being aware that you do not have HIV.  EWH

[Edward W Hook, MD]

There are numerous data, most of which are admittly anecdotal that indicate that people in fact do tell the truth when asked about STDs such as HIV and herpes.

If she did lie and was in the process of seroconverting you would still not be at substantially increased risk for HIV acquisition from oral sex.  It is too rare an event for much to change that.  EWH

[Edward W Hook, MD]

I understand your anxiety, what with the onset of a sore throat and neck following exposure to a potentially high risk partner.  Having said that, I urge you not to worry.

1.  Let's start off with your symptoms. They really do not fit with ARS and are more compatible with some other process.  In addition, on this forum we have made repeated statements that the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes.  In addition, it is also important to realize that many person who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.
2.  How can you expect me to answer that question.  Dr. Handsfield and I have never seen a well documented case of HIV acquisition through oral sex.  You could be the first but it seems unlikely, doesn't it?
3.  This is oral sex. Risk is low.  You have already stated the odds.
4.  No.  IN fact when STDs effect the throat they are usually asymptomatic.

Hope this helps.  You have little to worry about.  If you cannot shake your concerns get an HIV test, realizing that I recommend this only to alleviate your anxiety.  If you do, please wait till at least 6 weeks to get tested.  At that time more than 95% of tests that are going to be positive will be and you can then be confident that you do not have HIV.  

I hope this helps.  EWH

[Edward W Hook, MD]

Please see my earlier response regarding ARS symptoms.  That is what I have to say. Like any medical process involving human beings there are a spectrum of findings and generalizations regarding timing are similarly variable.  For you to continue to focus on this is truly a waste of your time.  EWH

[cgs40]

any thoughts on my last question

[cgs40]

Hi Doctor Edward

Thanks again for your comments and advice,  it is really appreciated...

I understand the statistics given.

As to whether or not there help kerb my anxiety is another question.

It does not help me that over the last couple of days (after five weeks off and on) my neck pain/tenderness has subsided (and it has now entered my shoulders as tension), which make me feel / think it was/could be an ARS symptom....

I cannot find any post in the "expect forum" about ARS symptoms as to whether they come as

a) singluarly or in groups
and whether
b) the symptoms all arrive together or one after another.....

Any idea whether i my find any analysis of statistics on this??

[cgs40]

Hi Dr

Thanks for that....

Two final questions - Not about ARS....

I have seen post by yourself and Dr HHH that if some states they are HIV -ve or been tested, they tend " Not to lie" is this ground on any fact or just human nature?

If the escort did not lie and when she was tested prior my exposure, she was clear, but within the two weeks from her test (or the HIV antibodies not being total present at the time of test) does the oral risk of 1-20000 reduce ?

Thanks

[cgs40]

Hi Doctor

Thanks for your reply, i have taken on board what you have said- but i have a couple of more specific questions if possible, these being

5) Do ARS symptoms normal arrive all together or one after another in my case?

6) Plus do ARS Symptons appear singluar or as a set of symptons?

7) If as a set was are the normal combinations?

8) Does it seem strange from what you know about ARS that my neck is sore on one side only, and that it aches periodically (not constantly) and that previously having a slight burining sensation, but it never hurt at night?