worried about exposure

[ottocar]

Dear Doc,
i have a question i had sex with a guy which i found out later is positive. we had sex with condom but it broke and i didnt notice it for 5-10 min...after i did i rinse my penis with water and soap...
well after 8 days later i had some mild fever with 99 degrees and mild sore throat this lasted about 7 days. i am soo worried about HIV now as you can imagine :(

I took a rapid test 9 and 11 days after my symptoms began. what do you think of:
- my risk of getting HIV
- does this sound like ARS symptoms to you?
- the test reliability after 11 days after symptoms onset and my test still being negative..

I am really so freaking out :-( and thank you in advance for your answer.
M.

[Edward W Hook, MD]

If your symptoms had been due to HIV and the ARS, testing at 11 days after the symptoms began would have been positive if your symptoms were due to HIV.  EWH

[ottocar]

Dear Doc,
thank you for your quick reply, i was the insertive partner. actually i took the test 11 days after the symptoms started and i read somewhere that at that time tests would pick up antibodies already.

in any case i surely will test again.

i hope it goes well... but if i read from your assessment symptoms could be ARS but timing not?

M.

[Edward W Hook, MD]

Welcome to the Forum.  Sorry to hear of your condom break which happens about 1% of the time that condoms are used.  Following exposure to an infected person, the risk for infection is affected in several ways.  Two of the most important factors are whether the person you were exposed to was on therapy for HIV or not and the sort of sex act that the breakage involved.  If your partner was on therapy at the time you had sex the risk for infection is decreased a great deal.  As for the sex act, the risk for infection is greatest if you were the receptive partner for anal intercourse (about 1 infection  per 100 exposures), less if you were the insertive partner for anal sex (about 1 in 200) and much much lower if the exposure was oral sex.  Do you know if your partner's HIV was being treated and can you tell us what sort of sexual activity you were engaged in at the time the condom broke?  I could comment more then.

As for your symptoms, mild fever and sore throat, are only some of the symptoms of the ARS and your symptoms, which started at 8 days started earlier than is typical for the ARS which more typically starts between 2 and 6 weeks after exposure.  Thus is is unlikely that your symptoms were due to recently acquired HIV.  Not all persons who get HIV develop symptoms however so we would recommend testing no matter what.

A test performed at 11 days is an unreliable indicator of whether or not you were infected.  If you have access to 4th generation, combined HIV p24 antigen/HIV antibody tests, reliable results occur at any time more than 4 weeks after exposure while if you are testing with tests that detect only HIV antibodies, results are not conclusive until 8 weeks after the exposure.

I hope this information is helpful. You need more testing.  EWH