Can these symptoms be ARS? Shoud I get tested?

[Piti43]

Good Day Dr,

24 days ago i had protected sex with a sex worker, At the end the condom didn't seem to be broken, during the act I was licking her nipples and her nipple pierced ring. (I hope that was not a recent piercing)
During the first, second and third week I had developed multiple small red (less than 5 mm) patches on both sides  my neck that all went away in max one day after I've used Polysporin on all of them. I believe that these red spots could  be associated with the HIGH level of stress that I had to deal with every minute for weeks...
On my left cheek I have aprox. 7 little light brown  flat spots that look like regular skin brown spot that I cannot remember if they were there before this event.
I had no other symptoms, I had checked my temperature every day, 35.5 C - 36.7 C.

Could this "rash" be a sign for acute HIV?  Can ARS occur without high fever?
Should I get tested, and if yes when?

Thank you!

[H. Hunter Handsfield, M.D.]

I recommend against home testing when someone has symptoms, such as your rash.  In any case, there is only one home-based HIV test (at least in the US), trade name Home Access.  And for general STD testing, it's generally a lot less expensive to visit a local health department for testing (which may be free) than to use online testing services.

[Piti43]

Thank you Dr. Hunter,

This was the only exposure, I know I have asked the same or a similar question thre weeks ago but now I had more data and the anxiety level still elevated.

I will go get tested at 6 wks.  Of the home tests would you have any suggestions on which is more accurate?

Thank you again.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You asked a question a few weeks ago on the HIV communtity forum about a similar but presumably different exposure. This was pretty much the same sort of event.  It is statistically unlikely your partner had HIV, but in any case you had condom protected sex, so there was no significant HIV risk; and of course there is no HIV fisk from oral contact with skin anywhere on the body, including breasts and nipples, regardless of piercing.  Further, your symptoms don't suggest ARS, which does not cause skin rash if the kind you describe and almost always causes fever.

From a medical standpoint and on the basis of risk, no HIV testing is necessary.  However, as a person who has extra-marital, non-monogamous sex, even with consistent condom use, you should be tested from time to time (e.g. once a year) for HIV and other STDs.  So this might be a good time, while it's on your mind -- but not because of this particular sexual exposure or your symptoms.  If you decide to be tested, I suggest waiting until about 6 weeks after the sexual exposure, at which time tests for HIV, syphilis, gonorrhea and chlamydia all will be reliable.

Finally, if the rash reappears on your face and neck, or if other skin spots show up, see a health care provider right away, and don't self-treat with polysporin or anything else.  Although such a rash does not suggest HIV, syphilis might be a possibility.

I hope this helps.  Best wishes--  HHH, MD