Avatar universal

Exposure Questions

Good afternoon,

I will make this brief for the experts on here since I know most of the questions are repetitive for you and I don't want this to be one of them. I had a high risk exposure, went on PEP, tested but have a lingering symptom that is worrying to me. I have a "sore" throat for over a month now. Itt does not hurt but is red along the back wall of my mouth and uvula. There is also small grey spot in one area and it's now starting to burn a little at random times. No pain while swallowing.

My exposure was insertive anal on a trans. Condom must have broke mid way through and I did not realize. I finished and did not notice until I pulled out. I have known this person for 10 years and it has always been protected. They state they are clean but would not prove anything to me or even test when I tried talking which is disturbing. They don't have the best past and have had MULTIPLE partners.

See my timeline below:

7/19 - Exposure
7/21 - Started PEP
8/17 - Finished PEP
8/18 - 4th gen test negative (30 days post exp and 1 day post pep)
9/5 - 4th gen test negative (48 days post exp and 19 post pep)
9/5 - Full STD panel - all negative except for Herpes 1

I am testing on 9/18 (60 days post exp & 32 post pep) and again on 10/2 (75 day post exp & 46 post pep).

The only other thing I want to mention is I did receive a "rash" on both my hands for roughly two weeks in the middle of pep or end of pep. Small red dots that looked like they were under my skin, not raised and did not hurt but where just there. My hands were also extremely dry with occasional small white dots of dry skin. As I said it lasted for roughly 2 weeks and disappeared.

Besides that, I have experienced nothing else physical. At this point a lot of mental stress.

Hoping for a little insight and guidance regarding this and not just a "nothing you can do, test again at the right time".

Thank you in advance.

2 Responses
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Avatar universal
Again, I'm not looking for a diagnosis but the fact that I have a visible & physical symptom, wouldn't that show up on a test IF hiv was the reason ? My doctor states that my "symptom" can't be from HIV because the symptoms are the body fighting. He said at least the P24 would show up on one of the two 4th gen tests IF infection did happen.

He also doesn't believe PEP will affect any test. I don't mean to sound negative but I feel my doctor just has an old way of thinking.
Helpful - 0
It's not the reason. It's not just that your symptoms aren't "typical" HIV symptoms. They aren't symptoms of HIV - AT ALL.  An HIV rash, if it happens, is always, every single time, present on the torso. You would not miss it.

PEP is widely accepted as affecting an HIV test, and that a test at least 28 days after your last dose is conclusive.

And yes, if you were having HIV symptoms, you would test positive - but again, a month-long sore throat and a rash on your hands would have zero relationship to HIV.
Thank you. As much as this is still worrisome, it’s also partly relieving.

Without getting personal, can I ask your history / experience ?
Thanks again CurfewX, I really appreciate it.

Two more questions if you don't mind:
1). Minus the "symptoms", and just based on my exposure - do you recommend an RNA test or just the 28 day follow up test ? By the way, today is day 28 post pep.
2). I'm confused because I know a sore throat can be a common system, is it always just usually a week or two and that's it ?
1) There's no need for an RNA test as long as you take a 4th-generation Ag/Ab test. RNA tests are more for early detection after a high-risk event.
2) Yes, symptoms come all at once, last for about a week, and then disappear. It's the body's initial reaction to the retroviral infection. It is EXTREMELY unlikely that the only symptom you'd experience is a sore throat, and it would not last a month.
Thanks again.

I had a follow up with my doctor today and his responses just contradict everything I hear. "HIV can cause mono-like symptoms which can be a prolonged sore throat, the rash if HIV can be on the hands. My "symptoms" can be getting worse now because the PEP could have delayed everything.  Blah Blah". Then on the other hand, he states that my 6 week post exposure test (two weeks post pep) is a very strong indicator and will not send me for another one until 90 days. Looks like I have to order my own test for peace of mind.

It just sucks because everything you read or hear seems to contradict each other.

I'm just venting, I really do appreciate your responses.
He's partially right about the rash. It CAN be on your hands, but it is also INVARIABLY on the torso. No torso rash = not an ARS symptom.  
Good morning. (At least in my area). Just wanted to follow up.

As of yesterday, I tested negative on a 4th gen - 8 weeks (58 days) post exposure and 4 weeks (29 days) post pep. How much faith can I realistically put into this test ?

As per my doctor, I should only count on a antibody test at least 3 months post, preferably 6. Also, he states that although any negative is good, there is a period where the 4th gen can test negative due to p24 not being high enough.

1 You've known the person 10 years and they always used a condom. Therefore they are almost guaranteed to be negative since condoms rarely break, unless a positive person happened to have a break with them.
2 It's almost guaranteed that PEP will prevent infection.
3 You tested conclusively negative.
hiv doctors can't diagnose from symptoms so no one here pays attention to them. Therefore, you shouldn't either, yet you are fixated on a sore throat that could be cancer or anything that makes sore throats. Your only problem is fear of disease, not actual disease. Consider therapy to get you through this issue.
1). Always used a condiment with me at my request. They did not want
2).Good to hear
3). I am not fixated, just asking questions as this website is for, hence medHELP. My last question is regarding accuracy of testing and possibility of not detecting p24. Perhaps my doctor is not educated in this field. Also, you should not say conclusive if it’s not. That is the type of confusion I am trying to avoid.
The P24 antigen would be gone by this point. You'd be counting on the antibody portion of the 4th-generation test, which is HIGHLY sensitive. Most docs wouldn't recommend further testing. Some might suggest testing at 6 weeks post-PEP. No doctor who is current on their understanding of HIV testing recommends 3 months anymore. That's at least 10 years outdated.
Testing again would mean you are counting on astronomical odds that all 4 of these things happened:
1. Your partner was HIV+
2. You were one of the 0.06% who got infected from a one-time encounter
3. PEP failed to prevent infection
4. You are one of the handful of people who tests negative at 4 weeks, but positive at 6 weeks.

The odds of ALL FOUR of those things happening are meteorite-hitting-you level.  Test whenever you want, but there's no further advice we can provide.
Thanks again for the response. I will probably test at 3 months for my own anxiety and also since that seems to be a general thing depending who you speak to. Also, I was not aware that #4 was a possibility.

Regarding what my doctor said, is it true that the 4th gen test can basically be stuck in the middle depending on the time ? Not be able to detect P24 or antibody ?

Again I’m not saying I have it, I just want to make sure my understand if the testing is correct.My doctor has mostly older patients so it’s possible he is not knowledgeable on it as much as he should.

Lastly: your personal opinion is to consider it conclusive ?
No. It seems your doctor does not understand immunology. The reason the antigen starts to wane and then disappears entirely is in response to antibody formation. The antigen would still be present and detectable if not for the formation of antibodies, and BOTH are present for a period of time - it's just that the antigen begins to wane as antibody production ramps up. The test is HIGHLY sensitive.

I already said that most people would move on from this event after getting a negative test 28+ days post-PEP.
Thank you. I really appreciate your help over the last couple of days. Not understanding how the virus works is the worst part.

Thanks again.
Hi Curfew.

Just a testing question if you don’t mind to avoid confusion on my end. You already see I have an uneducated doctor.

Without PEP, a 4th gen would be a good sign at 6 weeks with a follow up at 90 for conclusiveness. As per CDC and also doctors on this forum.

With PEP, shouldn’t I take the entire 28 days into account ? Basically starting the clock over ?

If that’s the case, how is my 4 week post pep conclusive with no need for a 90 day follow up ?
There is never a need for a 90 day follow up. That is outdated. You will not find consensus  about how long to wait, when you search, so pick whatever you want.
We rely on the opinion of expert doctors who say duo is conclusive after 4 weeks, so do not pay attention to other sites or we will be arguing all day.
Doctors left this site long ago.
I already answered this. It's 28 days from your last dose of PEP. If you want to test 42 days after your last dose, that's up to you, but ninety days is way outdated.
The mental strain has been the hardest thing to deal with.

Again, I really do I appreciate everyone’s help. Thank you !!
3191940 tn?1447268717
There really isn't any more insight that anyone can give you.  Symptoms don't mean anything, and a rash on your hands isn't a symptom of HIV infection. Neither is a month-long sore throat.

A one-time risk event with an HIV-positive partner is very low risk for HIV infection, even if you hadn't taken PEP.  You should expect your next test to be negative, and there's no reason to keep testing.
Helpful - 0
I knew "rashes" and "sore throat" were possible symptoms but it's good to hear that my situation isn't common. That helps, thank you.

Any advice regarding the Herpes 1 ? I will follow up with a doctor but any advice if my "symptoms" might be because of that ?
The rashes would be on your torso, and be non-itchy. A sore throat for a month is way too long.

We only cover HIV in this forum, but you can ask about herpes here: https://www.medhelp.org/forums/Herpes/show/195
This is not a herpes forum, and I don't know what advice can be given to you anyway since herpes is not curable.
Only a test can prove anything so try to not think about hiv until then.
The first step to peace is to stop studying your body looking for clues because your throat proves nothing - it could be throat cancer etc. so it's wasting your time and emotions trying to make a diagnosis from a throat or any other body part.)
Thank you. I appreciate it.
Wasn't really looking for an definitive answer but more of if my situation was common or a possible sign. It's good to hear that my two symptoms differ slightly then what's normal. That gives hope.
You're wasting your time studying symptoms. It just makes you more anxious. It could be cancer etc. which is why hiv doctors can't diagnose from symptoms so no one here pays attention to poster's claims of symptoms - and you shouldn't either.  
Hi AnxiousNoMore. I do appreciate your response but please understand, I am not asking you to diagnose me. Although what I am experiencing can also be throat cancer, can it also be HIV ? As per CurferX, it's not a normal sign. She is not saying it's not a possibility but that it's not usually something they see. Based on that type of answer, at least I know how to react. My "symptom" is very specific along with my hands, they are not general flu symptoms.

I am not studying my body as I know most of it is in my mind BUT, the red throat with small grey circle is not a coincidence. It came 2-3 weeks after my one and only "unprotected" sex act in the last 10 years.
Good luck with your test!
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