I would like some expert advice

[exmetoo]

Dear Doctor,
I am white female
Over a year ago I had unprotected sex with a guy. About 5-6 times for about 10 minutes each. There was no ejaculation. He was white male,  he didn't think he had hiv, don't think he was homo/bi or IDU.

I had a blotchy red rash on my trunk soon after that, but no fever or swollen lymph nodes or anything else that would be considered ARS.

I should also tell you that I started taking VaLtrex once a day at the same time as the incident. (for cold sores)

I was tested 3 months later and was negative.

My questions to you are...

1) Since once daily valtex is antiviral, could it be possible that it supressed hiv antibodies and resulted in false negative?

2) Does the risk lessen with no edjaculation?

3) Could the rash on my trunk been from the medicine I started taking at the same time?

4) Is my 3 month rapid test accurate?

5) If someone was getting ARS, would there be more than just a rash, or can a rash be the only sign?

Please help, thanks :(

[Edward W Hook, MD]

Correct. Valacyclovir becomes acyclovir in the body.  I tend to use them interchangeably.  Sorry if I confused you.  EWH

[exmetoo]

I just noticed that you said acyclovir does not have a direct effect on hiv results. I was taking Valtrex once a day at the time of testing. Are these drugs the same? If they are not the same, I'm assumeing Valtrex does not effect hiv results either.

[Edward W Hook, MD]

You are right, the valacyclovir package insert does indicate that rashes are "common" side effects. If I was the FDA (and I am not), I would say "relatively common".  In my experience giving many patients valacyclovir, I have never seen a rash.  That does not mean it doesn't happen but is by no means common.  EWH

[alienshadow]

Look you have a conclusive result so the rash is invalid move on and forget about it being ARS  
So if you can put this behind you and stop digging into the medicine and the rash you might  be able to be happy again

SORRY DR HOOK

[exmetoo]

I asked, "Could the rash on my trunk been from the medicine I started taking at the same time?"

This was the FIRST time i started taking the Valtrex, so in that case, could the rash have been due to me just starting Valtrex?

Valtrex common side effects does list a rash as one of the side effects of the drug.

I'm so concerned because I had never had a rash like that before and it happened right after the unprotected sex and right after I started taking Valtrex for the first time.

I'm hoping the rash was just from the Valtrex.

I won't ask any more questions..

Thank you in advance

[Edward W Hook, MD]

Your risk of HIV is low.  As a heterosexual man without other risk factors he was most likely not infected with HIV.  If he was, the odds of you catching infection from him are less than 1 in 1000 per act of intercourse.  Most importantly, you have a HIV test at 3 months- you can take that as definitive evidence that you do not have HIV.  Having said this, let's answer your specific questions:

1.  No, acyclovir has no direct effect on HIV.  Taking ACV would not keep or slow you from developing antibodies.
2. Probably although how much is unquantified.  This is not a concern since you do not have HIV.
3.  Unlikely, particularly if you have taken the medication before.
4.  Absolutely- believe it
5.  A rash is part of ARS but there is more, More importantly, you may have missed our 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.

I hope this helps.  EWH