Aa
your opinion please
Hello and thanks for your help on this issue,
In January I had a single event of protected vaginal, unknown status. There were no issues of the condom failing and had myself tested at 7 weeks, which was negative. I began dating someone in early March. In early April I had a mild flu and treated it as such. Nothing more than a low grade fever, which only lasted a few hours and aches for a few days. My gf and I have engaged in occasional unprotected vaginal. Once with some post menstrual blood only realized afterwards. I have also had issues where my skin was compromised. She has said that she’s std free, but I believe this is because she has never had an “issue”. I realize we need to talk more in depth. I have been having mild to extreme joint and muscle pain for 2-3 weeks. And as of the past 5 days, diarrhea and nausea.
Should I be concerned about ars? Or that the flu I had was possible ars from the event in January, or my relationship? And that these new symptoms are what follow a few months later? I guess I’m looking for a timeline. And your opinion on the issue, of course.
Thank You.
In January I had a single event of protected vaginal, unknown status. There were no issues of the condom failing and had myself tested at 7 weeks, which was negative. I began dating someone in early March. In early April I had a mild flu and treated it as such. Nothing more than a low grade fever, which only lasted a few hours and aches for a few days. My gf and I have engaged in occasional unprotected vaginal. Once with some post menstrual blood only realized afterwards. I have also had issues where my skin was compromised. She has said that she’s std free, but I believe this is because she has never had an “issue”. I realize we need to talk more in depth. I have been having mild to extreme joint and muscle pain for 2-3 weeks. And as of the past 5 days, diarrhea and nausea.
Should I be concerned about ars? Or that the flu I had was possible ars from the event in January, or my relationship? And that these new symptoms are what follow a few months later? I guess I’m looking for a timeline. And your opinion on the issue, of course.
Thank You.
MEDICAL PROFESSIONAL
You raise an important issue and one that is commonly misunderstood. So here comes a blog-like reply in more detail than perhaps you expected. I'll save this thread to respond to similar questions in the future.
A high proportion of all infections that affect humans, and innumerable non-infectious inflammatory conditions, regularly cause fever, headache, muscle aching, joint discomfort, gastrointestinal upset, chills, loss of appetite, and perhaps 20-30 other symptoms. If you were to list all the symptoms of influenza, pneumonia, rheumatoid arthritis, meningitis, urinary tract infections, primary herpes, mononucleosis, dystentery, various cancers, and innumerable other conditions both serious and minor, they would show major overlap with those caused by acute HIV infection. And, for that matter, with the physical manifestations of anxiety, stress, depression, etc.
This is what Dr. Hook and I mean when we describe the symptoms of acute HIV infection as "nonspecific": they are often reliable indicators that something is wrong, but they generally don't point to a specific cause, HIV or otherwise. For some conditions, there are specific as well as nonspecific symptoms. For example, cough with yellow sputum and unilateral chest pain, in someone with fever and muscle aches, would strongly point to pneumonia as a good bet; and the same general symptoms plus urinary urgency and painful urination would suggest a urinary tract infection. Unfortunately, however, HIV has few or no such specific symptoms.
It is for this reason that symptoms are exceedingly unreliable indicators of a new HIV infection, and why the lab test results always overrule symptoms in judging whether or not someone has HIV (as long as testing is done sufficiently long after exposure).
Further, lists of symptoms generally don't get into the importance of combinations or patterns of symptoms, their duration and sequence, and other factors. Even a very common symptom of acute HIV, like fever or sore throat, rarely occurs all by itself as the only symptom. I strongly doubt anyone with a new HIV infection ever had muscle or joint pain as the only symptom, but probably many had such things in combination with fever, sore throat, and skin rash.
Finally, even with typical and even classical symptoms of acute HIV infection, such as the combination of sore throat, fever, skin rash, and maybe enlarged lymph nodes, night sweats, etc, most of the time something other than HIV is the explanation. This is true even when such symptoms occur at the proper interval after a high risk exposure. While of course HIV testing is warranted in such circumstances, most of the time the results are negative.
For all those reasons, your limb aching doesn't raise my concern about HIV, not in the least. This symptom is not due to any infection from the sexual exposure you are concerned about, and probably is entirely unrelated to that event (unless through a psychological connection -- which you can judge better than I can).
A high proportion of all infections that affect humans, and innumerable non-infectious inflammatory conditions, regularly cause fever, headache, muscle aching, joint discomfort, gastrointestinal upset, chills, loss of appetite, and perhaps 20-30 other symptoms. If you were to list all the symptoms of influenza, pneumonia, rheumatoid arthritis, meningitis, urinary tract infections, primary herpes, mononucleosis, dystentery, various cancers, and innumerable other conditions both serious and minor, they would show major overlap with those caused by acute HIV infection. And, for that matter, with the physical manifestations of anxiety, stress, depression, etc.
This is what Dr. Hook and I mean when we describe the symptoms of acute HIV infection as "nonspecific": they are often reliable indicators that something is wrong, but they generally don't point to a specific cause, HIV or otherwise. For some conditions, there are specific as well as nonspecific symptoms. For example, cough with yellow sputum and unilateral chest pain, in someone with fever and muscle aches, would strongly point to pneumonia as a good bet; and the same general symptoms plus urinary urgency and painful urination would suggest a urinary tract infection. Unfortunately, however, HIV has few or no such specific symptoms.
It is for this reason that symptoms are exceedingly unreliable indicators of a new HIV infection, and why the lab test results always overrule symptoms in judging whether or not someone has HIV (as long as testing is done sufficiently long after exposure).
Further, lists of symptoms generally don't get into the importance of combinations or patterns of symptoms, their duration and sequence, and other factors. Even a very common symptom of acute HIV, like fever or sore throat, rarely occurs all by itself as the only symptom. I strongly doubt anyone with a new HIV infection ever had muscle or joint pain as the only symptom, but probably many had such things in combination with fever, sore throat, and skin rash.
Finally, even with typical and even classical symptoms of acute HIV infection, such as the combination of sore throat, fever, skin rash, and maybe enlarged lymph nodes, night sweats, etc, most of the time something other than HIV is the explanation. This is true even when such symptoms occur at the proper interval after a high risk exposure. While of course HIV testing is warranted in such circumstances, most of the time the results are negative.
For all those reasons, your limb aching doesn't raise my concern about HIV, not in the least. This symptom is not due to any infection from the sexual exposure you are concerned about, and probably is entirely unrelated to that event (unless through a psychological connection -- which you can judge better than I can).
Thank you Dr Handsfield,
If you don't mind a reply, though, I can't help but notice here on the medhelp "symptoms" page, that aside from the triad which most people fall under, joint and muscle pain is mentioned. I really wouldn't make a stink out of it, if it wasn't so noticeable in various joints and limbs and again, ongoing. How do you professionally feel about this condition in relation?Thanks again
If you don't mind a reply, though, I can't help but notice here on the medhelp "symptoms" page, that aside from the triad which most people fall under, joint and muscle pain is mentioned. I really wouldn't make a stink out of it, if it wasn't so noticeable in various joints and limbs and again, ongoing. How do you professionally feel about this condition in relation?Thanks again
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
With a single episode of condom protected vaginal sex, plus the statistical improbability that partner had HIV, for practical purposes you had a zero risk exposure with respect to HIV last January. And test results always overrule exposure history and symptoms, and your negative test at 7 weeks proves you weren't infected at that time.
As for your current relationship, I see no serious cause for worry. You describe no reason to suppose your new partner has HIV, and your symptoms are not particularly suggestive of a new HIV infection, which does not typically cause diarrhea or nausea; a minor, garden variety viral infection is far more likely than HIV. And by the way, sex during menstruation does not materially increase the risk of HIV infection through vaginal intercourse.
My advice is that both you and your new partner be tested for HIV and other common STDs -- not because I believe there is significant HIV risk in this situation, but because the negative test results will be more reassuring than anything I can say based on statistical probabilities. It's quite common for couples in new relationships these days to have common STD/HIV testing, and (properly proposed) your partner should appreciate your concern for her health and your own. But if you can't bring yourself to discuss it with her, certainly you can be tested on your own.
In the meantime, you shouldn't be at all worried. The chance that either you or your girlfriend has HIV is very close to zero.
Best wishes-- HHH, MD
With a single episode of condom protected vaginal sex, plus the statistical improbability that partner had HIV, for practical purposes you had a zero risk exposure with respect to HIV last January. And test results always overrule exposure history and symptoms, and your negative test at 7 weeks proves you weren't infected at that time.
As for your current relationship, I see no serious cause for worry. You describe no reason to suppose your new partner has HIV, and your symptoms are not particularly suggestive of a new HIV infection, which does not typically cause diarrhea or nausea; a minor, garden variety viral infection is far more likely than HIV. And by the way, sex during menstruation does not materially increase the risk of HIV infection through vaginal intercourse.
My advice is that both you and your new partner be tested for HIV and other common STDs -- not because I believe there is significant HIV risk in this situation, but because the negative test results will be more reassuring than anything I can say based on statistical probabilities. It's quite common for couples in new relationships these days to have common STD/HIV testing, and (properly proposed) your partner should appreciate your concern for her health and your own. But if you can't bring yourself to discuss it with her, certainly you can be tested on your own.
In the meantime, you shouldn't be at all worried. The chance that either you or your girlfriend has HIV is very close to zero.
Best wishes-- HHH, MD
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