HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Hello, I Have A Question Regarding My HIV Risk. I

default
Posted on Tue, 9 Feb 2021
Question: Hello, I have a question regarding my HIV risk. I was on PrEP daily for 6 days. On the 7th day I had a condomless insertive anal sex encounter. 3 days later, I had a condomless receptive anal encounter with no ejaculation. 20 days after the first encounter (or 17 days after the second one) I experienced swollen lymph nodes in the neck and groin, nausea, loose/watery stools, night sweats, low grade fever, chills, all for three days. After three days, most symptoms subsided except for the lymph nodes. 2 days later, diarrhea returned for 2 more days then went away. Is this possibly ARS?
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Hello, I have a question regarding my HIV risk. I was on PrEP daily for 6 days. On the 7th day I had a condomless insertive anal sex encounter. 3 days later, I had a condomless receptive anal encounter with no ejaculation. 20 days after the first encounter (or 17 days after the second one) I experienced swollen lymph nodes in the neck and groin, nausea, loose/watery stools, night sweats, low grade fever, chills, all for three days. After three days, most symptoms subsided except for the lymph nodes. 2 days later, diarrhea returned for 2 more days then went away. Is this possibly ARS?
doctor
Answered by Dr. Sankaranantham Murugan (8 hours later)
Brief Answer:
Your symptoms are not necessarily due to HIV infection.

Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
You had mentioned that you were on PrEP for 6 days and you had unprotected sex on 7th day and another after 3days. But not mentioned whether you are continuing PrEP still or not. PrEP has to be continued as long as the individual is sexually active and not for a specific period. Moreover PrEP is 100% safe only when it is used along with condom usage. In the absence of condom, the efficacy of PrEP protection cannot be taken as 100% safe.
Regarding your symptoms, the abbreviation, ARS is not used nowadays. Earliest manifestation of HIV infection (Acute infection or Primary HIV infection or Seroconversion illness) can appear not earlier than 4 weeks after the exposure usually.
Now this is a season of Fever... So your symptoms could be due to any other reason, including Covid 19. Only investigations can either confirm or rule out any condition. So consult you physician and have appropriate investigations and get well, instead of guessing the probablities.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sankaranantham Murugan (0 minute later)
Brief Answer:
Your symptoms are not necessarily due to HIV infection.

Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
You had mentioned that you were on PrEP for 6 days and you had unprotected sex on 7th day and another after 3days. But not mentioned whether you are continuing PrEP still or not. PrEP has to be continued as long as the individual is sexually active and not for a specific period. Moreover PrEP is 100% safe only when it is used along with condom usage. In the absence of condom, the efficacy of PrEP protection cannot be taken as 100% safe.
Regarding your symptoms, the abbreviation, ARS is not used nowadays. Earliest manifestation of HIV infection (Acute infection or Primary HIV infection or Seroconversion illness) can appear not earlier than 4 weeks after the exposure usually.
Now this is a season of Fever... So your symptoms could be due to any other reason, including Covid 19. Only investigations can either confirm or rule out any condition. So consult you physician and have appropriate investigations and get well, instead of guessing the probablities.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sankaranantham Murugan (47 minutes later)
Thank you doctor. I was continuing PrEP. And I was on PrEP during these encounters. And I am still on PrEP

I understand now that a condom is a non-negotiable.

I had a covid test during my symptoms and it was negative.

Do you think that HIV is likely in my case or can you tell? If I was your patient, would you be concerned of a possible transmission?

Also, thank you for correcting my usage!
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Thank you doctor. I was continuing PrEP. And I was on PrEP during these encounters. And I am still on PrEP

I understand now that a condom is a non-negotiable.

I had a covid test during my symptoms and it was negative.

Do you think that HIV is likely in my case or can you tell? If I was your patient, would you be concerned of a possible transmission?

Also, thank you for correcting my usage!
default
Follow up: Dr. Sankaranantham Murugan (1 hour later)
Also, I took a test on December 18 for HIV (4th gen) and it cam back negative. But I know it's not conclusive. I also am having diarrhea now but I think it is anxiety from thinking about the problem too much. I was supposed to get an HIV test today but I am not getting it on Monday, so I think my body is reacting to it.
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Also, I took a test on December 18 for HIV (4th gen) and it cam back negative. But I know it's not conclusive. I also am having diarrhea now but I think it is anxiety from thinking about the problem too much. I was supposed to get an HIV test today but I am not getting it on Monday, so I think my body is reacting to it.
default
Follow up: Dr. Sankaranantham Murugan (16 hours later)
Also, can PrEP affect the way seroconversion illness would present if I actually did contract the virus?
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Also, can PrEP affect the way seroconversion illness would present if I actually did contract the virus?
doctor
Answered by Dr. Sankaranantham Murugan (5 hours later)
Brief Answer:
Your symptoms are unlikely to be due to HIV infection.

Detailed Answer:
Hi,
Welcome back.

Despite Covid Negative, there are many other infections, other than HIV and Covid infections, can produce such symptoms. As you are continuing PrEP continuously your HIV risk is negligible only. Not to worry. If I come across such a patient in my clinic, of course, I would prefer to rule out HIV in this case with appropriate tests for HIV.

You had not mentioned that how many days back you had your first and next risky exposures.
4th generation test is a highly reliable test. 3-4 weeks after the last exposure and the nonreactive report of 4th generation HIV test can rule out HIV 1 infection (which is prevalent up to 99%) and the nonreactive test 12 weeks after the exposure will rule out both HIV 1 and 2 infections (Both antigen and antibody part of the combo test) in a normal situation.

As you are on PrEP, the possibility of delay in this duration of seroconversion can not be overlooked. At the same time in the presence of PrEP, the chances of getting HIV infection is negligible. Consult your physician and get well soon.

Dr S.Murugan
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Sankaranantham Murugan (0 minute later)
Brief Answer:
Your symptoms are unlikely to be due to HIV infection.

Detailed Answer:
Hi,
Welcome back.

Despite Covid Negative, there are many other infections, other than HIV and Covid infections, can produce such symptoms. As you are continuing PrEP continuously your HIV risk is negligible only. Not to worry. If I come across such a patient in my clinic, of course, I would prefer to rule out HIV in this case with appropriate tests for HIV.

You had not mentioned that how many days back you had your first and next risky exposures.
4th generation test is a highly reliable test. 3-4 weeks after the last exposure and the nonreactive report of 4th generation HIV test can rule out HIV 1 infection (which is prevalent up to 99%) and the nonreactive test 12 weeks after the exposure will rule out both HIV 1 and 2 infections (Both antigen and antibody part of the combo test) in a normal situation.

As you are on PrEP, the possibility of delay in this duration of seroconversion can not be overlooked. At the same time in the presence of PrEP, the chances of getting HIV infection is negligible. Consult your physician and get well soon.

Dr S.Murugan
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Sankaranantham Murugan (27 minutes later)
Oh, so my exposures were on December 1st and 4th and the test was December 18th
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Oh, so my exposures were on December 1st and 4th and the test was December 18th
default
Follow up: Dr. Sankaranantham Murugan (20 hours later)
Do you think that p24 antigen would have been detectable by this time? This is my final question, thank you so much for the in-depth responses
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
Do you think that p24 antigen would have been detectable by this time? This is my final question, thank you so much for the in-depth responses
doctor
Answered by Dr. Sankaranantham Murugan (3 hours later)
Brief Answer:
You can repeat the 4th generation test now and another after 6 months

Detailed Answer:
Hi,
Welcome back.
Your last exposure is 4th December. Nearly 44 days are over by this time from your last exposure. 4th generation HIV test are reliable up to 99% or more. That too it will be more conclusive and reliable 3-4 weeks after the exposure. (The test done on 18th day cannot be taken as conclusive). The nonreactive 4th generation HIV test after 6 weeks, will rule out the (Antigen part of test) HIV 1 unfection. Antibodies start appearing around 4-6 weeks after the exposre (after the window period). But it may get delayed in some individual up to 12 weeks. In your case as you are on PrEP, it may take even later, Upto 6 months. At the same time PrEP protects you from getting the infection. The prevalence of HIV 2 throughout the world except in certain parts of XXXXXXX is less than 1 %.
So not to worry. Your symptoms would unlikely be due to HIV infection.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sankaranantham Murugan (0 minute later)
Brief Answer:
You can repeat the 4th generation test now and another after 6 months

Detailed Answer:
Hi,
Welcome back.
Your last exposure is 4th December. Nearly 44 days are over by this time from your last exposure. 4th generation HIV test are reliable up to 99% or more. That too it will be more conclusive and reliable 3-4 weeks after the exposure. (The test done on 18th day cannot be taken as conclusive). The nonreactive 4th generation HIV test after 6 weeks, will rule out the (Antigen part of test) HIV 1 unfection. Antibodies start appearing around 4-6 weeks after the exposre (after the window period). But it may get delayed in some individual up to 12 weeks. In your case as you are on PrEP, it may take even later, Upto 6 months. At the same time PrEP protects you from getting the infection. The prevalence of HIV 2 throughout the world except in certain parts of XXXXXXX is less than 1 %.
So not to worry. Your symptoms would unlikely be due to HIV infection.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sankaranantham Murugan (13 minutes later)
I'm getting tested on Monday. If the test is negative, then can I be assured that I don't have HIV?
default
Follow up: Dr. Sankaranantham Murugan (0 minute later)
I'm getting tested on Monday. If the test is negative, then can I be assured that I don't have HIV?
doctor
Answered by Dr. Sankaranantham Murugan (23 hours later)
Brief Answer:
The 4th generation HIV nonreactive report after 6 weeks ruled out HIV 1 inf

Detailed Answer:
Hi,
Welcome back.
If your 4t generation HIV test becomes nonreactive 6 weeks after the exposure, you are assured that you are free from HIV 1 infection.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sankaranantham Murugan (0 minute later)
Brief Answer:
The 4th generation HIV nonreactive report after 6 weeks ruled out HIV 1 inf

Detailed Answer:
Hi,
Welcome back.
If your 4t generation HIV test becomes nonreactive 6 weeks after the exposure, you are assured that you are free from HIV 1 infection.
Dr S.Murugan
Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sankaranantham Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 3108 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Hello, I Have A Question Regarding My HIV Risk. I

Hello, I have a question regarding my HIV risk. I was on PrEP daily for 6 days. On the 7th day I had a condomless insertive anal sex encounter. 3 days later, I had a condomless receptive anal encounter with no ejaculation. 20 days after the first encounter (or 17 days after the second one) I experienced swollen lymph nodes in the neck and groin, nausea, loose/watery stools, night sweats, low grade fever, chills, all for three days. After three days, most symptoms subsided except for the lymph nodes. 2 days later, diarrhea returned for 2 more days then went away. Is this possibly ARS?