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More on HIV symptoms

stop aids signI previously wrote an article on early HIV symptoms.

I am still receiving a lot of questions with regards to HIV symptoms so I am writing another article to provide more details.

What is HIV ARS?

When people talk about ‘HIV symptoms’ they are generally referring to the symptoms that appear soon (2 to 6 weeks) after a person is infected with HIV (as opposed to late AIDS symptoms which take years to develop).

These symptoms are a result of the body mounting an immune response to the HIV infection, NOT due to the infection itself. That is why you find similar or identical symptoms with other infections.

It is also commonly known as Acute-Retroviral Syndrome (ARS, ARVS), acute primary HIV illness, acute HIV syndrome and Acute Sero-Conversion Syndrome.

HIV Symptoms are due to the immune system responding to the virus that is why many other infections can cause the same symptoms.

What are the early symptoms of HIV infection?

Because the whole body is reacting to fight off the virus, it is not surprising to find a variety symptoms affecting all bodily systems.

General – Fever, Sweats, Lethargy, Malaise, swollen lymph nodes, weight loss

Skin – Rash, ulcers , Sore throat

Digestive – Nausea, Diarrhea, Loss of Appetite

Neurological – Headache

Musculo-Skeletal – Muscle aches, Joint aches

Not everyone will develop all these symptoms. These symptoms can develop in varying combinations.  The most common symptoms are fever, sore throat, rash and swollen lymph nodes.

Only 40% to 70% of people infected with HIV will develop ARS symptoms

Who gets HIV ARS symptoms?

It is estimated that between 50% to 90% (some say 40% to 70%) of people who have been infected with HIV will develop HIV ARS. There is no way to predict who will develop ARS and who will not.

When do HIV symptoms appear and how long do they last?

HIV symptoms can appear anytime between 2 weeks and 6 weeks after infection. Most people who do develop the symptoms do so at 3 weeks.

Symptoms generally last for at least 2 weeks but have been known to last up to 10 weeks.

‘Flu-like’ is not ‘Cold-like’

HIV ARS symptoms are often described as ‘Flu-Like’. Many people think having a Flu is similar to having a Cold and this has led to a lot of confusion.

Many patients see me for minor cold symptoms such as running nose, sore throat or a mild cough and are worried to death about HIV.  These are Cold symptoms, they are not Flu symptoms.

For those of you who have had the Flu before, you will know what I am talking about. With a Flu, you will be very sick. The fever is high and persistent, the bodyache is very bad and you literally cannot get out of bed.

To be more precise, ARS is also described as mononucleosis-like symptoms.

The HIV ARS Rash

This is a great source of worry for many people I see. I have seen people coming in with literally one tiny red dot on their forearm convinced that it was a HIV rash. It is not.

The HIV rash usually comes on 2 to 3 days after the onset of the fever and lasts for at least 2 weeks. It is a Morbiliform (looks like measles) Exanthem rash consisting of macules and papules up to 1cm in diameter which are pink to red in colour. Each lesion remains discrete and do not become confluent. It is widespread and always (100%) involves the upper thorax and collar region also commonly (60% to 40%) affects the face, arms, scalp, thighs and palms in descending order of frequency.

Basically, the rash is BAD. Your friends and colleagues are going to take one look at you and ask ‘Hey why do you have a rash? Go see a doctor’.  If you have to hunt for individual spots or patches randomly on your skin, it is not a HIV rash.

The HIV ARS Rash looks like Measles

The HIV ARS Fever

Where do I start? I have patients measuring their temperatures hourly and freaking out when it hits 37.1⁰C because they read somewhere that ‘normal body temperature’ is 36.9⁰C and therefore they have a fever and therefore they have HIV. That is paranoia.

The HIV ARS Fever is high, usually above 38.5⁰C when taken from the ear.  The HIV ARS Fever is long, usually lasting for at least 2 weeks most of the time longer. It is usually associated with other symptoms such as lethargy, malaise, muscle aches and joint aches.

The HIV ARS Lymph Nodes

This is another great source of worry. I have seen patients who cannot stop rubbing their necks feeling for lymph nodes and melting into a panic state whenever they feel a lump that they have not felt before.

First of all, you can feel normal non-enlarged lymph nodes especially in thin people. So being able to palpate a lymph node does NOT mean it is enlarged.

Enlarged lymph nodes are about 1cm in diameter. In HIV ARS, there are usually many of such lymph nodes in the neck, groin and underarms. They are usually tender (i.e. painful to touch).

The HIV ARS Sore Throat and Mouth Ulcers

The sore throat associated with HIV ARS is bad. It is not a little discomfort in the throat or the sensation of having to clear your throat. It is painful. If you ever had Strep Throat before, it feels like that.

It is commonly described as an exudative tonsillitis. In other words, you will be able to see white or yellow pus-like substance on the tonsils. The tonsils themselves will be red and swollen. About 20% of the time, there are also ulcers round to oval in shape, 5mm to 10mm in diameter with a white base and red halo on the inside gums, tonsils or roof of the mouth.

Anxiety can frequently cause the muscles around the throat to tighten leading to some throat discomfort. This is NOT HIV.

What other diseases have the same symptoms as HIV ARS?

First of all, the Flu. And by that I mean an Influenza infection, not a cold. See above for details.

HIV ARS symptoms also mimic the symptoms of infectious mononucleosis very closely (also known as Mono or Glandular Fever). HIV ARS symptoms can also be mistaken for an acute Hepatitis A or B infection, Parvovirus infection, Cytomegalovirus infection and Toxoplasmosis. It can even be mistaken for Rubella (German Measles).

Take  home message: Do not assume and do not self-diagnose based on symptoms. Go get tested.

Click here for HIV Testing FAQ

Conclusion

The only way to know for sure if you are infected with HIV or not is to get tested. Until that is done, try not to worry about your symptoms.

If you have to worry, then worry if you fulfil the following criteria:

  1. You have had a high risk exposure 2 to 6 weeks ago
  2. You have a fever above 38.5⁰C that just does not go away
  3. You have multiple small red spots covering your face, neck and upper chest
  4. You have a really bad sore throat with ulcers in your mouth
  5. You have been diagnosed with another STD like Gonorrhea or Chlamydia
Click here to learn about other factors that increase HIV risk

If you had a high risk exposure to HIV within the past 72 hours, you can take medicines to reduce your risk of actually contracting HIV. Find out more on HIV PEP Treatment.

Click here for info on PEP Treatment at Our Clinic

Remember, you are not doing yourself any good by hunting for symptoms. Take a deep breath, calm down and focus on getting the HIV tests done.

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Click here for Info on STD Symptoms in Women
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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1,089 Comments

  1. Sonopotente

    Hi Dr Tan.
    I had high risk exposure on september 30 2014, after 55 hours i was put on pep Azt and 3 tc. I testednegativ at anti hiv 4 generation test after 6 weeks but i am having white tongue and some little ulcers in my mouth that stay 1 or 2 days and go. What do you think?

  2. Hi Dr,

    I had an exposure 69 days ago ( condom break with a sex worker in south Africa).

    I did a pcr DNA (not RNA) after 15 days and a combo test on day 30 and day 46. All came back negative.

    I had symptoms in the 1st 4 weeks like loss of appetite and weight, diarrhea and coughing which I connected to the stress I was in.

    In the last few days (day 66-69), I started to develop a rash on my chest and stomach and now it is spreading to my neck. I never had a rash in my life so I am starting to freak out. I thought it was already behind me.
    What do you think? Can this be related?

    I will appreciate your response as I am really worried here

    Thanks!!

    • Also, I have another questions that bothers me and might benefit all. Everywhere it is said that antibody test is only conclusive after 12 weeks (ab only, not combo) and that ARS can occur only between 2-6 weeks. Some even say 2-4.
      On the other hand, during ARS, the body develops antibodies, doesn’t it suggest that ARS can occur up to 11-12 weeks? (And thus making the 12 weeks ab test conclusive)

      I would like to thank you in advance for your advice’s and express my appreciation for the info you provide

      Thanks!

      • Good question. First of all, antibody production invariably occurs latest by 3 weeks (except in very very rare cases of sero-negative infections). Of course we know not everyone develops ARS when this is happening. So the question is not whether the antibody is there or not. The question is are the tests good and sensitive enough to detect the presence of these antibodies.

    • CSW in South Africa? Wow. Dangerous man. Anyway, your tests are conclusive. You do not have HIV. You really dodged a bullet this time. You might want to check for other STDs also. Syphilis rash?

      • Thank you ! I know I did (dodge a bullet) and have definitely learned my lesson.

        I am now at day 71. The rash (that was very itchy) is starting to go away but since last night I have high fever – 38.5 and sore throat.

        1. Are you still confident it is not ars?
        2. Do you think I should test again (medically not psychologically)?
        3. Have you ever seen a patient becomes positive after 46 days negative?
        4. For general knowledge- Sero-negative case will still become positive in a combo test because of the antigen, right?

        Thank you very much doctor! I will not post any more to this thread

  3. Hello Dr. Tan

    During the window period, I read that a person would be having a very high viral load and accordingly his ability to infect others becomes high, which leads me to have the following questions :

    1- Does higher viral load applies to saliva ??
    2- Does casual kissing become a higher risk?? how much is the risk??
    3- Does deep/french kissing become a higher risk?? how much is the risk??
    4- Does sharing a toothbrush by mistake become a higher risk?? how much is the risk??
    5- what is the risk from minor shaving wet/dry blood cuts on the face
    6- What is the risk of deep kissing with HIV+ person not on medication ie having high viral load?? especially that I usually
    see traces of blood after I brush my teeth with water.

    Thanks

    • 1. Yes it does. 2. No it does not. To me, kissing has zero risk of contracting HIV. 3. See answer 2. 4. No data. I think zero risk. 5. No data. I think zero risk. 6. To me zero risk. Some people might say there is a theoretical risk.

      • Hello Dr. Tan

        Thank you for your response. I have read the following
        link on aidmap.com which mention that quotes a study that measured Saliva during window and found saliva levels reaching between 2000-20000 copies per ml.

        The reason I am asking the questions is because I was engaged in deep kissing with a CSW ( I cannot believe I did this) and after 6 days I developed a 39C fever, chills, very sore throat with swollen tonsils with white patches. Was treated with antibiotics on the very next day and was feeling better after 5 days and sore throat disappeared after 8-9 days.

        1- Now first for the saliva question , if the CSW is in the window period or have a high viral load if she is not on medication, Isn’t concentrations shown in the study of saliva quoted below enough to cause infection???

        2- I understand that the saliva has enzymes that prevent infection, but does this apply to high viral loads?? If yes, what is the mechanism??

        3- Would having acid reflux -GERD any effect on HIV transmission given the above criteria

        4- what are the factors that affect the timing of ARS onset??? Would high viral load affect it??

        5- I did not have a rash. Would the reason be that I was on antibiotics and it prevented development of the rash???

        6- or if it was ARS, the rash would have happened anyway??

        7 – There are many conflicting information about ARS onset/ HIV incubation , 2-4 weeks maybe upto 6 weeks, 10-14 days maybe 7 days?? what are facts on this issue?
        and what is the range that you have actually seen in our practice

        8- From aidmap.com I have also read there are recent studies that tonsils are a relatively easier entry point for the virus into the body compared to the mucos of the mouth??? Is this true.

        http://www.aidsmap.com/HIV-in-saliva/page/1323976/

        “A more recent study found that infectious HIV can be detected at high levels in saliva during the early weeks of HIV infection (the ‘window’ period before antibodies appear), but that levels fall rapidly after this point. Free floating infectious viruses and virus-infected white blood cells (lymphocytes) could be detected in saliva taken from individuals with primary HIV infection attending clinics in North Carolina. In seven out of eight cases, free floating infectious virus could be detected at an average level of 2000 copies per ml, and in five out of eight cases cell-associated virus could be detected at an average level of 20,000 copies per ml.3″

        • These studies have good scientific and academic value but really does not impact medical practice. There have not been a proven case of HIV transmission via kissing. There is also no way to diagnose HIV via ARS symptoms. So at the end of the day, you need to get a HIV test to know if you have been infected with HIV or not. All this pondering over symptoms and risks really does not change this outcome. So why waste your time and energy on something that has no practical impact?

          • Thank you for your answers which are very sensible and I have already planned a test in three weeks as the only tests available are ELISA which I believe should be accurate in 6-8 weeks to a very high percentage.

            Meanwhile, I am really worried to death and I have already lost 2 kg of weight and I was trying to lessen my fears by getting answers to the questions I raised, so it would really be very kind of you to just give me brief answers if only to put the risk in perspective.

            Thank you again

  4. Dr
    I had unprotected sex after 3 days i noticed burning sensation in my legs after next day i had headace & some thrush on tongue.now its a month still i am not feeling ok can hiv symptoms appear in 3 days & what about this thrush?

    • Absolutely not. HIV ARS symptoms take 2 to 3 weeks to appear. This does not however mean you are not infected with HIV. You still need to test.

      • I am so worried actually tongue is little whiite & yellow inside i smoke also on 12 nov i had this incident on 14 i had sensation in my feet & 15 its was less headace by the night i become worse i had a test in 6 days which was negative i now it means nothing i had first time sex. I didnt have any sore troat swollen lymp nodes & diarrea only the headace & i was noticing some feeling in joints also this all symptoms came in 3 days & last near 10 days but still now i feel dizziness. Is some other dieases has been passed? I am waiting for test after 3 months which would be conclusive. Is oral thrush early sign of hiv ? Is not to much little only.

  5. Hie Doc
    I am 23 year boy, I had sex with a prostitute on 1st Nov 2014 and my condom broke. I started PEP after 6 hours (Zidovudine & Lamivudine) for 3 days then switched to Tenofovir & Lamivudine. On 7th and 8th I took beer. On 9th and 10th I had fever, night sweats, headache and chills. After finishing on 31st 2 weeks later I took beer and the fever, night sweats, chills started again. On 1st Dec took a determine HIV rapid test and it was negative. Today 15th i’ve a dry throat and feeling muscle weakness. Could this be ARS or post PEP side effects ?
    Thanks for your help

    • Neither. I think you are being paranoid and over-interpreting your symptoms.

      • Thanks for the comforting reply. My Doc prescribed me antibiotic now the fever is gone I just hope after 3months it stays like that neg

  6. Hiv rash can look like hives rash, affect only legs and very itchy (actually burned), spread and then disappear within the period of 2 days and then never show up again?

    I had unprotected receptive oral action, with contact with fluid (washed my mouth out with water immediatly after).

    I had this symptom only about 2-3 days after the risky situation, lasted less than 2 days (first day I noticed it after wake up, washed with cold water and it disappeared, but went back after I scratch it…2nd day it was there but disappeared soon after compleyely and I never had it again)

    • HIV rashes do not look like Hives. It looks like measles. And it does not appear 2 to 3 days after the infection. More like 2 to 3 weeks.

  7. I live in Uganda(East Africa) I recently 2.5 months to be precise had a broken condom with a sex worker status I was not sure of, Immediately after the action rushed to bathroom and washed my self I took PEP and stopped at seven days after testing her and she was found negative. I have gone back after 2 and five days and got my HIV test negative. However I continue to feel uncomfortable with body and joint aches and tiredness and sometimes headaches but i’ve had no fever ever since but constipation the same applies to my wifey and recently she got a severe dry cough with flu but she had no fever. I asked my doctor counselors but they don’t seem to give me clear answers. If its possible that I could have contracted HIV and these are the early signs kindly advise me on what to do next. Kindly help give an answer because i’m so tired for searching the internet for every pain and my wife gets.

    Regards.

    • You have not tested conclusively for HIV. I suggest you go back and get a conclusive test at 3 months. If the test is clear, you can forget about HIV.

  8. In addition also got dry lips/mouth, past few weeks also used alcohol and exposure to second hand smoking.

  9. Thanks Doctor.
    I will go tested when am off at work.
    Is it possible to have side effect when using antibiotics because I tried to deal with my reddish throat using ibuprofen and Betamox and gargle with mouth wash I also used halls and garlic .My tongue is whitish am trying to use yogurt to help my tongue and my throat is getting better, what might be the cause of my whitish tongue?
    thanks again Doctor.

  10. Can there be hiv symptoms for teens aged 13-16 after i.e. > 1year ( but not hiv ARS symptoms)
    such symptoms are itchy skin ( inner elbow/ arm area and wrist area) whereby the rash resembles eczema. Do symptoms differ from teens and adults?

    • Symptoms do not differ from teens and adults. After the initial HIV ARS symptoms, most people remain symptom free until they develop PGL (Persistent Generalized Lymphadenopathy) then AIDS defining diseases.

  11. Hello doctor ,

    Is it possible to have just mind ARS symptoms? For example low grade fever, slightly sore throat…etc?

    • I have not heard of mild ARS symptoms. I guess it’s because if the symptoms are mild, no one will think of ARS in the first place. But it is possible not to have ARS symptoms at all.

  12. I am seeing some white thick layer behind my lips inside my mouth when I wake up in the morning. Also when I take milk or curd or sweets, it gets worse and my tongue turns white or yellowish color and smelly. My lower abdomen pains when I consume 5 glasses of fruit juice with sugar. I went for testing Chlamydia trachomatis and it showed IgG 2.6 and IgM 2.4, but result was NEGATIVE. Even VDRL test is NEGATIVE. I sometimes get chest pain and also I see some grey color layer formed outside my forskin at head of my penis , making it difficult to pull my foreskin backwards, making it difficult to pass urine. This was seen and got worse when I started applying anti fungal cream on my foreskin at head of my penis. My body itches at hands, shoulders, chest, face, abdomen and thighs and I see some rashes which look like mosquito bite which last for 2 days and disappears. Please tell me if these are HIV early symptoms?

  13. hi can someone help
    I hade unprotected sex with a certain girlfriend that I don’t trust, I started experiencing changes in my body within a day after exposure I started having some little discomfort with my throat and went away within 2 days and after 5 days had a night sweat 3 times in the same night and diarrhoea came as well and I don’t know wether I was worried because from the first day I was on the 7th day went to the clinic and tested negative. I never had a fever no chills my throat was reddish with a swellen uvula and it was painless but irritating, I won’t to the clinic again at 4 weeks after exposure I was negative and the irritating of the throat was still there Im able to eat without any pain it get better and it seems to start again discomfort.
    I tried to talk to her my girlfriend she said she’s not hiv but she’s 3 months pregnant and gave me the proof of that. so now is week number 7, had no fever, no night sweat, no chills,
    but worry is taking place thus am now experiencing muscle iches I dont usually cough but sneeze a bit. please help thanks

    • First of all there are no STDs in the world that can cause symptoms within a day of exposure. Secondly, if you are so worried about HIV just go get tested and prove to yourself that you are not infected. That is much better than trying to figure out your symptoms and asking her for her risk level.

  14. Hey doctor! Quick question! I had unprotected sex with a person who I don’t know their status and I’ve been freaking out ever since! i haven’t had any of the symptoms (and I’ve been paranoid about monitoring them even though I know I shouldnt!) I also know that that isn’t a way to find out if I have it or not so I went to get a whole std test that was just 2 days shy of 3 weeks post exposure. I’m still waiting on results but I want to know if that’s too soon to tell or if that’s pretty definitive? (I asked and they said they test for both ab and ag) thanks in advance and help me to stop freaking out please!

    • The Combo test for HIV at 19 days post exposure is very indicative. It is however not officially conclusive.

      • Thanks for the reply! Just one more question, when is it conclusive? If I get tested again at 4 weeks is that good enough for do I have to wait for the 3 month test?

  15. Also I sent you a photo Of the rash. Did you get it?

  16. Hi doctor. I had unprotected sex and oral on October 26th. About 9 days later, I noticed a rash on my stomach. It was a bunch of small welts. There was about two or three that was a little bigger and left blemishes. I thought it was an allergic reaction because I changed my laundry detergent that week but then noticed I got a painful canker sore. I never get them. The guy did not ejaculate in my vagina. Also, it wasn’t until last week and I researched a fungal infection on my toes which I thought could be superficial white fungal infection. Websites stated that infection is common for ppl with hiv. Then I started thinking about the rash and canker sore I got earlier in the month. No flulike symptoms but my lymph nodes were a little bothered when I had the canker sore. My gyn ordered a blood test and tested me for everything. I’m so stressed and I’ve been crying for days. What is your opinion on this? I get my results tomorrow

    • Also, I took an oraquick oral swab on November 30th and it came back negative but i know they aren’t always accurate

    • Relax and breath. Your symptoms do not sound like HIV ARS symptoms.

  17. IrishGuy

    Hello Dr. Tan,

    I (drunken and stupidly) had unprotected vaginal and (very briefly) anal sex with a girl I met in a bar just over 3 weeks ago.

    I’ve had a dry blotchy sort of rash on my wrists, back of hands and between my fingers from about a week after exposure.It feels slightly itchy, and warm if that makes any sense? I’ve also had one very small coldsore on my lip.

    Does this sound like an ARS rash to you? I have a full STI test booked for next week but realise that its probably too soon for anything to show up in blood tests yet

    Thanks

    • Absolutely not. HIV ARS rash does not appear on the back of the hands. And here’s to Arthur. Sorry I had to do that since your nick is IrishGuy.

      • IrishGuy

        Thanks for the info. There’s so much conflicting/confusing info online about the rash, was very worried for the last few weeks about it. Probably where the rash came from!

        I’ll have a pint for you!

  18. Hi I had unprotected sex a more then a week ago I had none of the syntoms but I just realise a light red patch on my penis I am worried now that I will contract hiv

  19. Worried and anxiety

    Hi drtan,

    I had taken your advice and did the Anonymous HIV Combo Test at your clinic in Robertson Walk, the result came out negative. However I have left out a couple of questions during my visit there. Following are the questions I have left out. Hope you may clarify me here.

    1) I was masturbated by the worker in a massage center (there is oil involve and I did cum at the end of the session) and I did kiss her breast and suck on her nipples. Will this expose me to potential HIV infection?

    2) I was involved in a sexual intercourse on 1st November 2014 and I done the Combo test at your clinic today (01/12/ 2014), the result came out negative. Will this result be conclusive? I was told by the doctor on duty it is 100%. I would like to know do I still need to do another test after 6 months exposure or this test is sufficient to give a 100% confirmation and I can continue living my life without worrying about it anymore.

    Hope you will clarify me on this. Thank you in advance for your time and patience.

    • 1. No. 2. Yes it is conclusive.

      • Worried and anxiety

        Hi drtan,

        Thank you for your reply.

        Based on your reply, may I know what is the accuracy percentage for my result. Will I get a different result if I get tested again after 6 months period?

        Thank you in advance for your kind advise.

        • Feeling Anxiety

          Hi drtan,

          Due to a large number of question being asked to you everyday you might have overlooked my question. I would really appreciate if your could come back to me on my question above. Also will herpes virus affect the result of my test?

          Thank you very much for your patient and advise.

  20. Hi Dr tan,

    I have protected sex and was also given an unprotected oral sex with a sex worker on the 14 nov, the condom did not break during the session. I got no fever nor lumps. Except I have diarrhea for the past two days but it’s only one time for each diarrhea.. I’m not sure if it due to me eating spicy food. I
    I think I have dry skin as I always stay in the air-condition enviroment. Therefore I always got oitch on my body.. I’m
    Wondering am I high risk of hiv infection? How does hiv diarrhea feel like and wil it only be once a day of it hiv diarrhea and how long does it last normally?

    Thanks for your time and await for your reply..

  21. I am not sure, I am always sick, maybe I am paranoid about everything…

    I had sex about 2-3 weeks ago, nothing, no cold, flu, rash etc. Then 2-3 days ago I had oral with 2 guys, this was on a Wednesday, by Friday arvo I was feeling the sore throat, the sinus sensation, the weekend I had the sore throat develop more and it went away again.

    By Monday I was getting better but had also developed the runny nose, sneezing, then more of a cold type symptom with the tiredness and itchy nose and wanting to sneeze and a cough.

    Lasted nearly a week you could say, now I have aches in my legs.

    Nothing too serious but I always wonder if it is related.

    I feel better now but I did have lower back pain during this but I have always had lower back pain which spreads pain to my legs, not sure if it is still related since my back isn’t sore.

    Not sure what my odds are but I have always gone and had tests and always negative, but I am known to get sore throats after oral, always negative and no other STD ever.

    Should I be too concerned, cause when I read your article it sounds like I would need something severe like a FLU to really think I had it.

    • It is very hard to say whether you should be too concerned or not. You are sexually active so that puts you at risk of HIV and STDs. You are doing the right thing by testing regularly. There is not need to jump at every symptom.

  22. Hi Experts,

    I had an unprotected sex encounter with a female and condom broke. I had unprotected sex for 2 to 3 mins.
    After 36hours I started taking PEP. I did my blood tests done. everything seems normal I compared my current tests with old tests all in normal range as before except TLC and Platelet count. Does this show any infection ? or is it truvada effect ?

    TLC count : 8100 6 months before count was 4600 and normal range is 4000 to 11000
    Platelete : 3.64 6 months before count was 2.1 and normal range is 1.5 to 4.5
    Serum createnin is normal and SGOT/SGPT remained bit increased that because of Truvada.

    Thanks

  23. Hi there,
    I have some questions regarding ARS/HIV. What kind of body aches/pain would one have? I had unprotected oral sex with a sex working about 4 weeks ago and have been having severe back and shoulder aches the past 2 weeks. I read that a fever would develop but I’ve only felt feverish, temperature hovering around 37.1 degrees. Would this be a cause for worry?

    Thanks you

    • Bodyaches are too general a symptom to be useful. There are no specific characteristics of bodyaches due to HIV ARS. Also, 37.1 degrees is not a fever.

      • Thank you for your response Dr Tan. I got a 4th gen hiv test done at the 29 day mark and it came out negative, is this result conclusive?
        Really appreciate the time you’ve taken to answer all these questions

        Thanks again

  24. Hi Dr.
    Im glad I found this site. My question is ..does the rash itch? I had possible exposure in Dec 2013 from a guy i was dating, really.didnt think abou any hiv type symptoms..however i did lose weight with loss of appetite but i was thinking i was never home to cook then when i got to my destination i disnt want fast food so i just went to bed..no swollen lymph nodes or diarrhea..but around feb later developed rash? On my inner arms..they itched really bad so I scratched which led to blisters but if I didnt scratch really bad it just went away in about a wk. I was thinking it was bed bugs but I am a health hypochondriac and a little nervoys to get tested. I had these mainly on my arms wrist btwn fingers and my feet/toes there wwre a few on my chest and neck area but not like my inner arms and wrist. I know in this article you said it would resemble measles.
    My other worry is..since ive been having this hiv scare..my anxiety is sky high. I have these muscle twitches thruout my body..not any jerking or jolts..more like tiny twitches mainly in ny lower body..also i can feel my temples contract (all not painful just weird to feel) which led me to start panicking about neoropathy?
    Last but not least..are there any noticeable skin changes if positive and not of any meds yet?
    Im looking all over my body for different things when my anxiety kicks in

    Sorry for l o ng post and thank you for reading and giving guidance i will be getting tested in Jan i dont want to kill my holiday spirit in case there is a need for concern

    • Sounds a lot more like you may have scabies. The HIV ARS rarely itches. In fact, all the cases of HIV ARS rashes I have seen, I do not remember one patient telling me it itches. Secondly, your distribution of the rash is all wrong. HIV ARS rash appears always on the upper chest then maybe back and abdomen. Never fingers. Not everyone who is infected with HIV will get a rash.

  25. I live in East Africa I recently 2 weeks to be precise had un protected sex with a lady whose status I am not sure of, Immediately after I was diagonised with Malaria and a bacterial infection. I have treated these and had tests done which show I am in the clear of any infection even HIV. However I continue to feel uncomfortable with body and joint aches as well as a constant fever a week down the road. I asked my doctor if its possible that I could have contracted
    HIV and these are the early signs and he said he cannot as his tests kit only reveals an infection of exposure 3 months back so I am stuck and have to wait for atleast 2 and half months to know. The anxiety is killing me any advice

    • I really do not know what we can do to help you. The fact is you need to wait till the window period is over then get tested. Before that, analyzing your symptoms will only cause you more worry.

  26. I’m 18 and I had sex with someone I met who’s in her 20s. I had a condom on the entire time about a month ago.
    I have been seeing some spots on my body, countable with my hands, with a little bit of itch.
    I have not had any illness, in the time since. No flues, no fever, cough or sorethroat.
    My main concern comes from my rash , where I find like 2 or 3 small dots on my neck while I find another 3 or 4 more on my chest and 2 more on my face… I also find an area of my chest that turns quite red at night. they worry me a lot.
    What do you think of my situation

    • Well, your rash does not sound like HIV ARS. That in no way is to say you do not have HIV or any other STDs for that matter. You need to get screened.

      • I just went for a 4th gen test that came out negative. Should I still be worried since it’s only been a month plus, and is the test effective even if I had another exposure about a year ago.

  27. hie doc..lam frm zim…l had the following symptoms after encountering in an unprotected sex with my girl friend….sore throat, headaches, muscle spqms and aches, joint pain, fatigue, lower back ache, neusea, severe sore throat, gum infection and mouth ulcers….l have gone to see the doc and nothing seems conclusive..its unfortunate that in my country..some kind of advanced tests u have in your countries are relatively unknown in our country..and if known…some are quiet expensive..mighrt this be ARS….l have been feelin like this for many months.your help will be greatly appreciated

    • Your symptoms were sounding sinister to me until you said you have been feeling like this for “many months”. To which I say HIV ARS symptoms do NOT last for a few months. They last for about 2 weeks. So relax and go get a HIV and STD screening done.

  28. Dr. Tan thanks for the info. U have solve my all problems i had very bad anxiety about Hiv/Std even after testing negative after 6months post exposure i was getting mad and i have surf all the internet to collect information and was worrying because all info were incomplete. I just can’t express how happy am i after reading ur post thankyou Dr. Tan

  29. I am seeing some grey layer around my foreskin at head of my penis and it makes me difficult to urinate. Once I wash it twice, the grey layer goes away and my foreskin itches again and grey layer comes back again. The itch is so bad that I need to scratch my foreskin whenever this clear water discharge comes out of my penis. I can’t pull my foreskin back because of this grey layer. I went o Physician and he told me to go for VDRL test which is NEGATIVE/NONREACTIVE. Please advise me. Is it HIV or STI or STD symptoms?

  30. i know all of these post may be annoying too you due to the amount of comments you get but I just have a quick question doc !! Um I had sex with a 32 year old female and I’m 20 and she wasn’t the cleanest but ever since I have had sex with her I’ve been having symptoms that won’t go away for some reason . (constant diarehha
    , some soft stool , tiredness , cloudyness when i look at things , body feels like its over heating , body aches , pain on my sides including lower back no rash at all , nd my lymph nodes in my throat get swollen . its been 3 weeks since ive slept with her . i got a 4th generation hiv test yesterday and was wanderin how accurate it is nd how long does it take symptoms to show up ? Nd I got tested for everything do Idk I’m a hypercondriacte and I just wanna release some stress you know ?

    • Not really. I am only annoyed when the same person asks the same question repeatedly despite me giving the same answers to him/her. Honestly your symptoms sounds like they are due to stress and anxiety more than HIV. Anyway the 4th Gen test at 3 weeks is already as good as conclusive.

  31. Dear Dr Tan

    Thanks for the great information. I know you say that the ARS fever and sore threat are quite severe, but how severe is ARS lethargy and malaise? I have been feeling unusually drowsy during the day, but I am still able to perform general physical tasks and play sport – does this level of drowsiness qualify for ARS? Or would ARS lethargy/malaise mean that I would find it extremely difficult to move around?

    Thanks Dr Tan

    • It is impossible to quantify lethargy and malaise. Therefore I think it has no value in the diagnostic process for HIV.

  32. Hi, I had oral sex and then 5 weeks later got tonsillitis and tested positive for Epstein Barr Virus. Is there any chance this could be related to hiv?
    th

  33. Please help!

    I am a 29 year old female, I had sex with this guy I met after knowing him for 2 months. He did not have a condom on and it felt like he smushed his penis onto my vagina (i do not believe it went in) for about a good 10 seconds. No ejaculation, but there could have been some pre-ejaculation. Afterwards I pushed him off and insisted we used a condom. About a month after this incident , I break out in a rash (a bunch of little 2- 3 mm slightly raised NON pus filled red bumps individually scattered on both forearms and then my torso and side of my back had a rash but it was flat and itchy and red, as well as my legs, but mainly the leg not thigh, with red pinpoint flat 2mm dots. The rash on the torso looked like welts, was red and itchy. The rash on torso and back has gone away after 7 days, but the arms and legs rash is still present. No fever, no sore throat. My dr. Told me to take Benadryl., i was a little upset with this. Does this sound like hiv? Does it seem like i had a high risk of hiv? I get tested in january, and i am scared

    • Also the rash seems to get better in the morning when i first awaken, and gets more irritated after I come back from work in the evening. It seems to fluctuate.

    • From the way you describe the rash, it does not sound like HIV. It also does not sound like Syphilis. I also believe your risk of either of these 2 diseases is low. You should screen anyway to be sure.

    • Hi jasmine. I had a similar reaction. Did you ever get tested?

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