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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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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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837 Comments

  1. i’m a 21 years old male, and i’ve had unprotected sex with two different women of unknown status. few days back, i developed a swollen non-tender lymph node on my groin. before it got swollen, i had zits on my penis that i popped which is still healing. is the swelling related to hiv/std or its just some infection caused by the popped zits. Im freaking out!!!!

    • Are you sure what you have on your penis are just pimples? You have skin lesions on your penis associated with a swollen lymph node in your groin. Sure sounds really suspicious of STDs to me. Best for you to see a doctor and get it checked out asap.

  2. Dear Dr.
    I had an exposure with CSW where we had frottage but I am not sure if she was wet as it only lasted a few minutes when I ejaculated. I was drunk so I don not remember if I washed up or just slept. We also made lots of deep kissing. next morning I washed up and we had sex using a condom.
    Exactly 5 or 5.5 days after this exposure I had a 39.5 deg fever, throat infection that started with right tonsil and developed to the second one and it was very hard for me to eat with burning feeling on the right side of the mouth. No rash . on the 6th day my doctor prescribed amoxillin for 7 days. The temperature went down to 3.7 -37.5 in 2-3 days and i felt better but white patches were still there and so I went back to the doctor because I was traveling and I wanted to to feel better faster and he prescribed another antibiotis TAVANIC and after 1 days temperature and all symptoms were gone except for white patched which disappeared in 1-2 days.

    My questions are:
    1- Is it scientifically possible that ARS start 5 – 5.5 days??? are there any studies or statistics relating to the earliest onset of ARS??

    2- Is that fact that the infection responded to antibiotics exclude the possiblity of ARS ??

    3- During frottage and if there was blood or vaginal liquid that accumilated on my uretha, especially since I did not wash up immediately can this be a source of infection or if there was no penetration than there is no risk??

    4- Is there any risk of tranmission if she had blood in her mouth due to dental condition etc.

    Based on the above symptoms, please advise with your opinion and I would apprecaiate a quick response as I live in a country where you cannot test or even discuss this issue with your doctor

    • 1. Not that I know of. 2. No. It could just be coincidence and the ARS symptoms were fading anyway. 3. Anything is possible although I have not heard or read of any cases of HIV infection via frottage. There have been however cases of HIV infection via protected vaginal sex. 4. No. At the end of the day the only way to know if you are infected with HIV or not is to test.

      • 1-What is the minimum number of days for ars to start?? And what is the earliest recorded case?
        2- in my case, does it mean that the symptoms are definitely not ars related?? With the high fever and exudative tonsils?? What other possible reason for this infection?
        3- does a wbc count if it is in the lower standard range ie around 4800 affect the onset of ars

        • 1. I do not know. 2. I do not think so. There are many things that can cause these symptoms like Strep throat, Mono etc. 3. No.

          • Dr Tan
            Sorry to take your time again but I would appreciate your answer to the main question that I feel that you forgot to answer in my main request
            1- Is it scientifically possible that ARS start 5 – 5.5 days???

      • And I would appreciate your answer to the main question that I feel that you forgot to answer in my main request
        1- Is it scientifically possible that ARS start 5 – 5.5 days???

        • Dr Tan
          Sorry to take your time again but I would appreciate your answer to the main question that I feel that you forgot to answer in my main request
          1- Is it scientifically possible that ARS start 5 – 5.5 days???

      • Dr. Tan
        I would really appreciate your response to my questions at the earliest as I cannot ask any doctor or make any test where I am residing.

  3. hi..dr. i m 18 years old… i have fever, cough, headache from five days…i took medicines from my doctor. .also blood tested my cbc is totally ohk..n now 4th day i got some red tiny spot on my both hand…..n fever is also nt getting completely cure..it comes n go….my doctor said dat it is just a viral flu..take bed rest for 1 week…..m virgin but still m worried is im having hiv or aids????
    plz help me doc.

    • So I assume you have been sexually active and therefore are worried of HIV. Well my friend, you need to accept the fact that you cannot diagnose or rule out HIV from symptoms. So regardless of how sinister (or not) your symptoms are, you still need to get a HIV test.

  4. Recently 1 month I had a tattoo done on my forearm . Person had come
    to my place to do tattoo he had Fone every thing according to the
    norms he changed with seal pack needle but he did not clean the gun he
    remove the old needle from the gun and installed new one but did not
    clean the inner part of the gun ( last he had done tattoo about day
    back ) after 4 weeks of tattoo am feeling mouth soars only burning and
    become red on tounge, under the tounge and upper side. It’s become
    like layer coat on the tounge . I have two lymph node developed with
    this mouth sore under my jaw and end of jaw which does not pain it
    increase and decreases . no fever , no headache, no sore throat, I
    am very scared do u think there is any chance of hiv . Please reply

    • You said he used a new needle? Then the chance of HIV should be zero. Anyway, there has not been any case report of HIV infection via tattoos that I know of.

  5. Hi Dr. Tan,
    A bout three months ago, I had an insertive anal sex with a shemale using a condom in addition to oral sex like deep French kisses. I was the insertive partner and the intercourse ended quickly. I am circumcised. Two weeks later, I felt malaise and lethargic for two or three days. Five days after that, I had cold for three days: sneezing and running nose. Then I had rash on my back. Two weeks after the appearance of this rash, some other rash appeared on my chin, nose and forehead. Then I had some ulcers on the upper parts of my thighs under genitals. This ulcer is still there and it is itchy. The first symptom appeared two and a half months ago, and the ulcer still exists and it is itchy. According to your article. symptoms disappeared usually within two weeks. I had no other symptoms. What could this be related to? What are your tips?

    • First of all I cannot diagnose you over the internet. So I strongly suggest that you see a doctor about your symptoms. Secondly, your symptoms do not sound like HIV ARS. But as we have discussed, you cannot rule out HIV from the symptoms or lack of symptoms. So you will still need a HIV test to know for sure.

  6. Worried sick

    Hi Doctor,

    I had an unprotected sex with a female friend (HIV unknown) 2 weeks ago. Exactly 2 weeks later, I got fever and rashes came 1 day later. I had ulcer in my throat too. At the 2nd day of the fever, rashes appeared at chest area but disappeared on the same day. I also had rashes on both of my arms and it wouldn’t go away. I would say the rashes are only occupying less than 10% on my arms at the moment. A few on my thighs if you need to know. I have tried to look for the internet to see if there’s any cases in similar to mine but to no avail. So I hope Doc Tan, you can provide me with your insight. Thank you!

    Note: According to internet, there is no rashes at the common areas like face, back and body on myself.

    • There is no way for me or anyone else to say with any certainty whether or not your symptoms are due to HIV. The best and only way to find out for sure is to go get a HIV test.

  7. Hi Dr. 3 months ago I had low risk exposure in Spain. I had a combo test done at 2 weeks and 31 days post exposure both negative. Also fully checked for stds which were all negative. However I have had recurring sore throats which were mild between 6-8 weeks then 10 weeks after exposure I had quite bad sore throat (no pus substance etc) lasting around a week. Then a heavy cold for the past two weeks. So now I’m paranoid about hiv 2. So can ARS appear post 6 weeks even as late as 10 weeks. I’m awaiting my 3 month results but do you think I’m just being paranoid?

    • Since the combo test is conclusive from 28 days, it is logical to then conclude you do not have HIV. Which then logically leads to the other conclusion that your symptoms are not due to HIV ARS.

  8. Hie Dr about a month ago i had protected viginal intercoursefor the first time in my life for less than 5 seconds then i pulled out without even ejaculating because of fear with a girl of unknown status so was totally freeking out could not sleep because i saw a an odd patch on the shaft of my penis skin but it started to fade away like it was caused of friction and it had some dried scaly stuff on it and when i wiped it got back to normal and about two days before had felt some heat on the forskin and it desappeared then i went for an hiv rapid test at 28 days and it was negative please can you help me with this sitiuation i am in i am having wild thoughts thinking i might be hiv positive please reply Doctor

    • Pliz pliz DR TAN can you reply me icant sleep eat or do anything without thinking about it and the things i experienced i am a vey worried young man pliz reply doctor that we be greatly appreciated

    • Your risk of HIV is extremely low. In fact next to zero. You have already tested -ve at 28 days which is very indicative. So I have to say that your fears are bordering on irrational. Get a hold of yourself. Retest at 3 months to be absolutely sure.

  9. Thank you doctor. I got tested for HIV and the result is negative. Thanks a lot for your support. Finally, I am relieved from my worries.

  10. Almost dead because of all these symptoms.4months back i had done few sec cunninlingus with a sex worker.felt bitter in taste and stopped suddenly.protected vaginal sex and didnt notice weather the condom is broken or not.
    Symptoms on 5th weeks –
    *a small cold sore appeared outside the lip-lasted for a week and went away(had vitamin B med)
    *muscle pain
    *small small pimple on face and chest
    *burning sensation near mouth

    Hiv rapid test-negative

    10th week-
    *tingling and prickling sensation(only right side)
    *fordyce spots on lips
    *blurred vision(right eye)
    *terry’nail-red band(all nails)
    *pain under right arm
    *swollen node on neck(under jaw)usually it can be felt only when you get cold.
    *stiff neck(right side)

    During this time i took these medicines(CEFUTIC 500MG,COVIR 400MG,ROXONIN 60,ORAHERP FOR L A BD)

    Hiv rapid test at month 12-negative
    VDRL-negative

    12week
    Had (ATM-500,ACECLOPLUS,TELEKAST-L)

    HIV 1 and 2 rapid test at week 14-negative
    VDRL-negative
    Other blood test-normal

    week 15
    Sypmtoms continues and had (Nervit forte,oxidon plus) doc prescribed these medicnes for a month.aftre taking these medicine i got yellow coated tounge.for that he gave (T.AF 150mg,candid mouth paint,T.Actilife)

    Week 16
    Sore throat,cold,cough (had T.Gabantin 300mg,T.Fex 180mg,T.Aziclass 250)

    Pain under ear(felt like an obstricle is placed inside my ear.and felt so heavy inside.but i can hear everythng properly(right ear)..and stiff neck continues.(took Hifenac p tab,pantop 40mg)

    Hiv 1 &2 (ELISA) -non reactive
    HBS AG(ELISA)-non reactive
    HCV(ELISA) -non reactive
    ULTRASOUND ABDOMEN-Liver,G.B,spleen,pancreas,kidneys,urinary bladder,prostate-NORMAL

    Week 20-current problems
    *reoccurent sore throat,cold and cough
    *teeth mark on the side of tounge
    *yellow coating on tounge
    *red blood veins on both eyes(cmv?)
    *i can feel small peanut size lymp nodes on my elbow,biceps,thighs,stomach,hip and back.(most worrisome)
    *tinnitus(really worried about this)

    Ps-2008 i had done sinus operation
    1year back i tested pos for lyphoma.(during that time i can feel some small hard nodes on my biceps and stomach).

    My question is
    1-Do you think i am hiv infected?
    2-any other std?if so,what all?
    3-why all these symptoms one another one?
    4-i tested negative,is that bcz my body doesnt produce enough antibodies?
    5-heard that in some cases the window period is 6months(comp immune system).what does that mean?do i have a weak immune system because of lyphoma?is that the reason am taking lot of time to produce antibodies?
    6-if it is not hiv then why this lymp nodes, terry’s nails,trush and all other symptoms came.?
    7-do i need to test at 6month mark?
    8-do you think this symptoms could be a sign of thyroid,diabetes,tumor or lyphoma cancer?

    Actually am 24yrs old and it was my first sexual intercourse.am really worried about all these symptoms.if it is hiv i have to take proper medicines without informing others..bcz my family very relegious and have a good name in the society.i dont want to destroy that.it will be the first and last mistake i have done in my life.i know there is no use of telling this now.everyday am dying with a guilty feeling.i know am hiv positive.but i just want to hear your openion too.please give reply.sorry for the poor english and long post.

    • Your tests have already proven that you do not have HIV. Despite this you say that you are convinced that you are HIV positive. This to me suggest a very serious psychological disorder which you really need to seek help for. The other thing you are doing is self medicating without seeing a doctor and getting a diagnosis. I do not need to tell you that this is very dangerous. What you need to do is very straightforward and I hope you can do it. 1. Accept the fact that you do not have HIV. 2. See a doctor and get properly diagnosed and treated. AS for your questions: 1. No. 2. I cannot say. You need to see a doctor and get tested. 3. I also cannot say. I cannot diagnose you over the internet and cannot give medical advice either. This is very dangerous for you. I have not seen you and can easily be giving you a wrong assessment. 4. Why would you think that? Why can’t you accept that fact that you are HIV -ve instead of coming up with unsubstantiated reasons to scare yourself? 5. I do not know of any studies to say Lymphoma prolongs the testing window period for HIV. 6. I do not know. This is when you need to see a doctor who will examine you, do the right tests and get a proper diagnosis like what I do for my patients. 7. No you do not. 8. I cannot diagnose you over the internet. If this was possible the world of medicine will be very much revamped. The day may come soon when this is possible, but it is not today.

  11. Ahugemistake

    Hello Dr.
    Okay here is my problem, 2weeks ago I did take a risk when I slept with a friend(Girl) of mine. When we were having sex, I noticed after 1minute we started that the condom I did put was covering only the head of my penis and I did fix it. And after that I did have an oral sex with the same girl(on the same day). I s*cked her and she did it as well but I was not sure if that girl is hiv+ or not so 5days after the risk, I went to an hospital and the doctor althought he told me that it was a bit late for a PEP, he gave me an injection and some medicines to drink(Tribuss) for the next 30days. But here is my problem, the day I start drinking those pills(meaning 5 days after I did take the risk) I had a fever, diarrhoea, nausea, slight cold in the night, I did loose 6kg in 1week. Those feeling last 6days and I’m wondering whether the medicine I’m still drinking is working or not cause althought I take it, I can have sometime in a day a fever which won’t take a long time to disappear, my tonsils are swollen since 2days but it’s not painful and I can feel that my throat is not like it used to be. I don’t have yet any rash in my mouth or anywhere else and it’s been 2weeks since I took that risk. So I want to know what is your opinion doctor cause I’m stressed like never before. Is there any chance that the PEP works with all these symptoms or not??And 9days after I started the treatment the diarrhoea nd a small fever in the night are back, what does it mean?HELP ME DOCTOR, I want to understand

    • I am confused. The doctor said it was too late for PEP and yet still gave you the treatment? Why? At 5 days post exposure there is no evidence to say that PEP works. The symptoms you are having could well be due to side effects of the medicine. It is too early to be due to HIV ARS.

      • Ahugemistake

        Was it a high risk?I noticed that the condom was only on the head of my penis maybe 1minute after, was it enough to have hiv??And now at 16days post exposure and 12days after I started the treatment, I have a sore throat. Is it be beginning of the HIV ARS?I had also an oral sex with her, can it be a STD in my throat?

      • Ahugemistake

        Hello Dr.

        I know that it’s so tiring to answer at the same questions again and again but please Doctor, HELP ME. Please

        JUST WANT TO UPDATE MY STATUS.

        21 Days after exposure and 16days after I started the late PEP I have a small fever (37.0) since 5days wich goes and come back, I have a wound just around my anus which is bleeding when I clean myself with the toilet paper and it’s painful when I touch it(it started 6days post exposure) and before there was like water which was coming out of it, still don’t have any rash on my skin but I think it’s coming because I can see some small button on my arms, I have a small sore throat but my doctor gave me some antibiotics 3days ago and it’s getting better, I have a running nose sometime in a day and I have a joint ache on my right knee sometime since 6days post exposure. And I still drinking the PEP medication so 1)As a Doctor, what do you think about all of this after 21day? 2)And the wound around my anus, is it also a HIV ARS? 3)Can the PEP slow the rash on my chest and face?

  12. Hi doctor i had protected receptive oral sex for about 5min and and prototected vaginal sex for 10min about 2 weeks ago from a massage centre in singapore. It was really silly and i feel stupid for taking the risk. I dont have any symptomps but the worrying is really giving me anxiety and sleepless nights. Wat are the chances of contraction? i really need a truthful answer. thank you dr

    • Any reason you think I will give you an untruthful answer? Your risk is extremely low. Honestly I wouldn’t even worry about HIV. You should however worry about other STDs like Chlamydia and Gonorrhea.

  13. freaking out

    I am freaking out. It’s been 4 months since possible infection which took place on June 10th. Unprotected sex with a guy. I’m a female. In late September I had diarrhea which has continued on and off, I’ve been dizzy alot due to being dehydrated. I also have swollen lymph node on my neck and my chest hurts sometimes. No fever no cough. Is this ARS occurring? It’s been going on for a couple weeks.

    • That’s funny cos ‘freaking out’ is both a noun and verb. Good one. No it is not ARS because ARS does not wait for 3 months before it happens. That said, I am surprised you have not gotten tested. Not just for HIV but it is extremely important for women to test for other STDs like Chlamydia (infertility) and HPV (Cervical Cancer).

      • freaking out

        I was recently tested for other stds…came back negative. But my symptoms since you say aren’t ARS then what could it possibly be? This is the first time I’ve experienced anything like this…

        • So if your symptoms are not due to STDs and not due to HIV ARS then it has to be due to something else. There are so many infections, illnesses and diseases out there that can cause such symptoms. Stop trying to diagnose yourself and stop jumping to conclusions. See a good doctor and let him figure out what is wrong with you.

  14. Hello Dr tan I had protected sex with a CSW in Nigeria when I was done I checked and the condom was intact, after I wore my boxers I noticed blood on it.. In the next 7hrs I developed fever, I’m so worried doc

    • You are at risk of HIV but your risk is low because of the intact condom. HIV ARS symptoms cannot develop so soon.

  15. Hi Doctor

    I am in my 22nd day post exposure. I have red rashes at head of my penis and its painless, but sometimes itchy. Also I sometimes see white discharge comes out of my penis which is smelly. Is it STD or HIV symptoms? Please suggest when should I do STD test ( Chlamydia, Gonorrhea, Syphilis, PCR)? Will it be accurate results and conclusive if I do these tests at 23 days post exposure or do I need to wait until 28 days? Please advise me

    • Leo ,

      If there is rash and a white discharge it is a symptom of something , so whatever STD test you take should be reactive . Get tested for all STDs . My guess is Candidiasis , but I really can’t tell , I’m not a Doctor .
      When 4 weeks from exposure day comes , get tested for HIV as well .
      Both tests when taken should give reliable results .
      Summarising:
      – STD test as soon as possible .
      – HIV test when post exposure completes 4 weeks , then take another HIV test with 2 months from the exposure date and one 6 months later. The first should give a reliable result and the others two are required as well just to check if everything is okay .

      Wish you luck and may God bless you !

      • Very good advice indeed. Thank you.

        • I am seeing red rashes on my body which is very much itching. My eyes also keeps itching, it comes and disappears after some time. I have been diagnosed by dermatologist and he told me that Urticaria (Hives). Are they HIV or AIDS symptoms? I am very much scared now. please advise me what test I need to do now, since I am now 27 days post exposure.

          • Go get a HIV combo test and stop scaring yourself.

          • Dr.Tan please advise me which PCR test I need to do on or after 28 days post exposure? Which PCR test (RNA PCR or DNA PCR) gives conclusive and accurate results? What is the window p[eriod to repeat these tests? Please advise me soon.

          • Please clarify me if HIV RAPID TEST is same as HIV COMBO TEST? I have plan to undergo HIV RAPID test on my 28 days post exposure. Please tell me if HIV RAPID test will capture accurate results and conclusive?

      • Thank You a ton, Dr.Prem. You replied with no further clarifications, what a beautiful answer. I am in my 23 days post exposure now and hence plan to do HIV test on or after 28 days. Can I do STD tests also on or after 28 days? Please confirm me soon.

  16. Dear Dr. Tan,

    I had receptive unprotected anal sex with a man (I am a man too) two weeks ago and now I have an incredibly painful sore throat with many white ulcers on my tonsils and a very tender neck with one lymph node that feels larger than normal. I have no other symptoms. Is there any chance this could be a sign of seroconversion? I am going in to get tested on Monday morning although it may be too early to tell.

    Thank you,
    David

    • Yes it could be especially if it was accompanied by a fever and rash. If you had oral sex also I would also suspect Herpes and Gonorrhea of the throat.

  17. Hi Doc,

    I am 28 year old male.I had 8 warts got removed by electro surgey and wait for 12 days for it to be healed. Wounds were not bleeding nor it was wet and had already covered with new scrab. At 13 th day I had protected vaginal intercourse with a girl whom I met in bar. Later I realized red hematoma under the skin of my penis and findout that wart wounds can bleed if there is to much friction or have hard sex.

    Its been 3 weeks from intercourse and I have been strugling with tonsilis and high fever for 3 days and had some red dots in my hand and soulder but nowhere. I am very worried, please help

    • I also would like to add that I am clearing yellow/brownish phelgem from my throat. Does hiv ars cause this pelghmem or post nasal drip? Also my fever statrted to drop after I took antibiotics.

      • Hi doc,

        I am sure you are very busy with curing people. Can ypu please share your recommadition about my querry.

        Thank you

    • What would you like me to say? Yes you are at risk of HIV. Yes your symptoms could be HIV ARS. Yes you need to be tested. I am sure you know all these already. The best test you can do right now is the HIV Combo test.

      • Hello doc,

        Thanks for your feed back. I know your job is very hard and I glad good people like you is doing it to help people. I am definitely going to be tested asp. At this point I would like to know your answers to below questions so that i may relax a little bit…

        Thanks

        1) Can people having ARS tonsilitis can caugh yellow pelghm due to post nasal drip?

        2) Is post nasal drip is a ARS syptom? Or sinustis?

        3) I also developed a white coated tounge which is becoming to normal now.

        4) This is 4th day since first sympthom started and 3 rh day since I am on antiviotics and feeling very well now with no sypthoms. So I can say that severve symptoms only lasted for 2 and a half day. Is it possible ars to go in 3 days ? How long its usually lasts?

        5) Does what I am had in past 4 days looks like a bacterial throught infection?

        • 1. Don’t know. No data. Too specific. 2. No and No. 3. OK. Most likely anxiety. 4. ARS can last for 2 weeks or more. 5. I cannot diagnose you over the internet.

          • Thanks for your precious sharing doc. Anixety can make people very bad and thanks one more time again.

            Yellow pelghem/mucus indicates infection in sinustis and mostly caused by upper respirotary virus or bacteria thats what I learned from online. Thats why I am asking if hiv can cause nasal drip (Sinus infection or allargy) or can turn mucus colour into yellow just like upper respirotery germs do. So that I can understand what caused my symtoms..Whats your opinion about this ?

            Plus my symptoms go away 1.5 day after I started to use antiviotics for sore tonsilis. This is 4th day and I feel perfect, no fever, no sore tonsilitis no more yellow pelghm.. I think antibiotics worked and cleared infection, so if this theory is true, it must be something bacterial what causing this infection with the fact that antibiotics only work for bacteria but not for viruses.

            Otherwise if antibiotics didnt worked can we assume that it was ars what causing this infection and cleared it self in 4 days which normally last more then 2 weeks.

            whats your openion about those 2.possibilities?

            I know I become paranoid but its to heavy for everyone who is experiancing similar situation like me. Just cant wait for going and tested.

            With my all respect

            woried guy

          • My opinion is simple: You can analyze symptoms all you want. It will bring you no closer to the diagnosis. And it will cause you more anxiety. So why analyze symptoms?

  18. Dr.
    I had a condom break 5 weeks ago , she had endometriosis and there was a little blood there . I went to the doctor and took PEP within 12 h after exposure .About 1 week from PEP start I had candidiasis on my penis head , went straight to the doctor and he said that there was nothing to worry about because it had nothing to do with ARS . But I freaked out anyway , the caididiasis eventually went away within 2 days of threatment , I stoped the treatment then and it returned – few weeks later it was finally gone . My PEP was concluded last week ,but today (day 4 after PEP’s ending) I felt a lymphonode a bit enlarged . When I touch it doesn’t hurt , it hurts a bit when I kinda move it arround . I’ve got no fever , no sore throat or any other ARS symptoms but the nodes and a little rash – wich I don’t think is ARS rash because is only a few , not itchy and not measles looking alike at all . My point is , I’m freaking out , my 5 week test from exposure is this monday 13th , I’d like to know what is your oppinion on my situation .

    BTW Thank you for all your great informations , it helped to freak me out a little less about my” rash “. It is really better than anything I’ve read online about this subject ever . Thank you

    • Why are your freaking out? You have already concluded yourself that the rash is not ARS and I agree with you. You were at low risk and you took PEP anyway. So all the odds are already in your favor. Why are you freaking out? It’s not logical.

    • Ahugemistake

      Hi PRM. I hope that you are fine!!!Just want to know if when you were taking you PEP, you had a fever(37,6) which lasted 2days, nausea and dizziness at the beginning(For the 3first days). I’m at 3weeks post exposure nd I’m taking my PEP(Tribuss) which I started a bit late(4days after the risk) but I don’t have yet any rash on my skin or in my mouth!!!So just want to know how was your experience, it’s going to be helpful to me. Thank you

  19. Hello Doc.
    I gave an unprotected blow job to a guy I hooked up with and he ejaculated in my mouth and a little on my lips (I didn’t swallow). A few days later I noticed a small part above my upper lip (the size of a dime) starting to get irritated and had a burning sensation. It’s been two months and it still hasn’t gone away. I also sweat a lot during the day due to physical activity and thought maybe that’s what caused it. I’ve used Aquaphor to moisturize the area, and it’s still not going away and I’m starting to worry that I’ve contracted something.
    Please help! Thank you.

    • It could be Herpes. See a doctor and get a swab test.

      • Thank You Dr.Tan. I shall go for herpes test (HSV 1 HSV2) and swab test. But will it be accurate and conclusive at 23 days post exposure? Please confirm if I need to wait until 28 days 0r 40 days post exposure and then go for herpes test?

        • I think you are confused. The swab test is accurate when there are blisters or ulcers or other skin lesions to be swabbed. It has no window period. The one with the window period is the blood test. Read this for more info.

          • Thank You Dr.Tan. So from what i understand from you, only for HIV test (blood) we have a window period. For Herpes test, there is no windows period and can be taken at any time? Is that correct? I am in my 24 days post exposure. So I hope there won’t be any problems if I plan to take both HIV test and Herpes test on or after 28 days? I want to get accurate results, hence just want to take your opinion here?

          • I see running nose sometimes, gets sneezing when I blow my nose and also see yellow mucus comes from my nose. Sometime nose get blocked with difficult in breathing. Can this be symptom of HIV or sinusitis infection? I am in my 24 days post exposure.Also is sinus infection early symptom of HIV? Please clarify me.

          • Also this running nose and yellow mucus disappears within 3 to 4 hours and my nose gets cleared soon. Can this be sinus?

  20. I forgot to mention that after the condom had slipped, I pulled out my penis quickly.

  21. Hello Dr Tan, I had protected sex 3 days ago which involved cunnulingus which was unprotected. I basically put my tongue and lips around and inside her vagina. Now 3 days later I have stolen tonsils, a fever, slightly swolen lymph nodes on my leg and a lot of fatigue. The tonsils have reduced a bit after taking antibiotics on this third day. Could I have contracted an Std or HIV? Thank you in advance.

    • Yes you could have contracted throat gonorrhea or chlamydia. Go get a throat swab done. It is not possible to develop HIV ARS symptoms at 3 days post exposure.

      • I had a protected vaginal sex with a sex worker from Pattaya, Thailand four months ago; but unfortunately there was a condom slip during the intercourse. As soon as I found out that the condom had slipped, I pulled out my penis from her vagina. The condom wasn’t in its place; it was inside her. For two months, I had no symptoms at all; but after this period of two months, I had cold with swollen lymph nodes for which I saw a doctor and recovered within less than one week. If you were in my position, what would you do, doctor? Please, advise me. Best regards

        • I would see myself immediately and get a HIV combo test and a full screening for all STDs. Is that not logical?

  22. Dear doctor, I am having red itchy rashes on my chest anf stomach. It started after 16 weeks of my possible exposure. Last test I have done was combo test at 18 weeks after exposure. Can it be ARS rashes? There are around 8-10 rashes on my body.

    • Your combo test is already conclusive. You do not have HIV. So logically whatever symptoms you have now cannot be due to HIV.

  23. Had protected anal sex with CSW. When finished saw a small cut on penis shaft. I have tested on 2 weeks neg. but believe to have sore throut and itchy rash mild headaches.

    • Do the combo test at 4 weeks to be sure.

      • Have flusshed red face sun burn look but no raísed papules. No soreness On throat. No rash with raised papules On chest nor itchyness. Week 3.

        • Not having symptoms is always better than having symptoms. Take it in a positive light. Get tested.

          • Did The test at week 3 negative. developed a fever with extensive phlegm green/brownish color. No sore throat just productive coughing.

  24. doctor, i get a fever,cough,fatigue and diarrhea after having viginal unprotected sex with prostitute after five days. does this mean im hiv positive? i went for a anonymous test my result was negative. can you enlighten me up how to go about?

    • It is too early to get HIV ARS symptoms and too early for HIV tests to be accurate. Wait for 1 month then get the combo test.

      • > Below symptoms are seen post exposure on 3rd day onwards:-
        > 1) Sore throat with red bumps (painless) on both sides of tongue near
        > tonsils
        > 2) red color rashes on back behind shoulders which comes and
        > disappears often
        >
        > 3) white layer seen behind throat
        > 4) a single pimple near groin near right thighs near genital
        >
        > 5)mouth smells bad some fungal like smell comes out
        > 6)after a week saw a single mouth ulcer (with pains) below the tongue
        > 7)after ulcer came in mouth, i got cold and running nose until today.
        > 8) eyes itches sometimes

        Please confirm if these are HIV symptoms??

        • Of course not. Read the article. HIV ARS symptoms do not happen on day 3.

        • Thank You Dr.Tan.

          I am in my 20th day post exposure today (10 oct 2014). I see the below symptoms now.

          1)Sore throat with red bumps (painless) on both sides of tongue near tonsils which is seen for past 20 days and white layer seen behind throat which looks like pus formed and my mouth smells bad with some white color cheese like layer comes out in the morning when i wake up and it’s smelly. Also has got intestinal gas which goes through my rectum and has constipation also.

          2)red color rashes on back behind shoulders which comes and disappears often. for past few days i keep getting red itchy rashes and it stays below my neck and shoulders and hands.
          3)a single wart near groin near right thighs near genital which is painless
          4)I had running nose with cold a week ago, now it doesnt run, but has cold sometimes which feels to block my nose
          5)eyes itches sometimes
          6) got needle like pain around neck, abdomen and leg muscles.

          I have already done HIV COMBO test on 3rd day post exposure and result was NEGATIVE.could this be early symptoms of HIV? Do I need to do HIV test at 28 days? When do you suggest me to do HPV 1 and HPV 2 tests? Whom should I approach to prescribe these tests? Is it ENT or physician? Please advise me as I am so tensed now. Kindly tell me which all STD tests I need to undergo now?

          Regards
          Leo

          • Of course you need to get retested at 28 days. The HIV Combo test at 3 days is useless. We cannot give medical advice over the internet. You are welcome to visit us at our clinics.

          • I went for HIV RAPID test on 28th day in a clinic and result was NEGATIVE.I am not sure if it was 3rd generation test. I asked for HIV COMBO test, they told both are same, so now not sure if its conclusive? Do I need to redo again HIV test today (29th day) 19 Oct 2014? I also did VDRL test and result is NonReactive. What does that mean? I have also done COMPLETE BLOOD COUNT + ESR (Erythrocytic Sedimentation Rate) and URINE ROUTINE. My COMPLETE BLOOD COUNT results shows (Hb 16.4, RBC Count 5.14, WBC Count 6400, Lymphocytes 46, Neutrophils 50, Eosinophils 03, Monocytes 01, Basophils 00) and ESR 12. Also my URINE ROUTINE test shows pH Urine 6.5, Protein NIL, Sugar NIL, Pus Cells 2-3, Red Blood Cells NIL, Epithelial Cells 1-2, Crystals NIL, Casts NIL, Others NIL. Please tell me if my HIV RAPID test and blood and urine tests are conclusive? I am so tensed now want to know if I need to go again and find HIV COMBO test again now? Also please suggest if I need to go for other STD tests (Chlamydia, Gonorrhea, Herpes)?

      • christian mora

        Did oraquick swb test on 11 weeks to exposure
        Results where negative am I on the safe zone
        dr??

        • Officially no cos the OraQuick is conclusive only at 3 months. But practically you are. Stop worrying.

          • christian mora

            Just a little worried.
            Did the test on a clinic

  25. I have been diagnosed with Oveall bacteria growth in instestine and my doctor gave me a dose of Rifaximin,afetr few days i felt weak and i start have small caugh,my digestion was not good,after 10 days i stopped the anibiotic and started probiotics -suddenly i caught by cold from Air condition and same day i went smoke shisha.
    Next day i end up with dry cough and congested nose- i was feeling so tired and deprresed as i just stopped my Cipralex too- i took again antibiotic azomycine for cough and its been a week im feeling tired and change in my bowel and low hemoglobin diagnosed-i was so afraid as i had a vaginal sex befote 1 month and half and i was afraid if i had catched hiv….i went to the doctor 2 days ago and i did hiv blood test where it shows negative- but still im suffering from some congestion and coughing after 8 days -my cure is so slow and im living in a hot country where humidity is 100perecnt-so please can you advise what should i do foe my fatigue and non recovering easily -i start have Stress and depression and i dont feel i want work im even urinating frequently and shaking at some pint.
    Thanks and appreciate your help

    • I cannot comment on your symptoms. For that, please continue to follow up with your doctor. What I can say is that your HIV test which was done 6 weeks post exposure is already very accurate. To be 100% sure, repeat the test at 3 months post exposure.

      • Hello doctor, On July 13th, 2014, I was in Thailand. I had unprotected vaginal sex with a girlfriend who is not a sex worker, but whose hiv status I don’t know and that was one time only. I also had oral sex and protected vaginal sex with some female sex workers. I went back home on the 26th of July. On the first of August, nearly two weeks after my exposure, I began feeling warm. I went to a doctor and my temperature was normal about 37 degrees Celsius or less. I was still worried, therefore I bought a thermometer and kept measuring my temperature every hour. It was always between 36.5 and 37.2 Celsius. Three days later, I had cold with runny nose, no fever, no sweats, no chills, no swollen lymph nodes, no sore throat, no headache, no joint or muscle pain, no vomiting, no nausea, no diarrhea. I saw a doctor; he gave me medication for the cold and I recovered completely in three days. Nevertheless, rash appeared on the upper back of my left shoulder. This worried me a lot. This rash lasted for two weeks and then disappeared. After that, I had some red spots on my forehead, nose area and face. They are not very much apparent especially to others. But these spots come and go and they still appear after more than two months of exposure. I also have some spots at the sides of my testicles. Is it possible that I have hiv? Thanks a lot

        • Yes it is but that has nothing to do with your symptoms. It is already 3 months from your exposure. Go get a HIV test and free yourself from this suffering from worry.

          • Thank you, doctor, for your quick response. In fact, this is what I am going to do. I am going to get tested for HIV. Unluckily, I live in a country where the idea of getting HIV is a stigma and much more difficult than the journey of medication in case of testing positive. Don’t you think, doctor, that I haven’t fulfilled your criteria of getting worried except for two things: exposing myself to a risky experiment and having rash. The other symptoms are not clear enough. Thank you so much

          • I do not think your symptoms are significant and honestly I think you are worrying unnecessarily. Go get tested. I am confident you will be OK.

          • Thank you doctor for your answer which relieved me. Today, I asked the lady with whom I had unprotected vaginal sex, and she assured me that she is HIV negative.I know that she is honest and she never lies. But still my question is why I had rash. By the way, three to four small rashes appeared on each of my palms. Now, rash and the ulcer near my testicles have almost disappeared. AS I told you before, I have had no other symptoms like high temperature and sore throat. Sill, I will get the test. Best wishes

  26. i had sex with a woman 7 weeks ago.. i was given oral without a condom but had vaginal sex with a condom.. she had discovered last night she is HIV positive.. am i at risk?

    • i will add that I also have not had any problems with my health in the 7 weeks.. I eat healthy and exercise quite frequently and I am not really sexually active at all

      • There is a low risk of HIV transmission with regards to protected vaginal sex. I’d advise you test yourself to be safe. You can do a 4th Generation test at this juncture for very sensitive results.

  27. Dear Doctor

    If HIV infected blood mixed with water and drinking of that water can cause HIV?

    I scared someone mixed HIV infected blood in my glass of water. Is there any chance of HIV infection?

    Also after 7-8 hours after drinking that water my body showing symptoms such as high fever , body pain, headache, pain during urinating.

    Can I test for HIV?

    • That is pure paranoia. Sounds like you need a psychiatrist more than anything.

  28. Dear Doctor,
    Hope you are doing well
    1.I had protect sex With shemale at time of climax my condom break n cum outside of anal.
    2.I taken hiv rapid test After 4 days but result was négative.
    3.Again rapid test after 3 weeks result is negative and also taken rapid test after 4 weeks result is negative
    4.I had mouth soars twice in two weeks almost cure.
    5.I had hiv P24 antigen After five weeks is negative.
    6.I had Hiv 1 & 2 antibody test (duo test) is also negative.
    7. Now i my temp is above 100 dégree and sore thoart which is not paining ,also head is paining

    Can u plz tell me this symptom of hiv.

    Can u plz tell me any test which show perfect result before 3 months because I m so much worried .
    I m wait u r response

  29. Confused Guy 84

    Dear sir, I have a risk on the middle of may, I got tested on 4 week, 8 week and 12 weeks using 4th generation hiv test and negative but about 8 days after last test I got swollen lymph node on my neck..I took another test alere determined combo rapid test,10 days after symptom it came back negative..do the symptom indicate that i starting to seroconvert since came out after 3 month? do i need to retest again?

    • Regardless of your symptoms the fact is your HIV tests are conclusive. So you do not have HIV.

  30. Hi, I had an oral sex with a bleeding cut on my penis with a sex worker, she sucked my penis for 10 secs and I pulled it out realising the cut and masturbated outside. What are my chances of getting HIV?

  31. Hi

    I had sex with a hiv positive woman

    Vaginal sex twice

    Took pep 69hrs later finished the 28day dose

    Happned on june 22nd2014 did a pcr on 30th june 7 days later it was negative

    July 22nd i was done with pep

    Last week of augast i started feeling a cold stuffy nose etc i found one mouthsore in my mouth left and under of a tooth. It was healed in 3 days

    I drank alcohal to forget it from then ive had sinus issues then one day ago until now i got a full blown cold alot of a runny nose sore throat so i bought antibiotics and night nurse now im hoping the cold goes. No fevers no rash or swollen lymph nodes just a blocked nose n i can taste my cold. I could even 2 weeks ago.

    I know my luck is down girl says she had 1000cd4 and 20000vl it doesnt make sense y she would do this to me. Her analysis doesnt mke sense her vl and cd4 dont make sense. Im scared cause i know the probablility is high .i told her ill be ok. She said oh! Really! Its like she has done this bfore on purpose. According to wat i hear she gve birth a yr ago . Had to b a cecerian so as not to infect the baby. Her baby is fine but wat i wonder is. Y deos she drink if she knows she is positive? Also she excersices every morning. Says she is on a tripla and started a month ago.

    • I agree with you that her results don’t make sense. But that is not important. What is important is that she is on atripla (assuming she is telling the truth). This actually lowers your risk very significantly. So does the PEP. I am very suspect of the accuracy of your PCR test at 7 days post exposure. Since you have already completed your PEP, this is a great time to get an antibody test done and get a very good idea of your status. Click here for more info on HIV testing post PEP.

      • Thanks. Can ars 10 wks later after exposure . Blocked dry nose for 2 wks then third week a full cold full of phelgm mild sore throat one cold sore . But alot of mucus. Can a cold build up for 2 wks before coming on. I felt feverish for those two weeks .

        What if she was not on a tripla a year later does that mean her viral load was very high. And may she hve done so so as to infect others. I hve to go for the test. Ill do so next wk.

        Thanks

        • ARS occurs within 6 weeks of infection. It does not matter what her viral load is. You still need to get tested.

      • Dr tan

        Exposure was june 21st

        I tested pcr on july 4th got a negative

        It was 13 days after exposure .not 7 wat do u think?

        • I think you should stop worrying about HIV, pop some champagne and celebrate. After getting over your hangover, I think you should also talk to your doctor about screening for other STDs.

  32. Anxiety Guy

    Hi Doctor

    About five weeks ago i had an exposure when condom broke during intercourse with woman who’s status i did not know. Following the event i have gotten the following on my body.

    1. Small ulcer inside lips that disappeared in a week.
    2. Small tiny row on spots on my penis shaft.
    3. Slightly enlarged lymph node in right side of groin.

    My question is, could these be possible indications of an HIV or any other STD for that matter. I made the mistake of researching symptoms on the internet and am in now in panic. I have an ELISA test on the 6th Oct and don’t know if I’m seeing things due to enormous amounts of stress and anxiety.

    Please help in whichever way you can.

  33. Dear dr
    Have a nice day
    I got tested after 32 days after expose.
    I got full blood screening test for std and ELISA ag/ab.i got chalamydia positive but HIV 1 and 2 is non reactive.
    Can i get HIV infection after 3 month test.is it conclusive after 32 days?
    I read from your article some one who have chalamydia infection could be catch HIV infection.i got infection after had unprotected sex with sw.

    • In my opinion the HIV combo test that you took is conclusive at 32 days. Click here for more info on the combo test.

      • Can ARS happen in 1st week, I have a uncomfortable feeling in one side of throat during 1st week, with a runny nose on day 9th and 10th, dry cough to spit out greenish mucus. I went to doctor and she checked my lymph nodes and said fine. Told common cold. I had protected sex and a hand job. The only thing I was afraid was I sucked her breast upon which I left some sour taste. She siad she was not lacating, but worried to death if she had a cut in the nipple. She said it might be the body lotion. I followed up with her later and she said she is clean and got tested 2 months back. I am worried since I caught a cold 9 days later. The risk as I read is low, but since I caught a runny nose cold on 9 days later makes me worry. I didnt have fever except sever runny congested nose, and nasal drip on my right throat making little uncomfortable. But anxeity made me feel worser, the primary care doctor I visited checked my body and said no lymph nodes sowllen and only cold gave me nasal spray and ibroufen.
        any ways it almost end of 2nd week after the incident and I still hvae slight cold with slight discomfort in right side of throat while swallowing. Other than that no symptoms.

        What are the chances of contraction from breast nipple sucking and if it has a cut or lacacting. any advise would keep me less stressed out. I will definetly go for a test at 4 week mark, in the interim need some advise.

        • Dude, you are really going over the deep end here. Your exposure has minimal risk. Your symptoms are completely insignificant. You are basically worrying about nothing. Take it easy.

  34. Hi Doctor,

    During intercourse with a girl, it is found that condom got broke (discontinued as soon as it is realized). Next day both of us got tested for HIV and our base results came as negative.

    After 72 days again got tested using an card method tri-dot test(antibody test) and again result came as negative.

    I am really worried of the thing happened,kindly confirm whether I am safe.

  35. Hi Doctor,

    During an intercourse with a girl, we found that condom got broke. Next day both of us got tested for HIV and both of our results came as negative (base test). After 71 days again I got tested using card method tri-dot test, result came as negative.

    Kindly confirm whether this would be sufficient to suggest that i am safe, I am really worried.

  36. Doctor, i had unprotected oral sex with a lady around a week back. After my ejaculation was out into her mouth, she spilt the semen on the floor and realise that there’s blood. We are not sure where the blood from.. Presume that shes hiv positive, and the blood is from her gums, will e virus be passed to me through penis? Will there be symptoms such as abit redness on skin(like mild rashes), ulcer on 1 week after exposure?

  37. Dear doctor, I am hardeep from India. I m 22 yrs old gay boy. I had unprotected sex with a guy some months ago and now I am worried.. I am not experiencing any fever, sore throat, rashes nothing like that, BUT still m really tensed. I noticed very tiny single lymph node in my left neck just for 2 days n it disappeared n again after a lymph node in my groin one side just appeared for 2 days and went away. I am really confused that having such lymph node for 1 or 2 days can lead to hiv?? Please help me? Is it hiv or STI?? Rest I don’t have any other symptoms excluding that lymph node which lasted for two days only.

    Please reply me doctor?

    Just like to add:

    Sometimes I do have neck pain but I don’t know why it happens. Is it because I spent too much time in mobile, internet? Or neck pain is something related to STI or HIV? Please reply my previous question and also this one.
    I m really depressed.. Thank u.

    • Your symptoms do not sound typical of any STDs or HIV. However, that does NOT mean you are not infected with STDs or HIV. The fact is the majority of STD and HIV infections remain symptom free. Since you have engaged in risky activities, you should get screened.

  38. Dear Dr

    About 4 weeks ago i had an exposure with a woman who’s status i did not know. I now have tiny spots on my penis and headaches that come and go.

    Could these be HIV symptoms?

    Much Thanks

    • Dr Elaine Loh

      Does not seem like ARS symptoms. However, as we have mentioned before, we cannot go by symptoms for HIV. It is only confirmative through testing. In your case, you can consider the 4th generation HIV combo test for a conclusive result.

  39. Dear doctor, I am hardeep from India. I m 22 yrs old gay boy. I had unprotected sex with a guy some months ago and now I am worried.. I am not experiencing any fever, sore throat, rashes nothing like that, but still m really tensed. I did noticed single lymph node in my left neck just for 2 days n it disappeared n again after a lymph node in my groin one side just appeared for 2 days and went away. I am really confused that having such lymph node for 1 or 2 days can lead to hiv?? Please help me? Is it hiv or STI?? Rest I don’t have any other symptoms excluding that lymph node which lasted for two days only.. Please reply me doctor?

    • Just like to add:
      Sometimes I do have neck pain but I don’t know why it happens. Is it because I spent too much time in mobile, internet? Or neck pain is something related to STI or HIV? Please reply my previous question and also this one..I m really depressed.. Thank u.

  40. Another short question is that in your whole experiences with dealing hiv cases, have u seen any incident whereby a person is tested 6 weeks negative for hiv with the p24 antigen and antibody test (the combo test at your clinic) and their test turns out to be positive (touchwood) after a retest at 90 days?

  41. Dear Dr.Tan,

    sorry for my bad english.

    My name is tony, and i’m student. I have unprotected oral sex with old man (HIV Status Unknown), he have child and family. And not ejaculation in my mouth, but make me freakin out bcz i’m orthodontic patient. :(

    3 days from exposure, i have sore throat and for my lab test from swab pharynx i got result Diplococcus not found, Gram(+) Coccus(+), Gram (-) Bacill(+) and not found spore, yeast cell. my doctor give me antibiotic.

    8 days, i got swollen lymph node in my mandible, my doctor say it’s normal.

    25 days, my sore throat its back because i drink coke. And my lymph node in my mandible back again to swell if i fell.

    27 days, i go to hospital for Rapid Test and was Non-Reactive. I think i’am in window periods.

    34 days, i got headache in my right head and i feel swell in my cheek.. I’m freak out and i’m back again to my doctor for my sore throat, and he give me antibiotic.

    And now 38 days, i feel in my cheek its facial lymph node and make me headache include my ear and eye but right head only. I have cold before, and for day my exposure i cant have fever but i got sore throat, cold, lymph node in my cheek, mandible, and my neck.

    Dr.Tan.. My condition looks like ARS Symtomp? I’m very scared now. Sorry for my english.

  42. May I ask if hiv symptoms appear at week 11 ? Thanks doctor

  43. Hie Dr, i had unprotected sex on 27 july 2013 with a woman i dont know that much, on 29 august i took a lot of alcohol while walking very fast, so a few days later i had sore throat, i am not sure whether the sore throat is connected to the alcohol or its just a symptom from u protected sex, from the sore thoat i had like metalic taste in my mouth, i always eat normal, sleep well, temperature doesnt change, no sweats at night, however on 14 august i found a lymph swollen node on my right groin but its disappearing now, so because of this lymph node i have decided to go for a test, im going to collect them tomorrow And do further tests like for gonorrhoea and so on, what are my chances of being hiv positive here, thanks in advance
    Sent from my iPhone

    • Sorry i meant 27 july 2014

      • You typed all of that on your iPhone? Kudos to you man. Seriously, your symptoms sound nothing like HIV ARS. So that does not feature in my analysis. However, the fact if you had unprotected sex and if she is truly HIV +ve, your risk of catching HIV is about 0.1%.

        • Hie doc, got my results today and came back negative, told to come back in 6 weeks for another

  44. Hye dr
    I had unprotected sex with sex worker on 16th august and i ejaculated in her vaginal.after 2 days i feel itch during get pee and some fluid come out from my private part.so the doctor give me injection to cure it.
    After have been exposed 25 days.i take the ELISA test.and that test state

    (this test by ELISA/EIA method:HIV1/2 Ag/Ab combi that detect HIV-1 p24 antige,antibodies(IgG/IgM to HIV-1 inclouding group O and HIV 2 in human serum and plasma)

    My results for this test wan non reactive.my question
    1. is that prove or not for this test after expose 25 day
    2.what generation for this test.
    3.i still worried because i have symptom like weak.lost appetite.have multiple spot around neck and face.

    • Sorry additional..i had no fever.ulcer in mouth.sore throat.but a little flu after wake up in the morning anf whithe harsh in my tounge.and my nails indicate white stripe at before the edge on my nails

    • 1. The test you did was a combo test and not conclusive after 25 days. 2. 4th Gen. 3. The fact is you cannot diagnose HIV with symptoms. You will need a repeat test. Click here for more info on the HIV combo test.

  45. Dear Dr. Tan,

    Thank you for your very useful and informational website.

    I had unprotected intercourse with a Japanese girl (30 years) exactly 16 days ago. From the fourth day after the act till now, I have been having a recurrent sore throat, swollen glands in neck and armpits, muscle aces, and minor fever (37.4C). My illness is going up and down – I feel well for a few days, then ill again (same symptoms).I have been tested and everything came out negative; but I know it is too early to be conclusive.

    Could you please tell me if this appears to be common early ars symptoms? I have been having great anxiety over this matter.

    Thank you in advance for you time.

  46. Hi Dr tan, I had an unprotected sex with a guy (HIV unknown) in 7 weeks ago. However, the symptoms started right after 7 weeks, headache and muscle aching. Could be the symptoms occur on week 7? I did ask him about his health, but he says to me he is clean.

    • Its unlikely to be ARS, but still impossible to conclusively say no. I’d suggest getting yourself tested to be sure. At this juncture you may wish to get a 4th Gen test such as the combo for very indicative results.

      • Thanks so much for your reply! I will go and get tested with him together to make sure everything is okay. Once again thank you so much!

  47. I forgot to add that my right neck lymph nodes were very swollen at the time of the ulcers. No detectable other nodes in the armpit/groin (I am pretty muscular so I don’t know if I am doing it right). At the time of the ulcers no fever as well. The fever now is accompanied by lymph node swelling on both sides of the neck.

    • Thank you for the compliment. First of all, the chance of you catching HIV from your exposure is next to zero. Secondly, although you are right that throat ulcers are a ‘red flag’symptom of HIV, we must also remember that HIV ARS symptoms do NOT develop at 10 days post exposure. Thirdly, since you had a bad throat infection, of course your neck nodes will be swollen. Lastly, the 3rd Gen ELISA at 22 days is already rather indicative. All in all, my money is on the fact that you do not have HIV.

      • Thank you for your prompt reply. Out of posterity, I will post my 29 day result, for other worries like me. :) Thank you

      • Dr. Tan,
        I wanted to make correction on the timeline I presented earlier. The exposure event was on the 18th of August. Soar throat began the 2nd of September. Dr. Visit and penicillin shot on the 3rd and ulcers noticed the 4th of September. Ulcers remained until the 11th and healed completely by the 13th. I have a very good picture of the ulcers that I would like you to see. Thank you for your time.

  48. Dr. Tan,

    I chose to post here because you seem to have a clearer way of explaining things than most. I am 41, hetero, and had protected vaginal and unprotected receptive oral (cunnilingus) with a csw exactly 27 days ago. After 10 days from the incident I developed a severe exudative soar throat and my physician gave me a shot of penicillin and a 10 day coarse of amoxicillin. 24 hours after the shot, the back of my throat cleared significantly but my uvula developed several painful ulcers to the right of the midline and remained painful for 10 days before beginning to heal (I have pictures). During that time it was very hard to eat or drink anything. They have since healed and today (day 27 post) I have developed a fever of 101 for no apparent reason. At Day 22 I did go in for what I believe was a 3rd generation rapid test (finger prick) which turned out negative. I have had pretty severe anxiety since the encounter which has led to being short of breath and depressed. I have read that aphthous ulcers in the throat could be an atypical presentation of the entry point of the virus. What is your opinion? I will be going in on day 29 for another identical 3rd gen test in 2 days (day 29). Thank you.

  49. Dear dr tan

    I’ve been having recurrent mouth ulcers for past week…my exposure was four weeks ago..i took a test and m scared as hell..wat are d chances dt i got hiv from unprotected blowjob dt ended up bruising my penis… (No blood noticed)..

    • HIV risk from oral sex is next to zero. Don’t jump at shadows. Click here for more info on HIV and oral sex.

      • Dear doctor, i took the test at four weeks mark, it was negative.. However m still Having rashes at my back, i went to the dermatologist and he said it was back acne…i have like five bumpy spots with a tingling sensation.. my exposure was five weeks ago…insertive oral with a hooker in Dubai, came in her mouth, slightly bruised penis… Do i need to get tested again?

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