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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


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.

Click here for Info on STD Symptoms in Men
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. can hiv virus transmitt through using alum? Actually Here in India, I had been to a barber for a
    head shave. During shaving there was a cut
    and the barber used a piece of alum to stop the
    bleeding which is a common process here.I noticed that he used this alum to a person having Hiv.so can i get infected

  2. I did hiv 1-2 AB antibody test after 44 days of get infected can i get true results

  3. hi doc.is it possibke to transmit hiv by touching infected semen then wipe my urethra ??im so worried cuz now i have oral thrush ang rashes in my arms..ialso have constant peeling in the skin of my both arms and ahnd…i have this thrush a more than a year…doc pls response…how long does hiv survire outside the body..like doorknob…cuz i know some person put his semen to the doorknob with i remember i had touched then unfortunately wipe my urethra….before i felt this symptoms….

    • First of all the answer to your question is “No, in my opinion it is not possible.” What is more important is instead of stressing out so much about it why don’t you just go for a HIV test and find out once and for all if you are infected or not? If that not better that sitting at home and sweating?

  4. charmingheart

    I m 50 yr and went to one beauty parlor girl 49 days before and while massaging she took my penis in her mouth for one second. Immediately I removed my penis and told put condom and I received blowjob from her for 2-3 minutes,it was not erec, so I stopped.While sucking I feel her saliva coming down towards the base of my penis where I did shaved my pubic hair before 3 hrs and their might be some minor superficial nicks bruishes abrasions leisions. So what are my risk of acquiring hiv
    1.unprotected oral sex of one second. 
    2. I m not sure I saw any blood,but what if she had bleeding gums or sores in her mouth  and her saliva mix with her blood enter to the unprotected area of my genital area where their is minor superficial cuts before 3 hrs while sucking. 

    After 27 days of exposure I got runny nose for few hrs on first day. 

    Second day I was feeling chills all day.

    Third and fourth day mild sore throat and low grade fever coming and going.I was so scared that,I took rest for 2 days with 3 doses of paracetamol and 3 doses of antibiotic fearing ars symptom.

    Again after 39 days I got runny noses and chills on first day and very very mild sore throat(I dont feel anything otherthan two to three times like clearing sensations) and sometimes low grade fever for half hourto one hour especially in toe and now it is 9th day and Iam not taking any medicine.

     I m very depressed and very fear. 

    I had no other exposure other than this. had not any protected or unprotected vaginal or anal sex with anyone other than my wife since 20 yrs. Should I be tested or no test is required and I ignore this flu like symptoms as not related to hiv and move on.plz help me I m very anxious.
    Whenever I fear I read your article that one shud b involve in high risk, have high fever 38.5, severe sore throat,rash, ulcer n lymp nodes, which helps me to calm down, but still I fear.

    • I honestly do not think there is any risk of a HIV infection from this exposure of yours. However, it also sounds to me like you should get tested so that you can get over your paralyzing fear of HIV.

      • charmingheart

        today is 20 days and still I feel like low grade fever, but when I take temp it is always in the range of 36-36.9 maximum. But still I feel feverish and chills certain times of day and night.
        I work in middleeast where their is no anonymous testing, as it is conservative and anyone who is found positive are depirted.
        Does my low grade fever match with ars
        Ars fever goes on it own or it needs medication.
        How long the ars fever stay.
        My mild sore throat was only for 2-3 days only and now since 20 days only feverish and chills.
        I did my complete blood check up but Dr are not able to find the cause of fever.
        I m worrying this can be related to acute hiv infection.
        Everyone says receiving oral sex doesnt have risk and no need testing.
        Even superficial cut poses no risk.
        My anxiety is full blown panic and unable to relax.
        Plz need ur advice

  5. John Mahlon

    Hey Doc..I am a male aged 24.. I have had a rash on my legs for over 10 years now and it just doesn’t go. I went for HIV testing and i tested negative. What can be the problem doc?.

    • You should see a dermatologist to figure out what is causing your rash.

  6. Protected oral and vaginal sex with csw.before sex with 9 h i shaved the genital zone.concerns:1vaginalfluids on shaved area.2after removing condomn i touch the tip o the urethra.posibility vaginal fluid on the hand..symptoms:jonction pain.at 5 week s post exposure fever 2 day s..after fever a non itchy rash on the arm like rubella.the rash have gone in 3 days.at 3 ,5 mounth a rash on both low arm non itchy whose left brown spot til now.other diagnostic:streptococum infection,colesterhol,reflux acid syndrome..at 5 mounth a smal could with a small sore throat..this has gone in 7 days without drugs .tested negativ for hiv at 11 and 14 weeks 4 gen assays alere and elisa.other std negative.hepatities negative.what are your reccomandation?if i test at 6 mounth this resulst are gona change??

    • I do not think you need a re-test.

      • Today 6 mounth and 1 week.i m waiting for results
        2 test ..1 eclia ag ab and another one elisa..on diferent labs.thank u for yours respons..i hope just to be good

  7. Dear Dr, I had some sexual activity at massage paloure. The girl put my penis glan in her mouth for couple of seconds. After that I asked her to remove her mouth and give hand job. No sex , no fingering or kiss. What is my risk? Do I have to go for a test? Please share your opinion.

    • Risk is very low. If you are really concerned, get tested for the peace of mind.

      • Thanks DR, as per your opinion risk is low not nil. So what r my chances now after receiving oral sex? Is there any documented case of this kind of exposure?

        Please help.


  8. Sumit Kumar

    Hello doctor,
    In May 2016 I had protected sex with a sex worker , I had blow job from here without condom but I didn’t leak in her mouth at all and intercourse was safe as I checked my condom after sex it was fine . But that time I had little sore throat and I was already on antibiotics we had a few French kisses and below my lips there was a pimple as well , so now I have little fear as I Again had sore throat with an ulcer in my uvula though sore throats is not that bad . So do I need to get myself tested as I am very anxious

  9. Worried

    Receiver of unprotected Anal for the first time he was 6-8inches in girth now 5 weeks ltr I have just been thru 2 weeks of external hemorroids, and itching and tingly sensations in my groin. Had rawness all over groin but no spot pimples or rashes, it hurts when I ejaxulated like someone just kicked me really hard there. Is it just bc my a is was overstretched and the sex was very rough or could something other then hemorroids be the problem but I haven’t seen or felt any signs other than hemorroid? Any idea what it could be. My balls and penis also retract into me like it’s 35 degrees below.

    • drtan

      I think by now it is also obvious to you that your problem is not just haemarrhoids. Pain on ejaculation could be caused by Chlamydia, Gonorrhea or other infections. I cannot comment on the “rawness” without actually examining the skin. Anyways, you really should get yourself to see a doctor. And btw, he cannot possibly be 6-8 inches in girth. I think you meant length.

  10. fiona

    Hi Dr,

    I had an unprotected oral sex when the guy ejaculated in my mouth. We then had the protected sex. This happened in 13 Nov 2014. I then proceed to have the ECLIA test on 28 Dec 2014. Result is negative. I recently had the dry cough for more than 3 months. a little flames and no color for the flames. Can you please help to provide more details about the dry cough symptom?

    Thank you.


    • Dixon Pj

      Why you don’t go for retest?

      • Fiona

        Hi Dr,

        Appreciate if you could shed the light if the dry cough is the early stage or late stage symptoms? Also, what would be the other symptoms for the late stage?

        Thanks you very much.


  11. Hi doctor. Recently put myself in a high risk hiv infection situation(male to female intercourse w/out condom). Now im suffering from sore throat with oral thrush on tounge. Itchy feet and hands come and goes. I know symptoms are not best to judge for hiv but i just want to know if i should be alarmed by this occurance. Ur reply would be grately appreciated

    • drtan

      Your symptoms do not sound like HIV ARS at all. Sore throat could also be caused by throat Gonorrhea or Chlamydia. Itchy palms and soles may be caused by Syphilis.

  12. Dixon Pj

    I had protected sex with sex workers at thailand after 2 days I have noticed a red rash my stomach …38days after I test hiv ( elisa hiv1 and hiv2 screening test including p24 antigen ) I don’t know which generation test was this but the results was negative and index value is 0.22 …what is index value mean?..which generation test was that?

  13. Hello Doctor. I’m male. 12 days ago I had sex with a girl. I used a condom all the time, except when doing oral sex (I was the giver, she was the receiver). I only used my tongue to lick her vagina for 5 minutes, no vagina fluids came out. However, I’m feeling a little bit tired, itchy, something is in my throat 1 week after the sex. Are those the signs of *acute retroviral syndrome* or ARS? Is there any chance of me getting HIV or any STDs through my kind of oral sex which I was the giver if she had HIV or any STDs? Thank you Doc.

  14. Hello docter Tan, How r u?
    I had sex with a call girl in drunken state on 25th May… we had sex for 3 times in that night… I licked her vagina for 2-4 mintues while she did not ejaculate in my mouth… i had some sores at that time on my tongue due to excess cleaning of my tougue while brushing… i used condoms while having sex… but she used some coconut hair oil for lubrication too. I dont remember that the condom was broke or not… but was looking ok after removing it… i had a sore throat or swollen tonsil on 5th day after having sex… i never got any tonsil problem before this… then i had swollen lymph nodes in neck region at that time… after 3 doses of medication from docter it got normal… then i had rashs after 11 days which had small pimples far away from each other on back n back shoulder area which got pink due to itching by finger nails and was lasted for few hours but it was recurring for few days in the evening only or for few hours in the morning and the itching is continued till now as pimples has vanished now… i am also having a headache now with swollen back of head… kindly tell me that m I prone to hiv… n when should i check or test hiv n which test should be done… n will any test give exact result now as i hav heard about window period… i had some little weakness too ithe period… i didnot had fever or dieareah… please guide sir…

    • How does a girl ejaculate in your mouth? Of course you are at risk of HIV and all other STDs. Your sore throat could have been caused by throat gonorrhea or chlamydia. You should see a doctor and get tested for everything.

      • Thanks docter…sorry for my bad english…which test i should do…n can u tell me how long the skin rashes remain or occur…

  15. Hi Doctor,

    How are you? 6 weeks after having unprotected sex I developed a swollen tonsil on the left side only and it is not red or very painful (most of the time I don’t even notice it) and there are not any white spots on it and I have a slight white coating on the back of my tongue which changes color depending on what I eat. These symptoms have lasted for about 14 weeks. I know I have to get tested but can you please tell me in your honest opinion how typical of early HIV do my symptoms sound. If these are early HIV symptoms shouldn’t they have subsided by now?

  16. Hi,

    I am very worried tonight about the possibility I may have hiv and hope you can help me. Ten years ago I picked up some girl at a bar and had protected intercourse except kissing. Two weeks later I had a tonsil infection and flu like symptoms. The tonsils looked white and were swollen. When that cleared up I had a lump in my throat feeling that came and went on and off. Sometimes very severe and other times just a mild discomfort . My doctor diagnosed me with Gerd and acid reflux disease. Also my sinus would feel inflammed and was told to use a neti pot to irrigate them out. But I’m concerned it’s hiv. Had RNA test and T cell count a month after exposure. Then a test at three, then six months, then at 3 years negative. So I put up with this problem for ten years. Saw five different ENT drs without resolution. Had a home test last year negative. The thing is I guess I experimented with a few high risk individuals in the past of course protected. I’ve read that the tests are rated according to lifestyle and risk status so was wondering could the tests be wrong if i took a few stupid chances? Also had a mildly itchy rash on my back last month that lasted a week resembling shingles.
    Now for past week had a dry cough, sore burning feeling in back of throat, and my glands from my ears to inside my throat ache. Freaking out. Thank you.

    Thank you.

    • If you caught HIV 10 years ago you would very likely have AIDS by now and would be very sick. You have had 4 negative tests all conclusive in their own right. So why are you still worried about a HIV infection? Your worry honestly is completely irrational and if I was your doctor, I would be pushing for you to see a psychiatrist. Perhaps that is something you should be discussing with your doctor too.

  17. dettol like antiseptic can kill hiv virus?

    • That is a very strange question. The answer is Yes but what is your point? You cannot catch HIV from surfaces anyway. So wiping a surface with an antiseptic before touching it changes nothing in terms of HIV transmission. So I do not see the point to your question.

  18. scaredcat

    I got extremely drunk and my friends convinced me to get a prostitute with them. We each got rooms and when mine showed up, we showered, then we to the bed where I started sucking her breasts. We kissed on the lips a few times. Then I put on a condom and she gave me a blow job. The condom didn’t cover my full penis, it only covered about 70% of it, but it seemed like she was careful not to go further than the head anyway. Then she moved up and tried to put my penis into her vagina, I think it touched her vagina just a bit before I asked her to stop as I didn’t want to do that. So we changed positions, I played with the outside of her vagina a bit and poked it with my penis a few times, still wearing the condom. Then I wiped my hands on the bedsheets and took the condom off and finished between her breasts, with her doing the work and rubbing her breasts against my penis. I had enough self control to put on the condom, despite it being too small, and I didn’t put my penis all the way into her vagina. I think at most when she tried putting it in, it may have gone in just a little, but it still had the condom on. So I want to know what I put myself at risk for and when should I test if I should test? Thanks!

    • Your exposure does not sound risky at all. I cannot say you are 100% not at risk. So your should still get screened for HIV and STDs. Although your risk is extremely low. In fact, low enough to be negligible.

  19. Dear Dr. I have sex with paid worker in 24may and I had frenching kiss with her and protect sex. After 1 week later I had coughing for 2 weeks and sore throat and tiredness and some muscle aches and joint aches. Sorry for English poor. Am I in high risk getting hiv?
    I respect your comment and need your help
    Cause is this few weeks I live in fear and can’t sleep well.I am 21 year old male. Thank for your reply.

  20. Good evening doctor.sorry to disturbing but i m.despereited.i have to negative test at 11 week s and 3,5 mounth s (3 mounth and 2 weeks)first alere hiv 1 2 ag ab combi..and second elisa hiv 1 2 ag ab
    are this conclusive??i haded an protected sex (oral and vaginal)with a street worker..but i think after removing condomn i touch the head of the l
    penis.i don t know if on the hand was vaginal.secretion..on the tips was semen.before sex with 9.h i.shawed the inghinal zone..could.be a scratch and the vaginal fluid s contaminated that
    .i developed a lot of simptoms..fever 2 day

    a rash 2 day ..after fever..look like rubeola.this at 6 weak s after exposure.and now at 3, 5 mounths an rash without itchyng ..and no.other si
    ptoms. For this.rash..is posibile at 6 mounth to.be positive??.the rash was on both arms a little bit raise…firsf red spots, after inflamation ..incolor lichid and after they gone and the lichid was like honey bee..now at 5 6 week s in that place are brown spots.sorry for my english..should i ll concern

    • drtan

      As a general rule, HIV tests are conclusive at 3 months. You have done 2 tests at 11 weeks and more than 3 months both of which are negative. So the tests are conclusive. Do you have a logical reason to doubt the test results? I think if you saw a Doctor and found out what is causing your rash, you may not be so worried about HIV.

      • alirel

        Butt once the symptoms are related to hiv ,the test i think was positive at the 14 weeks.??i don t have other disorders of imune sistem.for me a flu or a cold is gone in 5 7 days without drugs.i took some medicine for colesthol and antibiotic for streptococ ..i don t know if thia was an alergy for those drugs

  21. WorriedSouthAfrican

    Help from South Africa!

    Please help Dr.Tan & Partners!

    8 days ago I engaged in drunken sexual intercourse with a CSW. During the session the condom broke and I had ejaculated inside of her. I wasn’t aware of this until I finished. When I got back home I noticed I also had a slight skin break (caused via excema however there was no bleeding present) under the head of my circumsized penis. Worried, (as you can imagine), I started PEP 7 hours later. I am currently taking Trivenz (the Atripla generic) and am on my 9th dose going onto the 10th tomorrow morning. Two days after the incident I had the CSW tested (I had to pay her for this) used a Homemed (think this might be a South African brand) rapid test. She tested negative. I am aware that she could be in a window period and am not leaving anything to chance as I am still on the PEP. Unfortunately I cannot get her to test via a PCR which I understand would be ideal as it would reduce the window period.

    7 days later after the incident (yesterday), I have a mild sore throat. Nothing serious just mild symptoms. Please can you assist in answering the following questions:

    1) Is 7 days/1 week possible for ARS? If so, have you seen/heard of a patient seroconvert in such time?
    2) I have read your article about PEP failure with “Mr.M” however have you seen/heard/had any patients whom have had PEP failure whilst taking Atripla or any of its generics? (Following perfect adherence of course)?
    3) What are the chances I picked up possible HIV infection? Have you seen/heard/had any paitient who contracted the virus from someone while they were in their window period?
    4) I am going for a HIV PCR test in 5 days time (13 days post exposure), would a negative be assuring or not? I understand that there is a possibility that the viral load would be suppressed.
    5) Should the result from above 4) be positive, would there be any chance the PEP could eradicate it by the end of the 28 days treatment?
    6) I have been issued 30 tablets instead of 28 for the course of PEP, should I take all 30 or stop at 28 as I have read a full course is 28 days and not 30?
    7) I am aware that rapid tests have a 3 month window however what would be the earliest that a 4th generation rapid test pick up a positive result should the person be infected?

    Please help me by answering these questions and please don’t recommend I see a HIV specialist as I find your website very informative and straight to the point, I’ve been a living zombie for the past 8 days. All I can do is think about this and it feels like it’s consuming me.

    Thank you!!

    Worried from South Africa

    • drtan

      I am very uncomfortable when you say “please don’t recommend I see a HIV specialist”. That to me implies that you have not seen a Doctor and are self-medicating with PEP. It also implies to me that you are taking the information given on this site as medical advice. Both of which I do not condone. You SHOULD see a HIV Specialist right away if you have not. I will answer your questions with the understanding that this is NOT medical advice and you MUST see a HIV doctor.

      1. Not in my opinion. No I have not.
      2. I do not prescribe Atripla for PEP so cannot comment on its efficacy.
      3. This is a moot point. Risk analysis should have been done BEFORE commencing PEP.
      4. There is no data on the accuracy if a HIV PCR test for HIV diagnosis while a patient is on PEP.
      5. NA
      6. The recommended course is 28 days. However, you should verify this with the doctor who prescribed you the medicines.
      7. I have seen a 4th Gen test pick up an infection as early as 2 weeks post infection for a patient not on PEP. However, you cannot interpret this as a 2 week test is indicative for you.

      • WorriedSouthAfrican

        Hi Dr. Tan

        Thank you for your prompt response. I am not self medicating as I have consulted with a GP and a pharmacist about the regimen and exposure. The GP immediately recommended that I start the PEP treatment as the risk did warrant it. The reason I have requested you don’t recommend I consult a HIV specialist is that I don’t want to be passed on without the questions being answered as I am gravely worried.

        My sore throat is getting worse and I am becoming more and more worried. I waited very anxiously for your reply despite not taking it as medical advice, viewing it more as what your informed opinion/experience confirms. As I have said this website is straight to the point and informative without beating around the bush like most other forums do. A few follow up questions please:

        1. Should the source have been in her window period, and have had a high viral load, would I be correct/incorrect in saying that should I have contracted HIV the inoculum would have been high?
        2. Does ARS ever create/cause a chest infection?
        3. I have read in an online US medical journal that there have never been any documented cases of transmission from a source during the window period to the infected person, in your experience have you seen this happen?
        4. How efficient do you rate PEP treatment on the whole?
        5. In your opinion when is the easiest I could test for a reasonably safe result? If so, what test should I take?

        Thank you for answering this. I really cannot express my gratitude. If does give me a lot of comfort.

        Still worried from South Africa.

        • drtan

          I am glad to hear that you consulted a Doctor. You should verify the answers that I have given you with him.

          1. Incorrect. Her high viral load increases the risk of infection but does not determine the inoculum. Anyway, that makes no difference. A person is either infected or not. And if you think a high inoculum means earlier and worse ARS symptoms, that is also not true.
          2. What do you mean by chest infection? Pneumonia? No.
          3. I have not. That said, the HIV patients I manage either do not know where they got it from, had a known HIV +ve partner or had a partner status unknown.
          4. Very efficient
          5. Click HERE.

          • WorriedSouthAfrican

            Hi Dr. Tan

            Firstly thank you for replying, you might not know it but your responses are really well appreciated and have eased the blow of this situation. Thank you!

            I’m on my 12 Atripla pill now, going onto the 13th tomorrow. I’ve taken a full STD screen and have so far tested negative for Hepatitis B & Syphilis. The remaining tests should come through tomorrow. Over and above this I’ve taken the HIV DNA PCR Qualitative test – the result is still pending. I have however read on many forums that this test has a very high rate of false positives.

            1. Have you ever experienced cases of false positives with the DNA PCR Qualitative test?
            2. My sore throat is quite persistent, it’s not bad but still mild, could this be a sign of ARS, it is the only symptom, I do not have a fever etc. It is getting cold here in Johannesburg so that could be a contributing factor but it seems all too co-incident, what are your thoughts?
            3. If I had to take medication (anti-biopics) for the sore throat will it affect the PEP efficiacy?
            4. What percentage of non-occupational exposures had failed after utilizing PEP in tie experience?
            5. Should the DNA PCR Qualitative test be negative, how would you interpret that? Good/Very Good/Excellent indication of my status?

            Thank you once again for your responses. If you were local (in South Africa) I would have sent you a fine bottle of whiskey or wine (should you drink) to thank you.

            Pleasantly await your response.


          • You do realize that testing for Hep B and Syphilis at 12 days is useless in terms of accuracy.

            1. Yes.
            2. Too early to be due to ARS.
            3. It depends on what antibiotic and you should ask your doctor this question.
            4. In reported literature about 10% to 20%.
            5. There is no data to back up the accuracy of using DNA PCR as a HIV diagnostic tool for a patient who is on PEP.

  22. Pholenz

    Hello doc, i have unprotected sex and i have colds, some joint aches in my shoulder and experienced 3 weeks after the sex. Is this a ars symtomps ? Please help

    • drtan

      It does not sound like typical ARS. However, this does not mean that you are not infected with HIV. You should still get screened.

  23. Hello Doctor,

    How are you? I had unprotected receptive anal sex a while back in January and about 6 weeks later my right tonsil became swollen it isn’t red and there isn’t any white pus on it but it has been this way for 12 weeks and antibiotics have not worked. Also my tongue has a thin white coating and I occasionally have a metallic taste in my mouth which I assume is bacterial overgrowth. I was wondering do these symptoms have anything to do with ARS or could this be a sign of another STD or just a coincidence that I am getting such symptoms shortly after a risky encounter and if these symptoms were HIV related shouldn’t they have gone away by now as it has been 12 weeks. I know I still need to get tested at some point but I just wanted to know if these symptoms and the timing of them was a cause for great worry or if I am just stressing myself out.

    • Your symptoms may or may not be related to HIV or STD. The best thing to do is to see a doctor and get yourself tested.

      • Thank you for your reply but if my symptoms were HIV related am I wrong for thinking that they should have gone away by now after 13 weeks and I should not be having symptoms anymore or is that not true? In your opinion of my symptoms how typical are they of HIV on a scale of 1 to 10?

  24. Hi Dr Tan, I had unprotected oral sex but protected sex with a lady overseas. There was a split second period where our genitals might have touched prior to sex but it is not penetrative. Shortly on the second day I feel sick with running and blocked nose as well as cough with phlegm. The running nose and block nose is still ongoing for the 3rd day. Are these symptoms of infection?

    • drtan

      You mean of HIV infection? Much too early to be due to HIV. The risk of getting HIV from protected sex is very low but not zero. You should still screen for it after the window period is over. Also condoms do not provide 100% protection from all other STDs. You should screen for those too.

      • Hi Dr Tan, when is the earliest that I can take the test. I’m quite worried. My blocked and running nose has stopped but has developed a slight fever.

  25. Hi Doctor Tan,
    How are you? I would like to ask you about something which such a big doubt in my brain. I hope you would answer me.I am gay and hiv negative versatile (Last hiv check was on 2.4.16) . I have kissed to a positive guy. He told me and i thought kissing is ok.It was on the date of 8.5.14. Trust me i wasn’t comfortable while kissing and all. He is undetectable. Took his medication since 2003. We didn’t fuck or had blow job. Unfortunately, I kissed his nipples and some part of his body. He gave me few seconds rimming in my ass but that wasn’t deep rim too. Also, We didn’t kiss deep throat, however I have a little pimple beside my lip somehow. Currently I jz finished my medication for syphilis a month ago for 28 days by 27.4.16 (doxycline). I am awared that it could get other diseases easily if you have syphilis and mess around. I have stage one syphilis. I couldn’t wait for 3 months no sex period just because I have syphiilis but I always used protection. Always. I have Never missed. I am so worried about this and will I get HIV? I know that kissing won’t get HIV but I am worried about my pimple beside my mouth which might touch or contracted by him unknowingly while kissing. Pimple was almost dry. What should I do? I hope I will get answer and thank you so very much.
    I am carrying such worries. I don’t really have related symptoms but my throat seem painful sometimes. No ulcer. My right neck is painful even before. Maybe too early to tell. should i need PEP? I have never expose or in the risk behaviour no matter what . I am not able to sleep for a week. Please let me know. Thanks once again.

    • drtan

      I am doing very well. Thank you for asking. Your partner is right. There is no risk of you getting HIV from kissing or rimming. Furthermore, the fact that he is on ART with an undetectable viral load means that he is almost not contagious in the first place. I think your worries are extremely misplaced. You are not at risk of HIV from this.

      • Hi dr Tan,
        Thank you so much for the reply. I am relieved. Just that i have std and that makes me so scared of everything. I will even be extra careful in future. I really appreciate it so much and thank you Dr for your time.
        You have a great day Mr Tan.

        • Hi Doctor Tan,
          I hope that you are having great weekend today. I started my syphilis medication on 2.4.16 and ended on 29.4.16. I went for the Syp Serology. This is what lab reported currently. I am so worried and should i even be worried? RPR is Reactive with 2 DILS, TPHA is Reactive. I am not sure what does this mean? I really thank you for all this replies and help.

          • Hi Dr,
            I hope you are well. Dr, I started my syphilis medication on the date of 2.4.16 and ended on 29.4.16. I went for serology test on the date of 18.5.16 n this is my result. RPR-Reactive 2 Dils, TPHA-Reactive . I am not sure what they are, Do i need to worry?
            Will u Please help me read this doctor? Thanks so much.

          • please see my other reply.

          • It takes months for the syphilis titre to drop. Even if you have been cured, the syphilis antibody will remain as positive. You have taken the blood test too early. Please wait for another 3-6 months to repeat the test.
            It is best to bring the results to a doctor to discuss further.


  26. jason

    hi Doctor, can I know whether ars symptoms would appear after 5/6 months of exposure to oral sex? we didn’t have sex, but we gave oral sex to one another and there was vaginal fluid present in the vagina and I didn’t lick it for more than 2 mins. Recently, I’ve been experiencing diarrhea, mild fever and small painless white dots on the corner of my lips. The oral sex was given at late December 2015

    • drtan

      ARS symptoms do not develop after 6 months. Anyway, ARS symptoms does not depend on how a person is infected.

  27. gave unprotected oral to male. 3-5 days later strep like symptoms. had 4th generation test at 7 weeks negative. i still have a swollen tonsil and one swollen gland the same side which doesn’t hurt. now i have an ear infection. Is this ARS?.is test conclusive as I’ve heard some places it is and some it isn’t? please help .

    • drtan

      Generally speaking the 4th Gen test is conclusive after 4 weeks. Whether or not there is a specific problem with your specific test that affected its accuracy I cannot know and cannot comment. You should see your doctor about possible throat Gonorrhea and Chlamydia.

  28. hi Doctor, I’ve had unprotected oral sex with another girl, we did it to each other during the end of December 2015, I didn’t have any sore throat or high fevers for the past few months, maybe just morning flus, but during the end of April until now, I’m experiencing giddiness, on and off diarrhea, mild fevers and fatigue in the legs, do you think these are the symptoms of HIV? I’ve been worrying a lot nowadays and getting very stressed over it.

    • drtan

      No I do not think these are symptoms of HIV. But I also know that you cannot diagnose HIV based on symptoms. It is still imperative to get tested.

  29. Hi Doctor,

    This was 3 years ago, I had unprotected coitus a couple of times with promiscuous ex who had many sexual partners in the past. I didn’t know this, and when I learned of it, I broke off with him.

    I didn’t suffer from any symptoms, and he didn’t have any. I was wondering, now 3 years on, is it possible that I have HIV? (I know I should have gotten tested, but I was young and foolish)

    Thanks for the advice in advance


    • If you are concerned, it is best to get yourself tested for HIV and other STDs. It is not possible for us to comment whether or not you might have HIV.

  30. Paranoia

    I gave a guy a blowjob while having a throat infection . He did not cum in my mouth but he did give me a deepthroat. I had a swollen throat for about 2 weeks before i Bj-ed him and it was going on and off. 2 days after I BJ-ed him, I experienced extreme tiredness and my feet felt hot. But after sleeping it off for one night I felt Ok. However my throat is still swollen and wont go away. Did I get HIV or is my infection just getting for the worse

    • Paranoia

      Also, I smoked for my first time (2 ciggs on the 5th.) could that be a contributing factor too?

      • drtan

        It could also be just a simple matter of your throat being traumatized after the act.

    • drtan

      Your symptoms cannot be due to HIV. HIV symptoms do not come on so quickly. Yes it could be your throat infection worsening. Yes it could be due to your cigarette smoking. You could also have gotten infected with Gonorrhea or Chlamydia in your throat.

  31. Jasonmedina

    If I have a rash and went to a doctor and then a dermatologist and they both say it’s fungal then it can’t be an arms rash? Please help

    • drtan

      The problem with an ARS rash is that it can look like many other types of rashes. That said, fungal rashes also differ greatly in appearance. So if you are asking if a ARS rash can be mistaken for a fungal rash I have to say yes that is possible. However, if you shared your concerns with your doctors, they would have considered the possibility of an ARS rash and would have excluded it already.


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