More on HIV symptoms

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

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

What is HIV ARS?

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

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

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

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

What are the early symptoms of HIV infection?

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

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

Skin – Rash, ulcers , Sore throat

Digestive – Nausea, Diarrhea, Loss of Appetite

Neurological – Headache

Musculo-Skeletal – Muscle aches, Joint aches

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

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

Who gets HIV ARS symptoms?

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

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

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

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

‘Flu-like’ is not ‘Cold-like’

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

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

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

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

The HIV ARS Rash

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

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

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

The HIV ARS Rash looks like Measles

The HIV ARS Fever

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

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

The HIV ARS Lymph Nodes

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

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

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

The HIV ARS Sore Throat and Mouth Ulcers

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

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

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

What other diseases have the same symptoms as HIV ARS?

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

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

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

Click here for HIV Testing FAQ

Conclusion

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

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

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

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

Click here for info on PEP Treatment at Our Clinic

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

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

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1,234 Comments

  1. paranoid

    Hello Dr, I would like to find out, can ARS begin 4 days after infection as GI symptoms with fatigue that comes and goes… And last for a maximum of 4 days… On the 10th day sore throat which lasts 2 days… I did not have fever, rash and any other symptom…

    • No it cannot. It takes at least 2 weeks.

      • paranoid

        Thank you soo much for that.. I’ve been extremely paranoid when it comes to HIV.. I had GI symptoms as the main, all did not last a week

  2. Dr i had sex with sex worker and i wear condom but my condom breake for last 2 mintues only and after 8 days i feel slighty headache continues from 5 days is it sign og hiv or not only headache is occur

    • HIV symptoms do not occur so early. So your headaches cannot be due to HIV. That does not mean you are not infected with HIV or STDs. You must still go for screening.

  3. Hi dr

    I have a protected oral sex wif a guy on new year eve.. after 60 days i went for a 4th gen test which result in negative.. so shuld i do another one after 3 mths?

    • You can if you want. But there is really no need to. You test at 60 days is already 100% accurate.

  4. The last time I had unprotected oral sex with a prostitute was 49 days ago, 10 days ago I experienced swollen lymph node on my Below my left jaw, around my left neck and between the bottom of my neck and collar bones. I do not have fever or flu like symptoms, no fatigue/lethargy and I am eating well. I do experience night sweats sometime in the night as it was very hot but I wouldn’t be drenched in them when I wake up. I have 3 ulcers on my lips. I had a mild rash that covered a little of my neck, right chest and shoulder(the rashes didn’t look like measles) and has completely healed now. I did a HIV anti body, Hep B and syphillis lab test 6 days ago which was 43 days after exposure. It was negative. My left tonsils are slightly swollen. May I know whether the test for HIV is conclusive or am I even experiencing ARS at all? If not what could be the reason for the swollen lymph nodes on my neck.

    Please reply as I am suffering from anxiety each day.

    • And my tonsils seems to be swollen. Could it be tonsillitis?

    • The HIV test at 6 weeks is as good as 100% accurate. There is some other reason for your symptoms. Please see a doctor about them.

  5. Dear Doctor,

    I have tested at 7 months and 10 days of post exposure with Abbott Architect HIV 1 and 2 ag/ab combo with a negative results.I have also tested rapid kit(TRI-DOT) at 90 days with negative result.

    1.Is it conclusive?

    2.Further test is required?

    Please help.

    regards

  6. DeAr sir,
    I had first time sex with call girl 7 years before
    After 1 month my gp get tested through screaning that was negative
    I relaxed after 1 year i agAin tested hiv test through eliza that was non-reactive
    After thAt i got married
    Now 6-7 years passed i got worried about hiv i again simple screen my test hepatitis b & c , Sifilics, & hiv that all was negative
    But don’t know i am very afrAid even 7 years passed
    During this 7 years i never got symptoms like rash,severe fever ulcer etc
    Please advise my cbc remain normal since thAt time
    My doctors said don’t worry you don’t have hiv & no need of anymore test

    • So why are you worried?

      • Sir I am suffering from flu since last 9 days along fever 99-100F taking daily 3-times panadol &-coldress but not getting well &
        Sir i have also seen lemph node at my left neck not appears but if I press n trace then i feel but not feel pain if i press
        I just want to clear as 7 years passed no still no dairea, & no rash in my chest
        Still I have to worried or not
        As my wife also don’t have such symptoms as we never sex protected by using condom
        Please clear n help me out
        I am very worried i have 3 babies the most eldest is 5-years age

        • One more important thing , after how much maximum times symptoms would be appear ,
          I think now a dAys which symptoms i am facing these would be the sign of enxity
          Fever 99-100F
          Flu since last 9 days
          Whitish tongue ETC
          I am very hopeful n believing on you definitely your further detail reply will help me out
          God bless you
          Anxiously aWaiting for kind reply

      • Respected Dr.Tan i am waiting for your kind response

  7. The doctor I visited done combo test for me at 22 days post exposure (yesterdy) and it was negative. He said that I need not repeat my test as the test is more or less conclusive.

    Should i be of concern of what he said as I remember conclusive should be at least 28 days.?

    Also, are all combo tests the same?

    • From the guidelines I have read, the official window period for the combo test is 28 days. However, you should always take your doctor’s advice. Like I have said time and again, this forum is not for dispensing medical advice. Not all combo tests are the same.

  8. Hi Doctor :)

    Love your articles as they really give me a greater understanding of HIV. But I am down with some anxiety about me having HIV. The last time(23 days ago) I had sex was overseas we did both oral and penetration which was both protected. The last time I did unprotected oral sex but with protected sex was 44 days ago. I am a frequent visitor of the commercial sex area and get tested frequently. The last lab test I had was 4 days ago and I am HIV, syphillis and Hep B free. What bothers me is that 1 week ago I flew to Thailand and was issued malaria prevention pills(Doxycycline). After a day I had mild rash on my neck and right chest. A day later I started to have a swollen lymph node underneath my left jaw and on my right collar bone. My left neck seems to be a little more swelled compared to my right. I constantly take temperature and the heightest was 37.6 degree(it was scorching hot in the afternoon). I would sweat before sleeping but wouldn’t be soaked in my sweat when I wake up, I believe all this is due to the temperature in Thailand as its very hot. I have 2 ulcers both about 1mm in diameter on my lower left lips. At day 4 I visited the doctor in Thailand and they gave me fexofanadine HCL to fight against my rash. After taking the fexofandadine HCL for 5 days, my rash is 90 percent gone and still no sign of fever or other symptoms. I seem to have another lymph node underneath my right jaw but all lymph node seems to be at a palpable state and it hurts only after I press on it with a lot of force and all of them are giving me very mild discomfort. May I ask it this a sign of ARS or it’s just the side/allergy effect of doxycycline as I have read that people may get allergy reactions to Doxycycline.

    • I also did another HIV,syphilis and Hep b test lab test 7 days after I first took the Doxycycline Pill. The test shows negative.

    • sorry one more crucial point. Up to today my lymph nodes has not enlarged till its visible.

    • Does not sound like HIV ARS at all. Stop scaring yourself.

  9. Dear Sir,
    (Hiv 1&2 Abs+p.24 Ag) this test I did already. is this is a combo test. i did this three times and (HIV- Enhanced Chemiluminenscence Detection- ECIQ) two times with in 1 year margin. now i have some eye concentration problem started and swollen lymb nodes. Also i read that in some person hiv virus cannot be detectable in blood for more than years.
    Pls Help sir and iam worried because of this i cant even do anything. Pl help me Sir 1. Is this a case of Sero-negative HIV. 2.If iam in sero-negative HIV which test i have to do for the conclusion or the test which i did already is covering the sero- negative hiv 3. Is the test which i did is a combo test.
    Awaiting for your valuable rply sir.

  10. Dear doctor, 38 days ago, I had unprotected anal sex around 5 minutes without a condom, im a gay and role as a bottom. and then I did CMIA test at 36 days or 5 weeks after potential exposure. and the result was negative. The method of my hiv test was CMIA, but it is not mentioned that duo/combo or p24 antigen and antibody on paper only CMIA, is my test already using the fourth generation with p24 antigen/antibody?, because I don’t know. and is my test result conclusive enough with the cmia method?. because im so scared, and really in a big anxiety. help me doc, to reduce my anxiety.

    • If the tests does not mention if it tested for P24 or not, you should assume that it did not. In other words you either go get a combo test now or repeat the test after 3 months.

  11. hi from 6 weeks i had prptected sex and unprotected oral sex on her after 2 weeks i haver sore throat go after week then it back again after 2 weeks then it gp at week 5 now im after 6 weeks it back again it could ne ARS by the way i test antibodies at week 4 was negitve

    • You cannot diagnose HIV from symptoms. There is no way anyone or any doctor can tell you what you have is ARS or not. You antibody test at 4 weeks is good but you must get it done again at 3 months.

  12. hie doc tan…lam from South Africa…, when l was researching about HIV thats when l came through your website…lam a young man.., last year l had unprotected sex with my long time girl friend for the first time..and after weeks l began to develop symptoms like sore throat, joint and muscle pain, headaches, mouth ulcers, gum infection and a blurred vision…one thing that then came into my mind was that l was hiv positive..,but l did not have the courage to go and get tested until recently.,,n um yet to collect the results very soon…what confuses me is that my doc is quiet confident that my symptoms are due to stress..

    • That is your doctor’s assessment and since he is the professional to saw you, I think it would be very wise to trust his judgement. This should give you confidence instead of confuse you. Sicne your doc is sure your symptoms are due to stress, it means your HIV test will be OK.

  13. I feel crazy

    Hey Doc,

    I’m having a panick attack over recurrent fever I’ve been having for the last 10 mths. It always came with bad sore throat. I was a fool and did 2 unprotected sex with the same person. After abt 2 weeks or so I got terrible fever and sore throat that prob last for a week. It was really bad like that it fits the description of “the worst flu ever”. Since then the combination of fever/sore throat has been coming back quite regularly. Now I’m currently having is again and the fever is still not going away (day 6 alr). I should add that I never exercise/eat healthy food and always knw I have a pretty bad immune system. Is this a strong sign of HIV??? Please reply I’m really scared. Also I wanna know how much is the chance to get HIV from oral sex (unprotected, not swallowed bt a couple of guys cum in my mouth). Thx before!

    • Honestly there is no use to analyze risks and symptoms in the hope of knowing you are HIV positive or not. The only way is to test. Although you are scared you must bite the bullet and test. If not the anxiety will just eat at you and probably ruin your life. Anyway, the risk of getting HIV from oral sex is next to zero. Click here for more info.

      • I feel crazy

        Thank you so much for your reply! I woke up this morning feeling much calmer than last night and I know that I need to get myself tested immediately. Wish me luck doc!

  14. Hello Dr!

    I had an insertive fellatio to a gay men, who later tested positive for HIV+ and Syhpilis… I also had some chlamydia now we found out about. I have done test 2 weeks after exposure, ag/ab 4th gen duo test, it came back negative!

    1.Could you estimate my risk from this?
    2.How conclusiv is my test in %?

    I also expirience some symptoms but it could be duo to anxiety:

    1.Slight fever – 37-37.2 under armpit
    2.I think i have swollen lymphs under my armpit and groin area.
    3.Mild headache(mostly when i shake my head or squint my eyes.
    4.Cold feet(sometimes sweaty at night when i sleep)

    Please advice! Thanks for helping.

    • 1. There is no risk of getting HIV from insertive oral sex. 2. My very rough guess is 90%. Your symptoms do not sound suspicious of HIV at all.

      • Thank you Dr.Tan!

        Im slightly more concerned now, since the last two days i had high fever and lots of sweats, 39.3+ .. now 2 days later everything is back to normal only some slight cough.
        I lost some weight and I am really scared, tomorow is 28 day and i will go for Ab/Ag duo test again.
        Could you please explain, how is my chlamydia not getting the risk higher, it is resulting in inflammed urethra (red) and by my knowledge this is increasing the risk isnt it? Also this guy did not knew it(assume he had high Viral Load) I somehow think that i am the first one to get infected that way, i promise to let you know the results !

  15. hi , i had virginal sex protected and perform oral sex on her from month ago yesterday i did the test elisa test it is what available in my country and dr told me it is ok to do it , my result came 0.04 negative . should i test again can i move on in my life

    • I think your risk is very low. But the ELISA test as far as I know is not officially conclusive at 1 month post exposure. As far as I know it needs to be repeated at 3 months.

  16. Hi Dr Tan, ytd i went to get a 4th Gen HIV test post 30 days after my low risk exposure, it cane out negative. Do i need to get another test at the 3rd month? :O How accurate is it at post 30days fpr the 4th Gen Test? Can it be considered conclusive? :O

    • In my view the 4th Gen test is conclusive after 28 days.

      • Thank you for your reply doctor :) but would it be advisable to go for an oraquick on tje third month?

  17. Hi i had protected sex and unprotected oral on her lick vegina for less than min with sex worker 21 days ago after 2 weeks i felt sore throat and then some runny nose and gone after week i had no temperature. but my nose still have stuff anyway today im in 4th week tomorrow my last day in week 4 and today i wake up and i found have 2 spot one in both side in my tonuh in the tip looks like mark burn with white around and painless

  18. Hi doc,
    I’ve deep kissing smoothly just about for 20nd and suck gently her breast n lick…no sex activity…just kiss,suck,n lick…but after one week until now (now it’s already 11 weeks after exposured,i’ve rash.Rash just come n go about 1-2 hours,itchy,big pink n red…my question:
    1.Is rash apart of hiv ARS?
    2.Can i get hiv just from doing above..?
    3.should i tes doc
    Thanks doc..sorry my english really bad

    • Dr Elaine Loh

      firstly HIV transmission via deep kissing is close to negligible. Rash that came and went after 1-2 hours definitely does not sound like ARS at all.
      That being said, It will still be advisable to do a check at 4th week with HIV combo just to be very sure. hiv combo

  19. Hey everyone Im new to these boards. I pretty much have no one to talk to so these anxiety boards are all ive got. October 10th like the idiot that I am I had unprotected sex with my friend who i have known for 10+ years. I have had sex with him numerous times before and always came out clean. (hes straight and not a iv drug user that im aware of) But I know he gets girls. And if he doesnt use protection with me chances are he doesnt with other girls either. Before October 10th I had sex with him in July too but I know he could not have had anything then because all stds including HIV came back clean after 6 months which is this month of January. Here is where my nightmare begins. A little over 6 weeks after October 10th I came down with horrible horrible fatigue which continued for weeks, along with dehydration, dry eyes, pimples all over back/chest itchy dry skin, diarrhea, numbing tingling in hands feet legs, constipation some days, my vagina even dryed up. I was also nauseous and dropped like 10 pounds. I looked up these symptoms and thought ***** I bet I contracted HIV. I ***** bricks so at 8 weeks post exposure I bought an oraquick it was negative. I wasnt convinced so at week 9 I took another oraquick also negative. I thought no way I dont trust these tests so I went to my GP and requested an HIV Elisa blood test at 10 weeks post exposure. It came back in 2 days Non Reactive for HIV 1/2 from Questdiagnostics with reflexes. I still was not convinced even though most people who have a normal immune system would of converted by then considering my symptoms started at 6 weeks. But the thing is my CBC blood count was elevated so I totally thougt that means I probably havent converted yet from negative to positive even though Ive always been relatively healthy with no ilnesses or any issues I know of. So my doctor resheduled me to come back for more blood work just to see if my blood count goes back to normal. He never believed it was HIV infact he thinks im nuts. So pretty much I had to wait another 1 month in a nightmare. I cried everyday, quit my job cuz I couldnt focus because my odd symptoms kept persisting, drove all my family and friends crazy, contacted numerous HIV hotlines and even been on all kinds of HIV forums only for people to tell me im negative and to move on. Sotime for my conclusive test on January 22nd which would be around 15 weeks past my sexual exposure. I go get blood drawn for a CBC count and a final HIV test. I was absolutely sure it would come back positive. But to my surpriseI called my doctors office and they said my CBC was normal and my HIV test came back Non Reactive once again 15 weeks past exposure which is over three and a half months. But I am still not convinced due to persisting symptoms. My anxiety and nightmare continues. I still have tingling, numbness, diarrhea, abdominal pains, red burning eyes. I am so tired of living in fear of this disease. I read that although HIV tests are conclusive after 3 months Im scared im one of those people who do not create antibodies to the virus or that I still could be in the process of seroconversion still and although its rare maybe I will convert at 6 months. And the thought of living like this for 2 and a half more months makes me want to drive off a clif. I do not what to do. Pretty much I would have to be the unluckiest person live and my guy friend would have had to contract HIV somewhere from July 11th to October 10th and he would of had to have been in the HIV window period himself and have infected me. I am undeniably depressed and lost all my marbles. Noone will listen anymore. My doctor just keeps telling me that I dont have it and that Im blowing it way out of proportion and my family and friends wont listen and pretty much laugh at me. So pretty much that is how I ended up on these boards. I feel so alone.   

    • I have to say I agree with your doctor, family and friends, You do not have HIV. Just as you are puzzled why no one listens to you, I am equally puzzled why you do not listen to everyone else. To me, it is plain as day that you do not have HIV. If you choose not to believe that, I do not see how anyone can help you. Imagine you take your friend to the park in the middle of the afternoon and tell her that it is daytime. But she insists that it is night time. How can you convince her? You cannot. She has an illogical belief. Just like you have an illogical belief. What you need to to do is to accept the fact that you are not infected with HIV and go find out what is actually causing your symptoms. Until you do that, no one on earth can help you.

    • I understand I’m in your same shoes.I’m at almost ten weeks after. I keep getting negatives. But you are outside the window, so be thankful. It’s stress that is making you sick. I have been down this road before.

  20. uneasy1995

    Doctor, I had a unprotected oral with a prostitute 9 days ago, me being the insertive partner. I have been taking PEP due too my concern and insistence. I know I am in very little risk, but I am already experiencing a mild sore throat.

    • Dr Justin Sim

      ARS symptoms can present as flu-like symptoms (fever, chills, sorethroat etc) but usually present between the 2nd and 4th week after exposure (peak symptoms at week 3). Your symptoms are appearing a little early for ARS. Another point is that you are already on PEP, which is minimising the virus should it be in your system. The last point is, as you mention, your risk is low considering your type of exposure.

      Common things are common and your sore throat is most likely down to a common cold virus, or something in the environment irritating your throat. Either way, continue to monitor your symptoms; if things get worse then it is best to get reviewed by a doctor.

      Getting tested for HIV once you finish PEP will be the only conclusive way to eliminate HIV as a cause but unfortunately requires waiting.

  21. Hi i had protected sex and unprotected oral on her lick vegina for less than min with sex worker 21 days ago after 2 weeks i felt sore throat and then some runny nose and gone in same day and tired im so afraid and scared i had no temperature im on antiputics for 6 days my sore still until now but better but i feel something inside my throat like phlegm but i cant spell it out im really so afraid it now will be week and i didnt get better

  22. Hi
    I have scratched the tissue inside my mouth trying to take some food out of my mouth and it started to bleed severley. I have been touching public surfaces all day and have not had washed my hands. Am i at risk?

  23. Hi Doctor

    Im a 29 years women, I had protected sex but had an “accident” with the condom (it splipped after he ejaculated) I got a flu with 2 days fever 5 weeks after and got very scared.

    I havent had sex since rhen and We both got tested 41 day after with a “combo test”(chimio and p24) both negative… can I consider this conclusive or should I test again?

    Thank u!!

    • By the way I tool this test in a recognized lab, it was not a rapid test.

      • In my opinion your test is already conclusive. Please do not worry.

        • Thank u for your advice Doc!! Saludos desde Mexico.

          • Eres bienvenido! I must admit I got that from Google translate. Literally the only Spanish I know is “Hola soy Dora!”

  24. Hi Dr. Tan

    I had a sexual intercourse with a female sex worker around 6 weeks back. I did used the condom but not sure if it was put rightly. I had some throat infection at the time of the encounter and it did continued for 5 days more. I had took Cefroxime followed by Amoxycillin+Pottasium Culvonate for the same.

    3 weeks after the encounter I have noticed 2 red spots on right side of my stomach and 4 red spots on the chest. these spots are not itching and are flat. 3 of the spots got converted to small bumps but latter became flat. Now its the sixth week and still the red spots on the skin are there.
    I wanted to know can these be a cause of ARS and how long do the rash in seroconverison last.
    Have gone through various web site and am getting confused.

    • What do you mean you were not sure if the condom was put on rightly? In what way can it be put on wrongly? Your rash does not sound like ARS. However, you should still get screened for HIV and STDs.

  25. hi doctor tan my name is steven i am a 19 years old teenager i had protected sex with a sex worker and i bought a rapid kit test for hiv on urine type and blood but came out negative in 42 days of my explosure do u think is it still possible for me to get hiv becuase i have a severe backpain that does not go away do u think it`s a symtom because i am tested negative by a rapid test twice by 42 days from today .

    • The only HIV test approved for home use is the OraQuick test. Even then, it is not 100% accurate. I really cannot comment on the accuracy of urine tests for HIV. I suggest you see a doctor for a proper HIV test and at the same time screen for other STDs.

  26. Hello Dr.

    Typically, how long after ARS a person will test positive? I had a possible exposure eight weeks ago. At 6 week, I had experienced a possible ARS. Then at 7.5 weeks, I had a rapid test done but it came back negative. It’s exactly 10 days after I experienced the symptoms before I had the test. Would the test pick up some thing if what I experienced was ARS ?

    • I don’t know. I don’t think there is any specific data on this. My guess would be 2 weeks give or take. That is purely a guess. Personally I do not take ARS symptoms into account at all when calculating testing window periods. So that is a moot point to me.

      • Thank you. If so, how much should I trust my 7.5 weeks hiv test ?

      • Parker gorley

        About 6 days ago i received oral sex from a sex worker in thailand. I did not ejaculate into her mouth and it was very short period of time. I got home after and cleaned myself with soap. Today I woke up and felt a bit of nausea, had diarrhea and have a rash behind both sides of my knees, and I am slightly fatigue. Should I be getting tested?

        • I do not think what you did put you at risk of HIV. However, it does put you at risk of many other STDs like Herpes, Gonorrhea, Chlamydia etc

  27. Hello Dr,

    I would like to find out if this would sound like ARS to you, 2 weeks ago I had what I remember as protected sex with some who’s status I don’t knw, exactly 2 weeks later I had heartburn and diarrhea and some nausea.. Heartburn lasted only one day, the diarrhea maybe 2 or 3 days.. the nausea is still there though not as strong… Could this be anxiety or would this be some strange symptoms of ARS… Please help

  28. Dear Dr. Tan,
    During the fifth week after the post oral unprotected insertive exposure with a prostitute, I felt burning back and developed a rash on the lower back. It was itchy,the pink area was big with some bump like and disappeared within 12 hours…again appeared the next day with same nature but changing the place and disappeared I had also sore throat and found that the neck was swollen.No fever because i took temperature three times a day.i had night sweat for only one that….i am scared regarding all these symptoms.Are these ARS,doc? I would be really grateful for your kind reply.
    Thank you.

  29. Hello Doc,

    I had possible hiv exposure with a female sex worker. I’m uncircumcised, I used a condom but before I put on the condom we were making love while we were kissing the tip of my penis touched with a vaginal fluid but I didn’t put my penis. The monent I felt my penis touched with viginal fluid I put my the condom on and proceed with vaginal sex. Exactly for weeks later I’ve been having symptoms like low fever 99-100 degree F, light sore throat, nasal congestion. All symptoms bother me mostly at night and the symptoms still going and been more than six weeks since they started. I went to see my doctor but he told that could allergies he gave allergy pill which helps but symptoms still not completely gone. Could that be hiv ARS last that long? I’m scared to death I don’t know if I can live with hiv.

    • What you are describing does not sound like ARS. But you know what I am going to say right? Go get a HIV test.

      • Yesterday I called the female sex worker and asked her if she is hiv positive, she said no but I don’t really believe her. I’m planning to go get an HIV test next month if symptoms still persist. What bother me the most doc is a possibility that my girlfriend can get infected because a week after I had sex with the sex worker, I had unprotected sex with my girlfriend so if I get infected my girlfriend could get infected too.

        Question is hiv rash always multiple can it be just one? Because I had one small black mark on my nose that last for about a couple weeks.

        • Doc,

          Have you seen hiv patients with one tiny hiv rash on nose and itchy face (not the tiny rash) the rash was not itchy.

          Thx,

          Bob

          • Nope. But I don’t see how that is relevant. You still need a HIV test.

  30. rapid test

    Hi Dr.

    I have experienced ARS symptoms after possible exposure 6 weeks after.

    have done rapid test 8 weeks after (venous blood drawn ,results in 30 min). the test came out negative.

    Currently waiting for the combo results and extremely anxious.

    What is the chance to get positive combo after my negative rapid test given that the symptoms were at 6 weeks and lasted for 4 days.

    Thanks a lot

  31. Jessica

    Good afternoon Dr. The article is very helpful but I still have some doubts regarding the symptoms. It has been around 8 weeks since I had a possible exposure with my ex boyfriend. We had a protected anal and viginal intercourse. The condom was intact after he finished. I experienced no symptoms during my 6 weeks and I already tested negative at that time using ELISA test. During my 7 weeks, I experienced some symptoms including fever, diarrhea, slightly headache and abonominal pain. All of the symptoms last only for one day. It went away after I met my doctor. So I want to ask:

    1. In the article, it states ARS occurs between 2-6 weeks after exposure. Is it possible if it occurs at 7 or 8 weeks considering with 3 months window period?

    2. Let’s say it’s possible. Are my symptoms that last only one day and went away after taking some tablet consider ARS?

    • 1. I have never seen or heard of HIV ARS appearing at 7 or 8 weeks. 2. If you say things like “let’s say it’s possible for symptoms to come on at 7 or 8 weeks” then what is stopping you form saying “let’s say it’s possible that symptoms only last 1 day”? It makes the entire question meaningless. Based on what we know scientifically, HIV ARS does not come on after 6 weeks and HIV ARS symptoms last for 1 week to 2 weeks. You cannot pick and choose which facts you want to stick by. A few more facts: Condoms greatly reduce the risk of getting HIV so your risk is low. The 3rd Gen ELISA test at 6 weeks is as good as 100% conclusive except in very very rare cases of sero-negative infections. So it’s time to take a deep breath and calm down Jessica.

      • Jessica

        Thank you Dr. Your further explanation made more sense than the fact I choose to believe. I will try calm down and wait for my 12 weeks test.

  32. Its been 3weeks after unprotected sex n im fine now all of my sysmptoms are gone after 12days if those symptoms were belongs to stds symptoms when i get conclusive result i was using drugs also at that time(cough syrup,cold syrup, nicotine chew gum and i was drunk also at that time )plz suggest me dr.tan

  33. Plz review my messages it could be easy to give answer of my question.

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