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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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1,820 Comments

  1. Sabrina

    Hi I had unprotected sex with a man about 3 months ago most of our encounter was oral sex but then he put his penis in my butt for a little while maybe at most 7 minutes then we went back to having oral sex for a bit longer and he eventually ejaculated on my boobs. How likely is it that I could have gotten HIV from such an encounter? Also lately I have noticed that there is a white coating mainly in the far back of my tongue there is no bleeding or pain even when I try to brush it off but I have a bad taste in my mouth and I am not sure as to whether or not it is a bacterial infection or possibly thrush also is this a symptom that should cause a lot of concern or is this not a typical early HIV symptom? I do plan to get tested next week.

  2. I say a lymp node on my neck 3days after having unprotected sex….no high fever,no headaches, only one rash,…..am I infected??

    • There are many causes of enlarged lymph nodes. You need to see your doctor to find out the actual cause. What I can say is that your swollen neck lymph node cannot be due to HIV as HIV ARS symptoms do not come on so early. However, this does not mean that you are NOT infected with HIV. The only way to know if you are infected or not is to get tested.

  3. dear doctor I had unprotected sex….but wen I wanted to ejaculate I withdraw my pennis n after DAT I stopped wats ma risk of getting infected

    • Ejaculating outside your partner does not reduce your risk of getting HIV or any other STDs. The only way to know if you are infected or not is to get tested. Please see your doctor for more advice and information.

  4. Jonathan

    Dear Dr Tan and partners,

    last night I gave a female cunnilingus for around 5-10 minutes. I had two large ulcers/sores on my bottom lip due to biting it accidentally 3 days before the act.

    I understand that vaginal fluids may contain HIV and that ulcers in direct contact with vaginal fluids (which I am sure mine were) can serve to as portals for the virus to enter the body. the intercourse I had afterwards was fully protected.

    I intend to get a 4th gen test asap but could I trouble you to give an impression of the risk I am facing of an infection?

  5. Hello

    Can the hiv rash appear after 5 months?

    • I have never seen, heard or read of HIV ARS rash appearing after 5 months.

      • Hi I had fever, 6 days after unprotected sex and only for 1 night and no more. Also I had a kind of cold not flu-like, after about 2 weeks, but generally ppl around the area experience this cold and sometimes sore throat, after about 7 weeks a rash at my arms (both sides) appear. No other symptoms. What is the possibility of being HIV positive? I am worried sir pls help

        • It is not logical to assess your HIV risk based on symptoms. You can assess your HIV risk based on exposure activity. The fact is that you had unprotected sex. There is a risk of you having HIV and other STDs regardless of the presence or absence of symptoms. The only way to know if you are infected or not is to get tested.

  6. Hi Docs,

    I had sex with a prostitute about 2weeks ago with condom.she gave me an oral sex and we kissed as well.i would like to know if she had a ulcer or any thing going in her mouth would she transmit hiv to me if she is hiv positive(im jst assuming she is hiv positive).

    • There is a higher risk of getting HIV from protected sex compared to unprotected oral sex or kissing. Of course, the risk is extremely low.

  7. Hi Dr tan
    Sir now I have completed 11 months and 3 days I am from India sir I have told you my story before my symptoms 4 weeks after that condom broke diarhodiarrhoea for 4 days went away by taking tinidazole nausea, headache, mild pain for 2-3 days in throat blister on both side of tongue PPP on penis went to Dr he prescribed me antibiotics and antifungal cream for penispenis because moisture was present there. After taking those medicine my tongue become thick and white coated which is still present in 12 month.
    Body feel feverish for 3-4 day but temperature was normal in clinical thermometer 36.9. Tested 18 time hiv antibody test(clia,cmia,trio dot ,comb/aids, rapid test) in different laboratory including ictcictc at 25,42,63,75,84,88,90,106,125,169,183,206,225,241,282 &290 days.
    Hiv Rna pcr quantitative test at 225 days(not detected sensibility of test 20 copies)
    I have sent you image of my tongue in Facebook and also anotheranother form (Monty) and I have also took vdrl test 6,18,26 weeks hbsag 11,26,weeksweeks.hcv.11 weeks sir this is my sad story and these day I am feeling stomach gargling everyday.
    My questions
    1) can I start my sexual relations with my wife without condom ? Sir I live far from her due to my job and don’t want to infect her.
    2)sir which type of hiv test I have to take and after how many days?
    3)if I am infected why the test are negative?
    4)if I am not infected why these problems after that exposure?
    5)if I am not producing antibody to hiv in that case viral load test at 225 days(7.5 months) would have been positive?
    6)if I am co infected with hepatitis c in that case hiv RNA pcr quantitative can detect the infection at 225 days?
    Due to my tongue I have been to ENT specialist but no relief he prescribed fluconazole twice for seven dayday.
    7)after how long we can be sure there is no hiv infection and which testtest?
    8) sir can you still give me 100% guarantee I am not infected?
    Sir please don’t ignore read carefully and reply with your heart.you are only one person who can save my life
    Sir I have been to Dr but no relief

  8. monty 29

    Hi Dr tan
    Sir now I have completed 11 months and 3 days I am from India sir I have told you my story before my symptoms 4 weeks after that condom broke diarhodiarrhoea for 4 days went away by taking tinidazole nausea, headache, mild pain for 2-3 days in throat blister on both side of tongue PPP on penis went to Dr he prescribed me antibiotics and antifungal cream for penispenis because moisture was present there. After taking those medicine my tongue become thick and white coated which is still present in 12 month.
    Body feel feverish for 3-4 day but temperature was normal in clinical thermometer 36.9. Tested 18 time hiv antibody test(clia,cmia,trio dot ,comb/aids, rapid test) in different laboratory including ictcictc at 25,42,63,75,84,88,90,106,125,169,183,206,225,241,282 &290 days.
    Hiv Rna pcr quantitative test at 225 days(not detected sensibility of test 20 copies)
    I have sent you image of my tongue in Facebook and also anotheranother form (Monty) and I have also took vdrl test 6,18,26 weeks hbsag 11,26,weeksweeks.hcv.11 weeks sir this is my sad story and these day I am feeling stomach gargling everyday.
    My questions
    1) can I start my sexual relations with my wife without condom ? Sir I live far from her due to my job and don’t want to infect her.
    2)sir which type of hiv test I have to take and after how many days?
    3)if I am infected why the test are negative?
    4)if I am not infected why these problems after that exposure?
    5)if I am not producing antibody to hiv in that case viral load test at 225 days(7.5 months) would have been positive?
    6)if I am co infected with hepatitis c in that case hiv RNA pcr quantitative can detect the infection at 225 days?
    Due to my tongue I have been to ENT specialist but no relief he prescribed fluconazole twice for seven dayday.
    7)after how long we can be sure there is no hiv infection and which testtest?
    8) sir can you still give me 100% guarantee I am not infected?
    Sir please don’t ignore read carefully and reply with your heart.you are only one person who can save my life
    Sir I have been to Dr but no relief

  9. SoStressed

    I’ve been having for a week now this rash on my chest and arms, down to my palms, barely noticeable most of the time, sometimes itchy(in the palm area). Though, when I expose my skin to the sun, it gets pretty bad, it is very red and spotted. are HIV rashes constant and visible all the time?

  10. Ashley

    I was raped about nine weeks ago and the man who assaulted me did not use a condom. I am really scared about HIV but I have been told that I should wait another 3 weeks in order to get an accurate test result (do tests nine weeks after potential exposure tend to be accurate?). As of about five weeks after the potential exposure I noticed that my left tonsil is swollen and much bigger than normal there is only one white dot on it and the pain is very minimal and so I do not often notice it. Also during that time I have experienced mild on and off nausea where during the day I will feel a little sick and week but I never vomit. These symptoms have not gone away since and a few days ago I got several canker sores clustered on the inner part of my lip on the left side (everything on the right side of my mouth seems normal) sometimes I have also felt minor muscle aches on and off that usually last for a few seconds and mostly occur around the neck. I know that I cannot know for sure whether I have been infected or not by the symptoms and I do plan to get tested in three weeks but are any of the symptoms that I have described possible symptoms of early HIV or am I just making myself crazy? Thank you.

  11. Dear Dr,
    I had enagaged in frottage with a lady while overseas. There was oral sex and rubbing of naked gentials but no penetration was involved. No protection was used. 10 days later I am having cough, chills, bodyaches, mild sorethroat, rash. Can this be HIV ARS?

  12. Ashley

    I was raped about 9 weeks ago and the man who assaulted me didn’t wear a condom. After about 5 weeks I noticed that the tonsil on my left side has swollen with one small white dot but the pain is quite minimal and I hardly notice it but it hasn’t gone away after about 4 weeks I have also been having episodes of mild nausea for about 4 weeks which often comes and goes and I am still able to function though. A few days ago I also found a collection of crack sores on my inner lip also on the left side (I am not sure if there is any difference between the appearance of crack sores or mouth ulcers associated with HIV). I know that I cannot rely on symptoms alone but I am scared and I have been told that I should wait 12 weeks for an accurate test result (would a test result 9 weeks after possible exposure be accurate?) In the mean time I am wondering if the symptoms I am experiencing are typical among people newly infected with HIV or if they are something I shouldn’t worry too much about until I am tested. Could there be other explanations for my symptoms? Thank you

    • We are sorry for your encounter. I do not think your symptoms are related to HIV. Please see a doctor to get a thorough assessment.

      • Ashley

        Thank you for your reply but I am curious why do you not think my symptoms are HIV related?

        • They do not sound very typical of Hiv symptoms, although Hiv symptoms can vary from person to person. Like I said, see a doctor to get your symptoms evaluated.

  13. Marquis

    Dear Dr, I have posted my comment earlier and it has gone missing, I will repost again my situation summarily, was I went to a club and i wrestle with a lady, there after I buttoned my shirt and after that i try to pop a pimple on my forehead and i felt that i popped but i try touching it again there was no liquid or fuss or blood on my hand , i went over to the girl after a while she told me her finger is cut and it was a fresh wound and i think i saw blood but not sure, she said that it was my finger nails which cut her. I am worried now as after 10.5 weeks i’m now suffering from running nose, no fever or if got mild one, throat discomfort, fatigue n headache for a day, I wonder if i am at risk of HIV from my pimple ? I have done a ELISE test during the 7.5 weeks of the incident. please advice. worried. will take a test on the 12 weeks again

    • Marquis

      The fever is only mild fever round 37-37.1 and for a day or two.

    • Your risk of HIV from this is literally zero. There is absolutely no reason for you to be worried. Your test at 12 weeks will also be clear.

  14. Hi doctor tan ,, I had a protected anal sex (me top)with a male cross dressing prostitute . Exactly a month later now I have a swollen lymph node on left side of my neck ,, no fever , no rash , no night sweets , except my weight loss as I’m not eating the way I used to cuz of anxiety ,, plz tell me a single swollen lymph node very visible n slightly tender on left side of neck can be a ARS ?

  15. Hi Dr. Tan, I would really appreciate a response. PLEASE HELP. I had an exposure to a potential HIV contaminated saliva. I was walking to a strip club with me and some friends in Tijuana, when these prostitutes who were outside started spraying saliva everywhere by making a tschh sound to call us over. It happened to me about 5 times,I came down with flu like symptoms and rapid weight loss at 9 weeks post exposure. I got the antibody test negative at 10 weeks post exposure and it came back negative. I’m waiting for my RNA test as I write this. Should I be worried about a positive result from this exposure? The test is a day late can that possibly mean that the lab is swamped with work, and I came back negative?

    • Eh… How should I put this. I am frankly shocked that you even believe you can get infected with HIV from saliva. Where did you learn this? Dude, if HIV can spread by spitting saliva then there really should be a mandatory law that every human being having a conversation with another must stand 10 feet apart. Many of us come into contact with HIV +ve people everyday without even realizing it. At work, at the supermarket, on the street. Sometimes they stop to talk to us like normal people do. Sometimes they ask for directions like normal people do. Sometimes when they talk some saliva is sprayed like normal people. And if HIV can be spread this way, more than half the world’s population will be HIV +ve by now. So I honestly do not know why you are so paranoid. I also honestly do not know why you went through all those tests which to me are completely unnecessary. What I do know is that you should have better sources of information on HIV. Because whoever told you HIV can be spread by spitting saliva is just ummm.. f***ing with you. Excuse my French. What I also know is that you should really see a doctor and find out what is causing your symptoms. It sure isn’t HIV but flu like symptoms an rapid weight loss are serious symptoms that can indicate a serious disease like Typhoid. So your priorities are a little warped. Stop thinking about HIV and start thinking about finding out what is causing your symptoms.

  16. Worried...

    I live in canada. Straight male.

    I fingered a femsle CSW recently. No sex. No cuts on hands. Am I at risk?

    I also recently got over a bad chest/nasal cold (before the CSW incident). Now I’ve noticed two swollen nodes on the side of my neck. No other issues. If this were ARS would more issues have arrived?

    • There is no way you can catch HIV from fingering. That is an unalienable fact. You can catch many other nasties though. Syphilis, Herpes etc

  17. Hi
    I had 4 unprotected sex , After2 week I had mild sore throat with 1 aphthous on right tonsil,and my neck(dewlap) became hard,I ,m not sure that was lymphnod, after using druge aphthous became good 6-7 days . I had running nose and sinusitis,
    NO fever,…
    This symptoms are like HIV? Especially 1 aphthous on my tonsil…

    • It could be. It could also be a symptom of Syphilis or throat gonorrhea. It could also be symptoms of a non-STD throat infection. Please see a doctor.

      • Tnx a lot …my doctor said that was aphthous ..bout now its question for me ,sore throat with 1aphtous without fever or rash …can be HIV symptoms ? My aphthous became ok when I used liquid that have tetracycline and dexametAzon …

        • I do not think your symptoms have anything to do with HIV.

          • Tnx …one aphthous in tonsil with one swollen lym node and running nose without fever ,rash ,fatigue…
            In not ars ? Tnx a lot
            My aphthous became ok when I used liquid that have tetracycline and dexametAzon …

          • Please see a doctor if you are so concerned.

  18. Tom hardy

    Hi doctor I had sex with a cross dressing male prostitute ,, I had a protected oral sex and a protected anal sex (me top) with condom n lube ,, after sex I checked the condom for leakage by filling it with water ,, no leakes ,,, Wat are my chances of contracting hiv if that male prostute is hiv+ with highest viral load ??

    • It is not zero. That is as much as I can say. There is no real way to put a solid risk number to it. Since you used an intact condom and were the insertive partner I can also say your risk is not high. But you should still get tested for HIV anyway. Oh and please screen for other STDs at the same time.

  19. Dr
    Today is my 5 weeks post PEP. Tested P24 Ag/ab at 3rd week ( one of ur clinic ), 4th week, P24 AG/Ab and RNA PCR test at 6 weeks and P24 AG/ Ab test( one of ur clinic) at 8th week after exposured. All come back negative.

    Case is condom broke with CSW girl during verginal sex.

    The problem is 2days after PEP to till now, I have severe join, muscle pain and headache. Today is 10 weeks post exposure( 5 weeks post PEP), muscle, join pain are gradually reduce. But I have pain and tender all the lymph nodes on whole body Exspecially neck, armpit and gorine area. And also sore throat.

    I got also some side affects during PEP course such as lymph nodes pain, sleeping problem and join& muscle pain.

    My questions,
    1) How reliable to my test wich with negative result?
    2) All these symptoms after PEP are ARS ?
    3) what is the chance of HIV Infection to me?

    Regards

    • 1. Extremely reliable. In fact, in my opinion, as good as 100% accurate. Although officially you still need to retest at 3 months post exposure.
      2. No they are not.
      3. No.

      You should be looking for other causes of joint pain and headache. I would recommend you speak to Dr. Jessherin about this. She is very good as assessing and diagnosing joint pain conditions. You can find her at Robertson Walk. For our Doctors’ schedules, please click HERE.

  20. Rbl James

    Hello Dr Tan

    Is it likely to develop the onset of Ars symptoms at 7 weeks after exposure? 7.5 weeks to be precise.

    Thank you for your time.

  21. Hi Dr.
    I had unprotected sex about 6 weeks ago and for the past week my chest has been a little itchy and there are small brown dots resembling freckles underneath my chest hair which are only noticeable when looking closely in the mirror and the dots are only found where there is hair. I wasn’t too worried until three days ago I started feeling only slightly nauseas probably a 3 on a scale of 1 to 10 (I am still able to get out of bed and go to work) I have not been vomiting and for the past three days the nausea has been coming and going periodically with me sometimes feeling perfectly fine and other times feeling slightly sick and week. Anyways do these symptoms that I am experiencing have any relationship to early HIV or is it likely that these symptoms are something else. Are there ever cases of someone have mild ARS symptoms or are ARS symptoms when they do occur always severe?
    Thank you

    • I have said this many times before and I will say it again: You cannot know if you are infected with HIV or not based on symptoms.

      Yes I can say that your symptoms are not typical of HIV ARS but that is NOT saying that you do not have HIV. The only way to know whether you are infected or not is to get tested. So please get to your nearest clinic and get tested.

  22. Timothy

    Hi doc. I have crohn disease. Does crohn disease affect my HIV testing? As im tested neg on 31 days using 4th gen kit and 3rd gen kit on 94 days which is also neg. wanna ask does crohn disease affect your hiv testing? Must i wait till 3 more month to be conclusive? Which means at the mark of 6th month for my condition.

    Thanks doc.

  23. Good day,

    Doc i have engage unprotected oral sex with an unknown guy for 5mins no cum because i stop when he is nearly comming.
    After two weeks i got colds cough and head ache last for 2 days, no high fever, after 3 weeks i felt that my muscle in under of my left ears near jaw edge is hard i dont know if its lympnodes.
    I want to take a test but i dont know how and where.
    I have read your post and it seems that im over reacting, is this sign of HIV?

  24. Kar Eng

    Dear Dr Tan,

    I visited a thai prostitute at one of the geylang licensed brothels. We had protected sex. The condom looked intact to me the whole time.

    Question in point : Is it considered relatively low(er) risk if we visit licensed brothels? How stricly enforced is the yellow-card system amongst the brothels?

    Thanks doctor

    • The risk for HIV is absolutely lower when you visit licensed brothels. However, the risk for common STDs like Gonorrhea and Chlamydia is still significant. The yellow-card system is very strictly enforced. They basically lose their license and are arrested if they do not turn up for their regular screening tests.

  25. Packer Wood

    Hi Dr Tan

    I’ve heard about how professional, detailed and accurate your answers are to medical questions on HIV. Thanks for helping the world. I am hoping you can help me here.
    I am so scared of HIV and I always take precautions. But looks like I really made a mistake now and anxiety has taken over me.

    I had a sex with a woman in my college whom I thought was clean but later told me after the act that she is HIV positive, newly diagnosed not on drugs. We did the following.

    1. Vaginal sex with condom ( no condom breakage or slippage, only partial slippage like 30%)
    2. Oral sex with condom. This one scares me most as it looks like she was biting my penis some times and she vomited on my penis at the end. An afraid that she may have created some invisible cuts on my penis with her teeth and the vomit may be full of HIV virus that could penetrate through these small cuts. I examined my penis for injury but did not see any, but I can feel the sensation.

    3. After the oral, we did another vaginal sex with condom. Am afraid that some vaginal fluid with HIV virus may have entered my penis through the small cuts made during the oral sex above the area covered by the condom.

    4. I also fingered her for some time, deeply. I have no physical damaage on my finger.

    Did I put my self at risk on any of the above acts. Do I need a test for this. Do I need PEP. Please help

    • It is difficult to tell if your condom has been damaged based on your description. If condom remains intact, your HIV risk is low.
      I suggest you see a doctor to discuss this in details.
      If you are worried, please go ahead with PEP.

  26. Hi Dr Tan,

    I had a prolonged oral sex with condom with a HIV positive woman. During the act, I have some feeling of her teeth biting my penis shaft. No visible skin damage nor blood. Only feelings of some abbrassions after.

    Am I at risk of HIV. Do I need to testing

    Thanks

    • For more information about getting HIV from oral sex, click HERE. In my opinion your risk is negligible. You should regularly screen for HIV as long as you are sexually active regardless of your risk level.

  27. Dear Dr Tan
    Thanks for your selfless works on HIV education saving millions of lives world over.

    I made a regretable mistake of my life and now am down with extreme anxiety.

    I had sex with a girl with two condoms, No condom failure (breakage or slippage).

    Before the sex, I kissed her and fingered her. I had no cuts on my finger, but I had a small one week sore on my lower lip from bitting my lip while chewing. It was still healing not completely.

    After the sex, we got talking of HIV and decided to test her for HIV with Alere determine HIV 1/2. I pricked her finger and did the test. Surprisingly she was positive.

    After the test, I noticed a small blood on the back of my finger. I think little of her blood may have touched my finger while pressing out the blood. I had no cut on my skin.

    Am I at risk here and do I need to test for this.

    • I am very sorry to hear of your experience and completely understand your anxiety. The good news is that your risk of contracting HIV from this is extremely low. You should certainly still test to be sure. However, the chance of you being infected is truly miniscule.

  28. .. hi doc how long infcted hiv

  29. Hello Doctor,

    I had a protected sex and some oral unprotected sex and had a hot tub naked after sex, about 60 days ago on a trip in South Africa, Cape Town.
    On the 7th week after the encounter I had for 2 days a high fever 38.7, I was taking antibiotics as well, but I was completely fine on the 3rd day, havent had any sorethroat. I am just panicking, could I got HIV infected?
    Thanks

  30. Hi Doctors,

    pls help to advise.

    I had protective sex with a sex worker about 1 year ago.( march 2015)
    I do not have any symptoms until recently months , i start to develop the occasional low grade fever ( 37.1 deg)
    which got me a little bit worried.

    2 days back, i had a high fever of 39.5 and my family doctor cannot diagnose any problem . He did a series of blood test ( the usual blood cells count, blood platets and even dengue.
    The test result show some virus. Slight diarrhea occurs but since recovered from the watery stool

    My fever has since subside to the range of 37.5 – 38.3 with panadol taken every 6-8 hourly but it havent gone away completely yet.

    I had also been fanatically searching for all possible symptoms
    such as weight loss,swollen lumph nodes , rashes around body,neck
    fortunately they do not exist

    Do i need to overly concern based on the above.

    thankyou and appreciate your kind comments on the above matter.
    thankyou

    • I have never heard of HIV ARS symptoms occurring 1 year after infection. However, HIV infection can cause fever in other ways aside from causing ARS. Although the likelihood of your symptoms being caused by HIV is extremely low, you should test nonetheless. If anything, just to tick the box so that your doctor can investigate you for other causes of fever.

  31. Hi Doctor, i had 2 unprotected encounters 3 weeks ago,a week ago i develop what you mention as exudative tonsillitis, i have fever up to 40 celcius, which will subside with consumption of Panadol. I have all the symptoms mentioned above except the rash. Up until today, i am still unwell. Should i get a rapid test on the third week after exposure, how conclusive will it be ? Thank you !

  32. Hi doctor
    After having protected vaginal sex and oral sex with sex worker ,i tested 14days 4th elisa rapid test .8weeks 9 weeks 12weeks ECLIA hiv 1 and 2 ab/ag lab test and on the 12weeks after exposure i tested 2times another was Cmia ab/ag lab test on the 100days/14weeks i tested again due to symptoms i tested using hiv 1and 2 ab/ag elisa and again due to symptoms on the 134days i tested again using hiv 1and2 ab/ag (elisa) the 2last test were in pathlab

  33. I had unprotected sex on January 1 then on January 23 I woke up with swollen lymph node below my jaw. I went to the pharmacy and they gave me some drugs(Lincomycin 500mg) . On January 26,the pain that comes when I move my head at a certain angle went and the lymph node healed. I started having fever from January 26 and took some antimalarial drugs but wasn’t too effective so I went for a malaria parasite and full blood count tests January 29 and the results says “Plasmodium Falciparum” is present . I started to treat the malaria with strong antimalarial drugs and injections. I had mouth ulcer also from January 28 but it is now gone.Now my body temperature after treating the malaria is not as before,sometimes I have abnormal heartbeat and currently I have a golf like substance in my throat which I have treated with antibiotics but no response and body pains especially in my right thigh. I asked my partner and she’s claiming she’s HIV- . However she told me she had flu-like symptoms after sex with his ex partner in Dec 2012 and also saying she does monthly check up at the hospital since that time . I am planning to go for All STD’S test in April . From my symptoms do I have Acute HIV ? Please Reply Asap .Thank you My leaders!

  34. Hi I hv been told by yr clinic that I am hsv1 positive, but I do understand the Low probability of false positive unless I hv symptoms and get it tested. Cold I know what’s the probability of a false positive and usefulness of doing another round of test for hsv1?

    Thanks.

    • It is not possible to give you an exact percentage for false positive. Generally, HSV test (be it blood test for antibody or direct swab for HSV PCR) has very low false positive rate.
      If you are concerned, you can repeat another test just to be sure.

  35. Hello Dr. Please help me have peace of mind. I had a ag/ab combo duo test at 12 days and 29 days both were negative. After 1 week , had a big seafood dinner and developed icthy rashes on my torso, arms and legs. A dr. injected me something that healed the rashes in 1 hour. Are these rashes HIV or Ars related? Hope to hear from u.Thank you.

    • Your combo test is conclusive and you very likely had an allergic reaction to your seafood dinner which is, I am SURE, what the doctor told you.

      • Thank you so much for your quick response dr. Tan. My doctor said it was urticaria- the allergies appeared just an hour after eating seafood, fresh oysters. Can I be confident that the allergies were not seroconversion/ars related? Again, thank you so much for contributing to my peace of mind.

        • If it is urticaria then it cannot be ARS. My advice is to trust your doctor’s medical opinion.

      • Hi again Dr, not sure if my message came thru. Just wanna ask if any rash or the one i must have gotten from seafood can be ruled out to be ars/seroconversion after my negative combo at 12 and 29 days. I Will very much appreciate your response. Thanks so much.

        • Thanks a lot dr.tan for the time replying. I promise this would be the last question. Can any rash/ars after my negative at 29 days be ruled out as hiv? Can I now move on? Thank u really.

  36. Hi drtan and partners, i have tested negative for HIV on day 31 with SD bio-line 4th gen kit at AFA and day 40 at DSC clinic with im not sure what kit they use in the lab. is it conclusive? because now i am still having cough for weeks and blocked/runny nose for 2 weeks? I have never encounter this issue before normally 1 or 2 days i am completely cure. But now its been on for weeks. Is it the HIV is making my immune system down thats why i having this kind of problem? Im kinda worried. Help me pls. Thanks doc. I will go to one of our clinic at 3rd month to do a test. Can a person tested negative in the first month with 4th gen kit and positive in the following months?

    • More to add, i have fever and aches on day 7th and its cured within 2 days. and aches everywhere in my body for several weeks. I’m really scared.

    • Yes they are conclusive. If you are worried, please see a doctor to get your symptoms assessed. You can get a HIV antibody test after 3 months just to be sure.

  37. Hi drtan and partners, may i ask if runny nose a symptoms of hiv? Been runny nose past 2 week. My post exposure was one month ago. I shall do a test at ur clinic soon

  38. Hi Dr. I had a combo test done at 24 and 26 days. Both negative. Are these results conclusive or should I retest now which is exactly 5 weeks past exposure? Thank you so much for your time.

  39. Hi, can ARS symptoms occur in a week’s time after exposure or is it too early to ?
    Thank you

  40. I have done hiv ag/ab combo test on your clinic at exactly one month post exposure and its negative. is it conclusive? Will it change to positive on 3rd month if i retest?

  41. Singaporean

    Hi doctor I would appreciate if you can assess if i am at risk of contracting HIV

    I tested on Jan 2 2016 at AFA Singapore and the results came back negative for HIV. during the blood taking process the staff who is beside me who is drawing another guy’s blood dropped a used Finger prick to the ground right beside me and I am worried that the prick might have contained blood and blood might have went into my eyes..

    In your experience does the finger prick actually contain blood after being used ? Or just to poke a hole to draw blood and does not contain blood even after use?

    1.Am I over thinking? What are my chances of getting HIV if indeed blood did went into my eyes?

    2.It’s in a air conditioned room so I suppose I he virus would still be alive?

    8 days after this incident I am now having a fever of 38.0-38.8 and would not go down i got phlegm also
    No sore throat
    Coughing
    I have back rash according to the doctor is feng mang in Chinese..

    3.Is this an ARS symptoms?
    4.At I at risk from the start?

    Thanks !

  42. Hi Dr. Tan,

    My hiv rna pcr test is negative at 28 days and

    hiv rapid test is negative at 93 days.

    Please advice me.

    1) both tests are conclusive.

    2) Any chances for positive am not suffering with immune system.

    3) Can i marry hiv negative person.

    $) Do i need another test.

    Please suggest me. Thank you so much for your help.

    • In my opinion your tests are conclusive. Please verify this with the doctor who did the tests for you.

  43. Hair sir I have headache and tongue dots and I feel some time fever like that. I was exposed 25days before sex one girl that time the condom come out so I scared. Pls reply what I dob.

  44. fadhilah

    Hi doc, i wanted to ask about swollen lymph nodes , because i kind of discovered it few days ago,
    It was betweeen the top of my neck and jaw. Its firm and sized along 2, 3mm or so… it doesnt hurt when i press it and only visible if i slant my head upwards…

    Its already 2.5 months after i had intercourse but i still cannot put my mind at ease…

    Is there anyway to test for hiv other than at the hospital?

    Thanks doc

    • fadhilah

      Addition its only on my left side of the neck*

      • fadhilah

        Remeassure again its now around 1 cm, hard not painful

        Will feel strained abit if i press it real hard

  45. NervousNelson

    Hello Docs,

    I (male) engaged in unprotected oral and vaginal sex. Nothing remarkable occurred. Roughly 5 days later, I began to feel ill. Initial symptoms included general fatigue and uneasiness, and a mild sore throat. No fever was observed.
    About 2 days after that (7 days after potential exposure), an itchy rash developed on the palms of my hands and spread up the inner surface of my forearms and arms. I was feeling fine at this point, the rash was my only symptom. The rash appeared consistent with pictures online of ARS, maculopapular. After taking some Benedryl, it relieved the itching and the rash began to subside, clearing about 80% within 2 days.
    At that time (9 days), my sore throat returned and worsened severely. Visited the Doctor the following day and he identified exudative tonsillitis, with the initial diagnosis of Strep Throat (despite a negative in-office rapid strep test). Antibiotics (Azithromycin) were started immediate and helped immensely.
    At that doctor visit, I asked for STD testing, but I believe he only ordered the HIV antibody screening, which at this point probably won’t be accurate.
    Now at 13 days post exposure, the exudate nearly appears resolved, with only small spots on the tonsils. No fever was ever observed in this process, and the symptoms appeared to present in a staggered way, not occurring simultaneously.
    I am severely distressed about ARS and potentially acquiring HIV. Please comment on my symptom history and advise with you experience in acute HIV infection.

    • The timing is wrong. ARS cannot occur so soon after infection. I cannot say you are not infected with HIV. But I can say your symptoms are not due to HIV ARS.

      • Slick Willy

        I had high risk exposure . I inserted myself in her anal cavity. This last for approx 3-4 minutes no ejaculation. At 6.5 weeks I had 4 the gen abbots ag ab test in emergency room. Then next day primary care followed up with 4th gen eia from quest diagnostics, Both negative. We shared a hot tub naked after sex. At seve week I took antibody rapid in home test, negative. 8 weeks took oraquick test also negative…..now for symptoms…. At week 4 post exposure I developed and was diagnosed with thrush given 4 weeks of probiotics , diflucan, and liquid steroids… This did not clear up now issue…now 8 weeks post still have mild thrush, ulcers on skin behind bottom back molars red and white in color night sweats… I’ve lost 23 lbs and stressed my self silly . what are my odds of two 4 the gens being wrong a day apart 6.5 weeks ? And all the othe two incorrect? I know I have to test at 12 weeks but how optimistic should I be
        I have no rash or fever. Going on 9 weeks post exposure now.

        • “what are my odds of two 4 the gens being wrong a day apart 6.5 weeks ?” – No practical chance.

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