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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.

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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2,551 Comments

  1. Clark Quay

    Hello.

    Doctor, I have several questions. I hope you can help me. I tested non-reactive on a combo test 29 and 36 days after a sexual encounter. I’ve been told that these tests are conclusive. However, 4 days after the last test, I had “rashes” on my arms. They look like flat red dots. Not itchy. I have about 10 spots on my left arm, 3 on my right arm and 2 on my legs. That said, here are my questions:

    1. Are my 29 and 36 day tests conclusive?
    2. Do these “rashes” seem like an ARS symptom? I’ve had no other symptoms aside from these.
    3. These rashes appeared 11 days after my 29-day test. When the lab conducted my test, I didn’t see the nurse open the syringe/needle in front of me. It slipped my mind to ask her to open the pack in front of me. I’m worried that it might have been a used needle and that the rashes are ARS symptoms caused by that. If, for example, a used needle was accidentally used to draw my blood, what is the risk of contracting HIV from that?

    Please please, I would appreciate your answers to my questions.

    • I would consider your tests conclusive already. Symptoms do not account for anything if your tests are negative. I highly doubt that a healthcare facility would reuse needles, but theoretically a needlestick injury from an HIV-positive individual would have a risk of around 1:300.

      • Clark Quay

        Thank you, Dr. Jonathan. Just a follow up question though. I’m actually on PrEP and the Day 29 and Day 36 tests that I’m worried about where I didn’t see the nurse open the syringe pack in front of me, were taken when I was already on Day 2 and Day 9 of PrEP respectively. You mentioned that theoretically, a needlestick injury would have a risk of 1:300. Since I was already on PrEP for 2 days and 9 days during these tests, would the risk be lower or was that too soon for PrEP to be effective? Now, I took another 4th gen test 26 days after the Day 36 test in question. Can that be considered conclusive? I know 28 days is conclusive if you’re not on PrEP but will the window period be affected if you are on PrEP? Thank you in advance for your help.

  2. Mahamad

    Hello Doctor
    You are doing great job by heling online to everyone God bless you
    I am 46 yrs. Male
    My previous exposer was 25th November 2017 unprotected oral with sex worker in night club after 4 months of exposer I have tested 4 to 5 times negative in between. On (25th March 2018 I have tested ELISA 4th generation and westernblott) both are negative besides having all symptoms. That time I had all symptoms like dryness in throat diarrhoea abdominal pain muscle/joint pain blister on penis, Night sweats many times. (That time No fever, No headache, No pain in throat, No swollen lymph nodes etc…)
    New exposer 2nd June 2018
    Again I have done stupidity I had protected veginal sex with sex worker I used condom had about 2 minutes sex (she used lubrication gel in and around her vegina).Condom remains on penis not slipped, removed condom seems did not break bcz my semen is in the condom I was drunk and washed after the sex with soap water later she used her finger in her vegina and played I did not touch her after in the same night I have very heavy night sweat I was scared. After 6th day yellow urine started last one month urine test done nothing found, after two weeks of exposer I started dryness in the throat feels like thirsty last about few weeks till now sometime comes and go no pain. Doctor gave me amoxicillin for 5 days and spray did not help
    After 25days (3.5 weeks) of exposer I have itching/tingling (sometime) and blister 2 to 3 and redness on penile head little and one blister broken and started soring spread around skin of the on penile head it was burning when water touch (otherwise no pain) no burning during urination no any discharge from the penis showed to skin specialist explained everything doctor said its condom allergy and gave me medicine tube and valacyclovir 500mg for 5days she did not recommended any STI/STD I asked her she said this is condom allergy after 10 days it was ok cleared mean time I had itching around neck she gave medicine it was ok
    Between 5th and 6th week I had mild fever 3 to 4 times lasting for 3 to 4 hours not more than that
    About 4 to 5 times had headache lasting for 5 to 6 hour but not during the fever (I used to have headache normally one or two times in a month)
    About two times I had night sweats in between on 24th day and 44th day (My weight is steady did not lose /gain)
    My stomach is also having problem for last six months gas/fullness sometime since my previous exposer shown to doctor no improvement
    Now I don’t think I have swollen lymph nodes and no pain in the throat, No nausea, No rash
    I wanted to know all these symptoms are HIV related or any STD I have hugged her we both are naked during this course I asked her do you have HIV she said no I can’t trust her
    What is the chances of getting HIV in my scenario?
    If these are not HIV symptoms do I get symptoms after 6.5 weeks?
    I am fearing to test HIV again, this is 6.5 weeks now 45th day today I did not done any test I am very scared that I had HIV.(I am in west Africa)
    Sorry for long story
    Pls help

  3. T Phillips

    Hi

    Can you please tell me the risk of HIV for the following

    1) open mouth kissing – i have heard that there would need to be a lot of blood transferred from the mouth of the person who is hiv positive to the person who hiv negative (i.e. active bleeding) and for the person who is hiv negative to have open sores or gum disease for infection to occur?

    2) Receiving a blowjob……again does the person giving the oral sex need to be actively bleeding for infection of the person receiving to occur?

    Finally –
    1) Can body ache alone be a sign of ARS while on pep? or can body ache be a side effect of PEP?
    2) can you get a RNA test as soon as you finish PEP – i.e. on the 28th day?

    • I would consider both scenarios close to zero risk. ARS symptoms are non-specific, so we would not gauge any probability of infection on symptoms. We would not recommend an RNA test with PEP, because PEP will suppress viral load in the face of a true infection – it would be best to do an HIV antigen/antibody test instead.

  4. Gauravethos

    Hello Doctor
    I got a handjob at a massage parlour in India. The lady later said she has hiv but I shouldn’t worry as she is taking medicines .
    Iv been a nervous wreck since then . Iv had non stop blisters on my lips since week 6 after exposure – atleast 5 blisters . Iv had herpes simplex cold sores since I was a child but not like this . I’ve gotten the following tests
    Day 51 – alere AG/AB rapid test
    Day 21, 26 , 63 and 73 – hiv 4th generation test in labs
    What is worrying me is the blisters ? Do you think I need to test again ?

    • I would consider your HIV testing conclusive. There are many other causes of blisters – please see a doctor for a proper evaluation.

  5. Please help

    Hello Doctor. I had receptive vaginal sex a few weeks ago. 3 weeks after this incident, I developed stabbing headaches, mouth sores, and a slightly swollen lymph node on the right side of my neck (which I think is due to the mouth sores). Exactly on Day 28, I woke up with a feverish feeling and slight muscle aches. Throughout the day, I also had headcaches. Basically, I felt like I was going to get sick. However, by night time, the feverish feeling was gone and I felt way better. I didn’t take any medication. The unwell feeling just went away on its own. The following day, Day 29, the back of my left thigh was very itchy. I also felt a burning sensation in that area at times. There were also instances when I felt that around my vaginal area. I initially thought it was shingles (I already had chickenpox before) but the following day, the itchiness was gone and all that was left was a slight pain (like a burning pain) in the itchy area. On the same day, Day 29, I also took a 4th generation CMIA test. The results were non-reactive.

    Now, I know that symptoms are not a good way of diagnosing HIV but I also know that there are certain ARS symptoms that can cause a person/physician to consider HIV after a risk. Do my symptoms – mouth sores and one swollen lymph node, slight fever and muscle aches for a day, itchiness and burning feeling on the skin – look like these ARS symptoms?

    If my symptoms were indeed ARS symptoms, then the 4th gen CMIA test should have turned positive, right? Because that means that my body has already started developing antibodies? Or if my body hasn’t, then the test should have detected the p24 correct?

    Is my 29-day test good? Or should I take another test?

    Your answers will be greatly appreciated. Thanks!

    • I would consider your HIV testing conclusive. However, we cannot rule out any other potential infections, for instance herpes simplex virus – this can cause ulcers and flu-like symptoms as well.

      • Follow Up

        Hi, Doctor.

        I had 3 mouth sores which healed in about a week’s time and the feverish feeling came when the mouth sores have already healed. The feverish feeling also lasted for only less than a day. Do these symptoms look like a herpes simplex infection? Or would symptoms appear more severe? I know the best way to rule out any infection is to get tested but I would like to at least know if my symptoms look like those of the infection that you mentioned. Also, I’m not sure if it’s of any importance but I got tested for all other STIs and Hep B and all were non-reactive. I don’t think HSV was included in the tests though.

        • They can be from herpes, but the symptoms are not specific. They could be normal aphthous ulcers, viral ulcers (from coxsackie, enterovirus, etc.). We cannot say without a proper evaluation and/or testing.

  6. Suzaul karim

    I did sex with a sex worker,first condom burst then she put another condoms.
    After 15 days i fallen recurring sick,with mouth ulcers which last 7 days with paracetamol and azithromycin.
    Fever cured,but weakness, dry cough and joint pain last 15 days after fever cured.
    Then again after 15 days joint pain and dry cough improved, now after a well sleep i feeling tired, eye discomfort and light balance problem.i feel like i lost 1 percent balance.
    Please help me

  7. Question

    Hello, Doctor.

    I have a question about ARS and I hope you can help me.

    20 days after having sex with a partner of unknown status, I took a combo test which came back non reactive. This was despite having symptoms like mouth sores, ice pick headaches, a slightly swollen lymph node on the left side of my neck (which I attributed to the mouth sores), and stabbing muscle aches.

    On Day 27, I took another combo test since I was told that the recommended window period for a combo test is 4 weeks. It also came back non-reactive. Again, this was despite having mild ice pick headaches (they’re more of a dull pain that comes and goes after a few seconds), some muscle aches, and some sensitivity on my left armpit (I tried to feel it but I didn’t feel any swollen lymph nodes). However, the following day, Day 28, I woke up feeling slightly under the weather, like I was coming down with something. I felt somewhat feverish. The muscle aches are still there as well as the headaches.

    So now I’m worried that these symptoms are ARS symptoms. Is it possible that I tested non-reactive on Day 27 because my symptoms haven’t started yet, or were just about to start since I started to have the “under the weather” feeling the day after I took the test?

    Should I get tested again?

  8. Anxiety

    I had an wound on my finger a month and a half ago. I am not sure what had stubbed my finger as it happened when I put my finger under the table in school. The wound was so tiny that I didn’t bleed but I could see a hole there and it hurts. Now, I am having sore throat and then later on I had severe acid reflux. The doctor concluded my sore throat was due to burns from acid reflux. The next day I noticed an ulcer at the back of my throat near my tonsils. It is white in the middle and red ring around it. It is about 1-2mm. But it was gone in 2 days and I am confused. My tonsils are red too but not really swollen. Currently there is a swollen lymph node under my jaw and I am afraid that it might be HIV. I do not have fever or rashes. Or high risk behaviour except the wound I got 1 month and a half ago.

    • I would not consider this a risk exposure in any way. We cannot diagnose or exclude HIV from symptoms or lack thereof. If you are concerned, please see a doctor and get tested if necessary.

  9. Lady kissing on chest cause hiv?

    Hi Doctor,

    i went to a massage parlour in singapore, but that massage lady forcefully kissed for 30 seconds on my chest nipple, no sex, she only kissesd on my nipple.

    is that kiss/saliva cause of hive infection? please help to answer my question sir as it give lot of stress.

    Thanks

    • Dr Elaine Loh

      There is simply no possibility of HIV transmission based on your exposure description.

  10. noreen sax

    Dr. Jonathan,

    I am sorry to bother you. I have a non-sexual related question about HIV. There were two incidents.I was in a foreign country. I ordered Oysters, in a place where everybody was eating Oysters. The man opened the Oysters without gloves. I checked to see if there was any blood blood, and I could see no blood.. And then 5 minutes or so later, I ate the oysters. I was wondering if this could put me at risk of HIV if the person actually cut his hands while opening the oysters.
    And then two weeks later, this lady opened a open bottle of wine, and removed the metal cover, and I wonder if she cut the fingers while opening it, could one get HIV from any blood if it had it.

    I ask this because of 2 weeks after the incidents. I started to have VERY LIGHT night sweats. With sweats around my neck. THis happened now 3 days in a row. I sleep in a room that is a bit hot, and it gets about 80 degrees before it cools down at night to 71 degrees with airconditioning, which turn on just before I got to bed. It is NOT drenching night swears I also have enormous muscle pain under my left arm, and it hurts really bad. I am really scared. DO I NEED to be tested? My own doctor said this is not a concern. thanks so much

  11. Anxious

    I had an wound on my finger a month and a half ago. I am not sure what had stubbed my finger as it happened when I put my finger under the table in school. The wound was so tiny that I didn’t bleed but I could see a hole there and it hurts. Now, I am having sore throat and then later on I had severe acid reflux. The doctor concluded my sore throat was due to burns from acid reflux. The next day I noticed an ulcer at the back of my throat near my tonsils. It is white in the middle and red ring around it. It is about 1-2mm. But it was gone in 2 days and I am confused. My tonsils are red too but not really swollen. Currently there is a swollen lymph node under my jaw and I am afraid that it might be HIV. I do not have fever or rashes. Or high risk behaviour except the wound I got 1 month and a half ago.

  12. Anxious

    I have been having sore throat for about two weeks. It started feeling like a sore throat from a cold but almost 3-5 days later I burned my throat due to GERD. My throat feels terrible and my tonsils are red but not really swollen. The doctor I went to suspect the pain happens fully due to GERD and acid reflux. A few days later I felt one side of my throat itching and saw that a tiny ulcer about 1mm in side grew on my soft palette (white center with red ring around it). But it lightens and disappear about 2-3 days later. Could this be HIV sore throat? I do not have any high risk exposure but more than a month ago I stubbed my finger on something under the table but I could not find what had stubbed me and got anxious. The wound is shallow and did not bleed but my skin was broken.

    • I do not believe there is any risk of HIV from what you have described, but we cannot exclude any infection without appropriate testing.

  13. I would consider the testing results conclusive already.

  14. hiv from testing center

    Thanks doctor for doing this service …

    i went to clinic to get tested for regular blood test , the person who draws the blood from hand keeps the cotton swab on the desk , but he has i have seen dried blood on that place , and he has used that cotton on me , i was patient on that day early morning, i think blood has dried for more than 9 to 10 hours , is iam risk of getting infection from this scenario , please help me doctor , waiting for your response . how much time the hiv virus lives outside the enviornment

  15. Welcome, thanks for your doctor to my previous question. but my recent blood test hiv eclia (ag / ab) negative . 4 days after my quick test hiv (ab) positive reaction very faint six 15 minute. I immediately asked to be done the test and results were negative after 15 minutes. 3 hours later I went to another hospital and made 1 2 Other tests are eclia (ag / ab) and rapid tests determin the second half were negative. Doctors can tell me the other positive result is my like? Results may change after 4 days from generation to generation negative 4 3 positive. I had unprotected relations 8 months ago I was one pep in 28 days and tested many times with the 4th generation HIV viral load & lt; 20 cps / mL at the time of 5 months after exposure. please help me because your answer will help me a lot

  16. Hey Doctor, Please get back to mee…

    I have just been suffering from anxiety that I might have HIV. I had unprotected sex that lasted less than a minute with a girl whose status is unknown. A week and a half later I got tested and found out I had Chlamydia (Certain it came from this exposure), got an injection shot, 4 pills in front of the doctor and doxy for 18 days. Did an Elisa test too but HIV came back negative. I suffered worse anxiety thereafter fearing that I might have HIV, lost a few pounds. And oral thrush. Even had little red dots, I believe it’s called Petechiae, popping out at random places. Never at clusters. So 6 weeks and 3 days later after exposure, I got a 4th generation HIV test which came back as negative/ nonreactive. How certain can I be that I do not have HIV now? Still afraid.

    • I would consider your HIV test results conclusive. If anxiety is the issue, then you should see a psychiatrist.

  17. noreen sax

    Hello doctor,
    I had a non-sexual exposure question. Can someone get hiv from a surface material? A man came to repair something in my house and he handed me a plastic nob and it slightly pierced my skin on the finger. He, of course, had touched it a seconds before. I did not see any blood. Next day I got flu-like symptoms. 6 days later I have a horribly itchy rash and stomach problems. Diarrhea and bloating. Can this from HIV infection? Thanks for any help. I also a did a 4th generation rapid test, two weeks later, and it negative, and now real 4th genration blood test on the 26th day day. Awaiting results. Am I in danger?

  18. Hello I did read the whole article and it did kind of make me feel a bit better. I just am worried about a few questions I have. Is the rash really bad with early HIV just like it was explained in this website. I recently had a red flat rash were my chest area was at like the collar area but no bumps just literally flat red. I am unsure if maybe it is allergy related since I sneez sometimes. Anyway my doctor took only a HIV 1 & 2 antibody test at 7 weeks after I had intercourse with my ex. I do not know his HIV status only his other STDs which he had tested for which were negative. I asked him about his HIV test he said he thought they did it but I feel like what of that was a lie he. What of he didn’t think they did he knew they didn’t and maybe didn’t want to tell me about his HIV status that is what has mee worried. Six weeks after I had intercourse I began to get chills and a sore throat. I went to the doctor and the doctor saw that my throat was getting read like I was getting sick. It wasn’t a severe sore throat as explained in this website about HIV. It just hurt and felt uncomfortable like when you start coming down with something. Anyway I took antibiotics for a bit since the side affects were affecting me so my doctor had me stop the meds. I did get better from my sore throat though it didn’t last long. After that on the 7th week it was only an HIV antibody test. Which came back negative. I felt relived till I started getting a rash on the 8th week on my chest neck area it is only red and flat with no bumps. I do sneeze sometimes not a lot. Anyway I am unsure if the HIV test is reliable I an unsure if I should of just waited for three months instead. And also unprotected intercourse didn’t last long though it was only about two min because i then told him to put protection. Even then I am still scared. Should I just go back and take a retest at three months so around 12 weeks? And as for the symptoms could it have been just me being sick not like early hiv sick just the rash put me at a worry

    • Dr. Julian Ng

      Hi,

      If the HIV test you did was only testing for antibodies, then my suggestion would be to retest 3 months after exposure. If the test you did was a 4th generation HIV test which tests for both Ag and Ab then the results would be considered as conclusive.

      • noreen sax

        Hello doctor,
        I had a non-sexual exposure question. Can someone get hiv from a surface material? A man came to repair something in my house and he handed me a plastic nob and it slightly pierced my skin on the finger. He, of course, had touched it a seconds before. I did not see any blood. Next day I got flu-like symptoms. 6 days later I have a horribly itchy rash and stomach problems. Diarrhea and bloating. Can this from HIV infection? Thanks for any help. I also a did a 4th generation rapid test, two weeks later, and it negative, and now real 4th genration blood test on the 26th day day. Awaiting results. Am I in danger?

  19. I had unprotected sex with sex worker and I took PEP within 48 hrs.I have tested many times in the time of 90.148 days with the method of eclia ag/ab negative.But on the day 151 I get hiv testing (ab) resulting in response.Then 1 week I go to the hospital and do 2 elisa test (ag/ab) and eclia (ag/ab) the result was no response. The same day I also do 1 load the amount of hiv virus rna that results is a 20/cps < ml.Now I'm at 240 days after exposure I've done 2 eclia testing (ag/ab) and rapid hiv (ab) both are negative.I have more ars in the days past. now the red spot and several lymph nodes on my neck it's killing me every day. I also have HsBAg Anti HCV negative test negative at the time of 180 days after exposure
    My question is
    1. My tests in the time of 240 days haveconcluded? Hiv testing (ab) fastresponse there is like?
    2. My symptoms were due to ARS hiv and I still have to worry?
    3. Have 8 months I do not know where is the end. Each day it's killing me. What should I do next to know I have hiv-infected or not
    Sorry my English is not good but the doctor please help me!

    • Your tests are conclusive. No HIV. Move on with your life.

      • am very worried because gaining experience quickly in time of 151 after exposure is positive. And more than half are lymph nodes on my neck. PEP have serum conversion delays do not doctor I too worried about this

        • The Dr. Please help me because I do notknow the quick tests in 151 days afterthe time of exposure is positive as tohow . In addition many lymph nodes on theneck of the I do I am very worried

  20. Hi Doctor Tan,

    Is it possible to be tested at 30d with a 4th gen test and have a false negative ?

    Thank you.

  21. Hello
    I went to a massage parlour on april 28 . It was a regular massage but she offered a happy ending . It ended with a handjob only. Nothing else. No blowjob or penetrative sex. She was completely clothed.
    Iv been extremely stressed out since this event. Havent been able to sleep or work properly.
    I2 days after the event iv developed a cold sore on my upper lip. Iv had cold sores before also in the previous year . Are cold sores a symptom of ARS ?

    Very worried

    • Cold sores are a symptom of herpes. Your exposure risk for HIV transmission is zero. If you are still concerned, please visit us for a proper consult and evaluation.

  22. Hai doctor,

    I had done ECLIA (4th Generation) test after 3 months of possible exposure & ELISA test after 7 months all are showing nonreactive (negative). But still from last 4 months I am having tingling,numbness, and burning like sensation through out the body. Now am loosing my hairs from my legs too.
    Got too much worried.
    My worry is all about my girlfriend. If am infected, probablity for getting infection from me to her is high.
    Please help me to get a conclusion.
    Is there any probability for changing 7 month negative result to positive?
    Should I consider my 7 month result as a conclusive?
    If can conclude my test result as negative, what is the reason for this symptom? (Note: these symptoms start 3 week after my possible exposure. Along these symptoms, I had flue, dry cough and sore through tooo (Which gone 2 week after).

    Thanks for your valuable supports.

    Anticipating for u r reply.

  23. Hai doctor,

    I had done ECLIA (4th Generation) test after 3 months of possible exposure & ELISA test after 7 months all are showing nonreactive (negative). But still from last 4 months I am having tingling,numbness, and burning like sensation through out the body. Now am loosing my hairs from my legs too.
    Got too much worried.
    My worry is all about my girlfriend. If am infected, probablity for getting infection from me to her is high.
    Please help me to get a conclusion.
    Is there any probability for changing 7 month negative result to positive?
    Should I consider my 7 month result as a conclusive?
    If can conclude my test result as negative, what is the reason for this symptom? (Note: these symptoms start 3 week after my possible exposure. Along these symptoms, I had flue, dry cough and sore through tooo (Which gone 2 week after).

    Thanks for your valuable supports.

    Anticipating for u r reply.

    • Dr. Julian Ng

      Hi,

      I would consider your results as conclusive. As for your symptoms, they may be unrelated to HIV. Please see your doctor for further evaluation.

      • 1. Is there any know case regarding 6 month negative result change to positive after 6 months?

        2. If infection happen will it present in all part of our body. Because for testing we are taking blood from a perticular part of our body (just a query)

        3. My doctor is refusing to consult me. He is telling that this all pain are only because my anxiety against HIV. But I know how much am suffering from pain.
        I read in some block that this all pain are due to neuropathic disorder and which are very common in HIV paitients.
        Is there any chance for neuropothical disorder at 7 month of exposure or at advanced stage?
        My girlfriend is forcing me to get marry. If I get status of my HIV, I can make some decision. Still if I have any risk, I don’t want to spoil her life tooo.
        I know what I done was not suppose to do & I regret for that. I hope u can give me a better advice.

        Thanks again for ur usual support.

        • Dr. Julian Ng

          Hi,

          It is generally considered that if HIV test was repeated 6 months post-exposure and it is still negative it is highly UNLIKELY that you are infected with HIV. If you are infected with HIV, it would be detectable in your blood regardless of where you take the blood from. In terms of your symptoms, as I mentioned, please seek further evaluation with a doctor as they are UNLIKELY to be related to HIV. You may also want to consider if the symptoms you experience may be due to your anxiety and may benefit from seeing a psychologist/ psychiatrist to help you manage it.

  24. Hello doc. Today is the 6th day. I didnt have sex just a handjob and massage. Im however worried about body fluids on the bed i was lying on.

    Im down with a slight fever, sore throat and muscle aches.

    If it helps, i was exposed to the rain during the weekend.

    Hope you can help me.

    Don

  25. Horea c.

    Hy, had sex with a sex worker with condom. At the end she took it of and i penetrated her 2 times ..max 2 seconds.
    At day 38 i took a ROCH 4th gen ECLIA method test at best lab in country. It was neg. Should i still be worried? I can t sleep for days.

    • Dr. Julian Ng

      Hi,

      Your results is reassuring. However, in view of the risk, you may want to consider retesting 3 months post-exposure.

      • Horea c.

        Why in some cases you say after 28 day 4th gen test is conclusive and in some you say retest at 3 months? Cause of the guidelines?

        Thank you

  26. Last exposure was end of January and 30th March 2018.

    Did a finger prick 4th gen test in February and a full test for hiv on 10th March.

    Protected sex but oral was unprotected.

    When should I get tested again? I’m worried as my flu symptoms persisted since 21st of March.

  27. hiv from insti kit

    Hi Doctor ,

    Thanks for your work , Please help me as i am feeling stressed now a days , i went for hiv test in one of the private labs in india and they have used tridot test for testing and it is negative , they have given the kit to me , unfortunately i have touched the innermembrane kit and i have small cuts in my finger , and i have touched my nose mucous membrane inside , will it pose a potential risk for hiv infection , this incident happened in november 22 2017 almost 5 months now , do i require hiv testing , please help me sir i am worried about this .

    • Dr. Julian Ng

      Hi,

      Tridot HIV test is considered a 3rd Generation test and thus if the test was performed within 3 months of exposure, then you will need to repeat the test after 3 months. Touching the test kit after use will not expose you to HIV transmission as it is your own blood.

  28. Protected viginal sex with CSW. Tested positive for Chlamydia. Sore throat for one month since 3rd week post exposure, rash skin (redness throughout entire body,blanching rash, itching) since 3weeks until now (4months), several neck nodes swollen. Tested with Abbott Architect Combo at 3rd, 7th, 8th, 9th, 11th, and 15th weeks post exposure. Is the test results conclusive? I still have rash skin and enlarged node as of now (17th weeks?

    • Dr. Julian Ng

      Hi,

      Your HIV results are conclusive. Please visit a doctor for further evaluation of your symptoms as they may be due to other medical conditions.

  29. Good evening I have posted here before extremely worried and confused. Had two supposed different exposures from two different individuals. One on September 19,2017 and one on November 23,2017. Had a 4th generation hiv lab test December 13,2017 non reactive. Jan 12,2018 did an rna tma not detected. Jan 21,2018 did an antibody test. February 10 did a 4th generation hiv lab test with an rna which both were non reactive and not detected. Took a few alere determination rapid hiv test the whole month of March and on April 4 took a rapid oraquick hiv test all negative. Have still loose stool since December, weight loss, and sore throat. Tested again 2 days ago 4th generation hiv lab test waiting on those but really scared. Are my test conclusive did I test pass the window period for both exposures? Is it something else? Someone please help me don’t know anything anymore

    • Dr. Julian Ng

      Hi,

      Your results are conclusive for both exposures. Please see a doctor for your symptoms as they may be due to other medical issues.

  30. Syed Ali

    Dear Doctors,
    I have an HIV exposure 3 weeks ago, It was a protected vaginal sex
    and since last week i am feeling body pains and intermitted fever of 99.5 degree F in oral, fever comes in evening arround 6 pm and becomes normal at 11 pm. I am having lack of appetite,fatigue, a single allergy bump like insect bite on my collar bone it feels itchy if i touch it and a groin boil (after having my groin shaved). no lymphedenopathy, no night sweats, no sore throat, no cough. please tell me whether these are ARS symptoms. i am waiting for my 28 days for my first 4th test.

  31. somen singha

    This is somen from Bangladesh.I have made 3
    stupid mistakes in my life and I am paying
    heavily for this Episode. #1 october 29,2014 I
    had protected vaginal sex with a female csw.I
    also french kissed her.Later found the girl HIV
    +.After 5 weeks I experienced severe flue type
    illness.Swollen lymph nodes under jaw and
    neck,loose stool,hedeach,severe muscle and
    joint pain,rash on both arm. I have tested after 3
    months with 3rd generation rapid test,after 5
    months with 3rd generation elisa, after 6.5
    months with 3rd generation rapid test.All are
    negative. Episode 2# July 16 2017 I had
    protected oral and protected vaginal sex with a
    female csw.Don’t know why? Vaginal part only
    lasted 10-15 seconds.The girl seemed a
    consistent condom user.No real symptom aftee
    1-4 weeks. Episode 3 # October 17 2017 I had
    protected vaginal sex with a csw.She offered
    me to have sex without a condom for extra
    charge.But she assured me she gets tested
    every month. Now you are thinking what’s the
    real problem…Actually I’m experiencing the
    symptom of overt aids.Loosing
    weight,fatigue,dizziness,swollen lymph
    nodes,loose stool,stomach upset,nail
    fungus,clubbing nail are making my life
    hell.From 2-3 days I’m experiencing
    dementia.My HIV doctor suggests me to see a
    psychriatist.He says it is inpossible to develop
    aids due to first exposure because all of my ab
    tests are negative and it is very unlikely to
    develop aids in a very short time after second
    and third exposure… I don’t know what to do? I
    cry and pray to God.Ive ruined my life.I haven’t been tested for 2nd and 3rd exposure.

  32. Ts escort insert the condom by her mouth and did oral sex with her mouth around 3 minutes. Is that activity has hiv risk?

    • Dr. Julian Ng

      Hi,

      Assuming I understand you correctly, if you wore protection when the escort gave you oral sex, the risk of HIV transmission is extremely low. Please visit a doctor for evaluation if you are still concerned.

  33. Rickey Jackson

    Hi Doc. Please help me!!!

    I had a brief encounter with this guy. We kissed for 2-3 minutes. Then I gave him a hand job and he sucked my nipples. He also gave me a blowjob but I didn’t. Then he touched the tip of his penis with my anal opening. There was little to no penetration. He was just touching his penis with my anal opening.

    Could you tell my odds of having HIV? Please reply fast as I am scared to death!

    Thank You so much for your time! 🙂

  34. Hello Doctor,

    Thanks for the voluntary work you do. I had what appeared to be protected receptive anal sex in a high risk situation (although status us not known) but he didnt check the condom when he took it off and threw it away and I didnt see it.

    5 days after it I had scratchy throat. 2 weeks now into it it added swollen glands under my ears (u cant see them unless you stretch out but ENT confirmed they were swollen). i did mention the event and he said he thinks its acute pharyngitis and sent me antibiotics.

    Feel warmer but am going through a lot of anxiety over this but no confirmed fever. saying at the 36.5 C level.

    I know I just need to wait but it doesnt make it easier. your posts (hard sore throat, significant fevel, generalized lymph node issues, etc) makes it comforting but keep wondering what if.

    tks

  35. franklino

    please help me guys with this situation , yesterday i was waiting in bus station , and some homeless guy carried a bag in his hand ( a plastic one ) he passed behind me so the bag touched my ( back of the knee area ) i felt poked when it happened when i came home i searched the area and i found a red dot it was not bleeding but it was itchy and reddish i put some water and soup but it still hurting and itching till now i am so afraid if the bag contained a syringe and the needle went out of the bag and poked me when the bag touched me what if the needle got HIV + blood, am so worried , god , please help me guys what should i do right now do i need to get PEP and get myself testing???!

    • It is difficult for us to determine if there was a needlestick injury, but if there was, the risk of HIV transmission is approximately 1:300. If you are concerned, it is best to speak to a doctor for a proper assessment and consult.

  36. Hi, my question is about Syphilis. I had intercourse on last year March with a prostitute, few weeks later I had genital ulcer and i tested negative for VDRL, HSV 1 & HSV 2 and HIV at 7 month after the exposure. today I’m having a solitary genital ulcer again? is this syphilis? I tested positive for EBV, can EBV cause solitary ulcer on penis?

    • It is difficult to say without a proper evaluation ourselves. There may be other possible causes of ulcers. Please visit us for a proper consult and assessment.

  37. Johnnybravo

    Dear Doctors,

    I had a recent exposure of a protected blowjob (with condom). During the session, I had some frenching with the escort for probably 30 seconds or so and also sucked on her nipples for awhile. Does that put me at risk for HIV? Appreciate your advice and knowledge. Thank you!

    • Dr. Julian Ng

      Hi,

      Oral sex carries a very low risk of HIV transmission while the rest of the the activities you describe carries virtually no risk. If you are still concern, please see a doctor for further evaluation.

      • Johnnybravo

        Dear doctor Julian,

        Thanks for the prompt response! However, if the oral sex was done with a condom and there was no breakage of condom, does it still possess a risk?

        Thank you!

        • Dr. Julian Ng

          Hi,

          If you are 100% sure that there is no breakage in the condom, in theory there is no risk.

          • Johnnybravo

            Dear doctor,

            nothing was leaking from the condom after ejaculation thus I assume there isn’t any breakage. I hope this is the case.

  38. issaqleo

    would i feel anything if i sat on a needle , cause i have feel that i sat on a needle that had been placed there intentionally but i didn’t felt poked or something

    • How do you “have a feeling” that you sat on a needle but “didn’t feel anything”? I would assume you would feel something, unless you had a problem with your sensory nerves. If you are concerned, please see a doctor or visit us for a consult and test.

  39. somen singha

    This is somen from Bangladesh.I have made 3 stupid mistakes in my life and I am paying heavily for this Episode. #1 october 29,2014 I had protected vaginal sex with a female csw.I also french kissed her.Later found the girl HIV+.After 5 weeks I experienced severe flue type illness.Swollen lymph nodes under jaw and neck,loose stool,hedeach,severe muscle and joint pain,rash on both arm. I have tested after 3 months with 3rd generation rapid test,after 5 months with 3rd generation elisa, after 6.5 months with 3rd generation rapid test.All are negative. Episode 2# July 16 2017 I had protected oral and protected vaginal sex with a female csw.Don’t know why? Vaginal part only lasted 10-15 seconds.The girl seemed a consistent condom user.No real symptom aftee 1-4 weeks. Episode 3 # October 17 2017 I had protected vaginal sex with a csw.She offered me to have sex without a condom for extra charge.But she assured me she gets tested every month. Now you are thinking what’s the real problem…Actually I’m experiencing the symptom of overt aids.Loosing weight,fatigue,dizziness,swollen lymph nodes,loose stool,stomach upset,nail fungus,clubbing nail are making my life hell.My doctor who is the best HIV doctor of my country suggests me to see a psychriatist.He says it is inpossible to develop aids due to first exposure because all of my ab tests are negative and it is very unlikely to develop aids in a very short time after second and third exposure… I don’t know what to do? I cry and pray to God.Ive ruined my life. I haven’t tested for the 2nd and 3rd exposure.

  40. Hi Doctor,
    I had an episode of unprotected insertive anal sex with a CSW of unknown status. I was put on PEP (truvada and raltegravir) within 3 hours of exposure. At week 3 I developed enlarged lymph nodes in my neck area. As far as I can tell this is the only symptom I have. Could ARS lymph nodes be localized to one area of the body without the presence of other symptoms? Is this suggestive of HIV?
    Thank you in advance

  41. Somen Singha

    This is somen from Bangladesh.I have made 3 stupid mistakes in my life and I am paying heavily for this Episode. #1 october 29,2014 I had protected vaginal sex with a female csw.I also french kissed her.Later found the girl HIV+.After 5 weeks I experienced severe flue type illness.Swollen lymph nodes under jaw and neck,loose stool,hedeach,severe muscle and joint pain,rash on both arm. I have tested after 3 months with 3rd generation rapid test,after 5 months with 3rd generation elisa, after 6.5 months with 3rd generation rapid test.All are negative. Episode 2# July 16 2017 I had protected oral and protected vaginal sex with a female csw.Don’t know why? Vaginal part only lasted 10-15 seconds.The girl seemed a consistent condom user.No real symptom aftee 1-4 weeks. Episode 3 # October 17 2018 I had protected vaginal sex with a csw.She offered me to have sex without a condom for extra charge.But she assured me she gets tested every month. Now you are thinking what’s the real problem…Actually I’m experiencing the symptom of overt aids.Loosing weight,fatigue,dizziness,swollen lymph nodes,loose stool,stomach upset,nail fungus,clubbing nail are making my life hell.My doctor who is the best HIV doctor of my country suggests me to see a psychriatist.He says it is inpossible to develop aids due to first exposure because all of my ab tests are negative and it is very unlikely to develop aids in a very short time after second and third exposure… I don’t know what to do? I cry and pray to God.Ive ruined my life I haven’t tested for the 2nd and 3rd exposure…

  42. Harry Potter

    I am using a fake name, but all I want to say is Thank You a million times for putting this information online.PLEASE READ THIS POST. I HAVE NO ONE TO TALK TO! 🙁

    I had an encounter with a man ~ 4 weeks ago. We kissed, he gave me a blowjob and he touched his penis with my hole. Thankfully, he did not penetrate as I stopped him.

    Exactly on the next day, my stomach became bad. I also had very small red pimples on the top of my shoulder ( 4-5 ). I won’t digest anything and would always vomit. But after a week, it resolved on its own. According to your info, this is probably not ARS as it appears after about 2 weeks and not immediately after infection!

    I have been very very very depressed from the last 3 weeks constantly thinking about HIV. Although I have no fever, no swollen lymph nodes, no muscle pain, no puss on my tonsils, my throat feels not exactly as it used to be ( no pain though ) still I just cannot stop thinking about HIV and it is interfering with my daily life. I am 18 years old and I have my finals going on. I JUST CANNOT CONCENTRATE. I HAVE MESSED WITH MY EXAMS! 🙁

    I am going to get an antibody test on 22 March, ( as they say that it will detect 95% of the infections after 5 weeks ). Is there a better test which detects HIV after ~ weeks? I have access to Rapid Test, Standard test, Early detection, Antigen test and antibody test! I have been saving money for the test, so need to worry about the cost of the test!

    AND THANK YOU SO VERY MUCH FOR PUTTING THESE SYMPTOMS ONLINE. YOU DONT KNOW HOW HELPFUL THESE ARE TO ME. MAY GOD BLESS YOU CLINIC SIR :)))

  43. elanglue

    i had sex with prostitute i used condom for both oral and vaginal and i also took 2 tablet of truvada for 2 days after exposure what are my chances of hiv infection?

    • Dr. Julian Ng

      Hi,

      The recommendation for post-exposure prophylaxis is to use 2 different anti-HIV medications for 28 days after exposure. In general, having protected vaginal/ oral sex has very low risk of transmission. If you are concerned you should seek further medical evaluation. If you like you may visit us at: http://www.drtanandpartners.com/where-to-find-us/

  44. Somen Singha

    This is somen from Bangladesh.I have made 3 stupid mistakes in my life and I am paying heavily for this Episode. #1 october 29,2014 I had protected vaginal sex with a female csw.I also french kissed her.Later found the girl HIV+.After 5 weeks I experienced severe flue type illness.Swollen lymph nodes under jaw and neck,loose stool,hedeach,severe muscle and joint pain,rash on both arm. I have tested after 3 months with 3rd generation rapid test,after 5 months with 3rd generation elisa, after 6.5 months with 3rd generation rapid test.All are negative. Episode 2# July 16 2017 I had protected oral and protected vaginal sex with a female csw.Don’t know why? Vaginal part only lasted 10-15 seconds.The girl seemed a consistent condom user.No real symptom aftee 1-4 weeks. Episode 3 # October 17 2017 I had protected vaginal sex with a csw.She offered me to have sex without a condom for extra charge.But she assured me she gets tested every month. Now you are thinking what’s the real problem…Actually I’m experiencing the symptom of overt aids.Loosing weight,fatigue,dizziness,swollen lymph nodes,loose stool,stomach upset,nail fungus,clubbing nail are making my life hell.My doctor who is the best HIV doctor of my country suggests me to see a psychriatist.He says it is inpossible to develop aids due to first exposure because all of my ab tests are negative and it is very unlikely to develop aids in a very short time after second and third exposure… I don’t know what to do? I cry and pray to God.Ive ruined my life

    • Somen Singha

      I haven’t tested for the second and third exposure

    • Somen Singha

      Doctor, please reply me. I haven’t tested for 2nd and 3rd exposure.

  45. hiv from cigratee

    Hi Doctor ,

    Please help me i went to buy a cigratee from a shop , i have noticed the blood stains on the tip of cigratee which we put in mouth after smoking cigratee at the end of the end of smoking i found blood on the cigratee , will is it a potential risk for hiv or hep-b and hep-c , Please help me sir .. i have seen visible blood on the cigratee , please help me sir .

    • I would not consider this to be a risk for transmission of hepatitis or HIV.

      • hiv from cigratee

        Thanks doctor , so no testing is required doctor for hiv and hep ? please sir reply anxiety is killing me .

  46. Hi doctor, I recently had unprotected anal sex.
    I experienced fever, sore throat, generalized weakness, and muscle aches 6 days post intercourse. The fever only lasted one day and the other symptoms were gone 4 days after. On this site it stated symptoms did not occurs until 2-6weeks post exposure and the fever usually persisted for at least a week. I will be getting tested one month after the intercourse date with a 4th generation test but until then I would be interested in your opinion.
    Thank you

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