ARS

[shiffrob]

Hello Dr. Handsfiled and Dr. Hook,


Is dry mouth considered a symptom of ARS?

I had a one night stand with someone. Multiple protected intercourses, but she used some jelly to lubricate me during the foreplay. Now I'm worried. If it was oil based - it could weaken the latex which could result in rapture. It was dark in the room and I didn't check the codnom - so now I've got a lot of "what ifs" in my mind which causes stress and anxiety.

For the past few days, I also feel a little discomfort on the left side of the throat when I swallow, but not your regular sore throat. It's minor and doesn't happen every time. Moreover if I press near the neck lymph nodes I don't feel the discomfort when I swallow. Maybe it's just some kind of a tension there due to my stress and anxiety? Or possibly it's caused by my constant checking of the lymph nodes on the neck and touching them.

For a record - I was diagnosed with Generalized Anxiety Disorder in the past. But I never had dry mouth before this incident.

It's been 22 days since the incident.

What are your thoughts?

I wanted to go for a test at 28 days. Reading your archives I understand it would be 95% conclusive. Do I understand it correctly? Or I should wait until 6 weeks or so?

Thank you.

[Edward W Hook, MD]

I hope that I can help to relieve your anxiety.  The risk of the exposure you describe is very low.  Here they are:

1.  You do not know that she had HIV. In fact, it is unlikely that she did.
2.  A condom was used.  If the condom had broken, you would have known it- trust me on this, even in the dark.  Although petroleum-based gels can WEAKEN a condom, they do not assured breakage.
3.  Even if she was infected and even if the condom broke (both are unlikely) the chances if infection are less than 1 in 1000 per act of intercourse.  Thus if all of these improbable things happened, your risk of infection would still only a 1/10th of 1%.

Putting all of this together there is very little chance that you are infected.

Finally, as for symptoms, dry mouth is not a prominent part of ARS--your symptoms do not sound like ARS.

Having said all of this, I realize you will probably still want to get tested.  At 28 days, a test will detect 85-90% of all infections, not 95%. Nonetheless, given your low probability of infection, the result at that time can be trusted.  I hope this helps. Good luck.  EWH

[shiffrob]

Dr. Hook,

Thank you so much for answering. Your words are very encouraging. Just a few questions to follow up:

1. Probably an hour before the intercourse, while we were in a bar, I noticed some red spot on her lip and I assumed that it was her lipstick a little more concentrated in that place. During the intercourse there was a lot of deep kissing. Assuming that it was her blood and not lipstick an hour before (maybe she accidently bit her lip or cheek), would that put me at risk? I do get bleeding gums sometimes more often when I brush my teeth.

2. At some point during the foreplay, she performed unprotected oral sex on me for just a moment (maybe jut 3-5 seconds). Would that put me at risk? (assuming it was blood on her lip an hour before as a result of some open cut) I'm uncircumcised.

3. She was a little rough during the intercourse and scratched my back a few times. If she had her vaginal secetions on her hands - would that put me at risk?

4. My throat is getting little worse when I swallow. Now I have the same feeling of discomfort when I swallow on both sides of the throat. It's not your regular sore throat, I don't know what it is. It's sort of down on the neck around the lymph nodes area. No runny nose, no cough so it certainly is not cold. No fever - just measured - 97.7. This really worries me because I've read that sore throat is very common during ARS and mine is sore in some unusual way. Maybe it's due to the dry mouth that I have (possibly due to stress and anxiety)? Does this sound like ARS? Maybe this just indicates that my lymph nodes are enlarged or sore?

5. Do ARS symptoms appear at the same time or they could come one after another? Sore throat, then in a day or a few something else etc...

I am very sorry for the long post but I really hope you'd help me clear things out as I'm verry worried. Thank you so much for your previous answer.

[Edward W Hook, MD]

Each of these questions has been answered numerous times on this forum by both Dr. Handsfield and I.  I will briefly answer them.  If you wish to read them again or see the answers phrased inn different ways, please use the search function on the Forum.

1.  IF she had blood on her lip, it still would not increase your risk
2.  IF she was infected, your risk of getting HIV from receipt of oral sex is less than 1 in 10,000 and, in your case, given the brevity of exposure far less than 1 in 10,000.
3.  No
4.  No.  While sore throat is part of ARS, far, far less than 1% of sore throats are ARS.  Your sore throat does not sound like ARS
5.  ARS symptoms start at about the same time, not sequentially over a number of days
EWH

[shiffrob]

Thank you so much Dr. Hook for your reply!

[shiffrob]

It's been 26 days since my encounter as I described above (multiple protected sexual intercourses, brief, 3-5 second unprotected oral) - if you remember I had fears that the condom might have broken and I didn't notice it. Your answers were very helpful - thanks a lot!

Today I noticed redness on the head of my penis with some red dots in that area that remind burst vessels. That area is more sensitive to touch now sort of like irritated possibly from rubbing and feels so during friction. I also noticed on that area the skin has a few circular micro tears - sort of like it's peeling off.

I recall having something like that years ago - maybe 6-8 years ago. Didn't go to the doctor - it went away itself I think.

I'm very worried about this. Does that sound like STD?

I hope it's just a simple irritation.

[Edward W Hook, MD]

Most likely simple irritation.  I you are concerned, go see a health care provider who can examine you.  Unlikely to be a recently acquired STD - far too long.  EWH

[shiffrob]

Last post here, just to clarify - you mean far too long for symptoms to appear after my exposure? Meaning if it would be STD they'd appear sooner? Lastly, do these symptoms even remind you of any STD at all?

Thanks so much for a quick reply once again!

[Edward W Hook, MD]

Far to long for STD symptoms to appear after your exposure.  They do not suggest STD.  Last answer.  EWH

[shiffrob]

Dr. Hook,

Please answer my last question - I promise I won't ask more - this is my last post in this thread.

I've read a few things and asked a few questions on dermatology forum and from what I understand I might have a balanitis or penile yeast infection