Hi Doctors! Firstly thanks for the great service you offer here. Im having some symptoms in Thailand after some (seemingly low risk) exposures, and I'm worried and am keen to hear your thoughts:
Risk factors
Within the 3 months leading up to two weeks before the sore throat, I've had sex with several Thai girls in Thailand. All normal girls in their 20s-30s, not sex workers.
Have used protection every time, but still the following incidents occured, with different girls:
-1 incidence of "dipping" i.e. putting head of penis in for 10-30 secs before putting condom on.
-2 incidences of condoms splitting - I felt it "go" and within 10 seconds withdrew and wiped penis on bedsheets each time.
-6-7 incidents of clumsy condom application - probably transferring a dab or two of vaginal juices from my fingers (after fingering her) onto my glans when applying condom, but otherwise protected.
I am also circumcised.
Symptoms:
Mild sore throat for ~10 days. No noticable fever - but perhaps 1-2 days of feeling a little bit hotter and under the weather. Certainly no muscle or joint aches, headaches, malaise, etc. Didnt feel "flu-like".
A day or two after sore throat subsided, noticed rash on upper inner arms. Has since spread down inner forearms, Noticed some on top of thighs, and some on lower stomach area, around "creases" and sides. Not obviously any on chest, back, face, outer arms or legs (apart from top of thighs). Has largely cleared up, 6 days later.
Rash had following qualities:
-Small raised spots, each light and pink. Very close together. Looked to me like a sweat rash or skin irritation. I thought it was this at first.
-On my inner arms, looked alot like pink goosebumps. Bumps very close together, alot seem to be situated on follicles. Could have sworn it was some sort of irritation, but no itch or pain and Docs said viral rash.
-Not itchy, but maybe a tiny bit sore if the area is rubbed.
-More patchy on thighs, but still pink and looks like a heat rash/irritation.
Diagnosis from Thai doctors ( 1 Dermo, 1 GP)
They said:'Unspecific Viral rash, occuring after the viral symptoms (sore throat)'. Had no fever at time of Doc visit (temp:37.1). One said viral rash is "very common", and HIV rash is "quite uncommon". Not sure what weight that holds, but good to hear that both their first thoughts were a common viral rash, I guess.
I asked about HIV, they said they cant exclude it; it can cause viral rash symptoms, and if Im worried about exposures I can get tested.
Worries
Obviously, worried about HIV - I had exposures in Thailand (albeit low risk) and then sore throat then rash within the seroconversion timeframe, which scares me alot.
I'm clinging to the facts that:
-My exposures were pretty low risk
-I got the sore throat first which cleared up, with no real fever. THEN I got the rash after; from what I understand in HIV they usually come together? with fever/flu feeling, etc?
-Rash maybe not be typical of the HIV rash? ( Can you comment?)
However, Im still scared I could be one of the ones with milder seroconversion symptoms.
Doctors - I'd really appreciate your opinion on my symptoms and exposure risks - of course, I intend to get tested, but if reassurance is possible, I'd love some!
I hope you're having a good time despite all this?
Overall its difficult to be too dogmatic even when there is a definite risk event. The condom splits are definite risk events although you seem to have realised promptly and withdrawn.
I think the likely duration of the dipping and the split episodes are reassuring and in your favour. We estimate that unprotected vaginal sex with an HIV positive female would carry a risk of approximately 1 in 1000 to 1 in 1200 per episode. This is not entirely random chance but nearly - so whilst the odds are on your side the possibility is a definite one.
Circumcision will offer a degree of protection - but again not complete.
The description of the rash does not add anything - in the patients we diagnose here as having new onset HIV then rash is a common feature. The doctors there are right to say though that a non specific viral rash is much more common than an HIV rash because non specific viral infections are hugely more common.
My gut feeling is that you will be fine and test HIV negative.
Risk Assessment
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