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Author Topic: need some advice, high risk exposure + ARS  (Read 11516 times)

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Offline lifechanger20

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need some advice, high risk exposure + ARS
« on: January 14, 2012, 06:16:33 pm »
hi

I need some advice/opinions on my current exposure. I had sex with a CSW, who's status I did not know and apparently neither do she, and during sex, the condom broke and I was fully exposed for approx 3-4 minutes, maybe more. Really intoxicated at the time. Anyhow, 44 days after the incident, I began to have chills and a headache with pain behind my eyes. That night I had a sevre night sweat and a rash started to appear on my forehead. At first it was just a few small bumps but then over the next day, it spread down my neck, covered my chest and back and a few on my arms and upper legs. The rash became raised bumps and a lot of them were clear fluid filled blisters. They did not itch nor were they painful. The rash lasted for about 6 days and then began to clear up. At the same time as the rash, I had a really sore throat for 5 days and two sores on my gums and one in the back of my throat and two sores on my lips. I could not eat at all due to my sore throat and lost about 10 lbs over 2 weeks. I have read that fever, rash and sore throat are some of the common symptoms of recent hiv infection. I went to the "doctor" and had a full screening done, which was 10 weeks after the incident, 3 weeks from when the symptoms disappeared, and it all came back negative. He told me not to worry about hiv. So then I read about the window period and decided to have another test done again, which was at 12 weeks and 2 days after the incident, again it was negative. My doctor told me I was over reacting and that I didn't need anymore testing, but I am still not convinced that it isn't hiv. I spoke to anther doctor about all this and explained the entire situation about my symptoms and testing but he told me that I need to have another test done at 6 months, just to be sure. This has added to my stress levels beyond belief. So here are my questions for you:

1. If antibodies are created during symptoms, which some people may or may not have, how long would it take to show up on a 4th generation Ag/Ab test?

2. I have also read that it could take between 6-12 weeks for antibodies to become detectable. If that is the case, and my symptoms did not occur until 6 weeks would it be right to say that it could be as long as 18 weeks post symptoms, or 24 weeks since exposure, for the antibodies to become detectable or reach detectable levels? Maybe this is why the doctor told me to take another test at 6 months.

3. The tests that I had done was the 4th generation. If antibodies weren't dectectable, would the p24 antigen still be in large enough quantities to be detected? I have read some on some sites, the body, that the p24 is only dectectable 2-3 weeks after infection and then disappears, while other sites, freedom health, state that it could be around for months after infection. Is there a point in time where neither the p24 or the antibody will be at detectable levels?

I am getting so many different answers which really adds to my anxiety and I have never had anything like this happen to me before. If I hadn't been with the girl and had this misfortune then I would just shrug it off, but this seems to be too much of a coincidence to be some random viral infection. Could you please shed some light on this situation, as my regular "doctor" just said he doesn't know what it is and doesn't seem to be too concerned.

Offline Andy Velez

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Re: need some advice, high risk exposure + ARS
« Reply #1 on: January 14, 2012, 06:55:31 pm »
The bottom line in all of this is that you have reliably tested negative for HIV with your result at 12 weeks. Your risk was relatively low to begin with but in any case with that negative result you don't have to be concerned any longer.

There is no need for further testing. The test you used yields a reliable result.

In the future I do suggest you avoid mixing excessive drinking and casual sex. It's a dangerous combination. Fortunately you have come out of this incident OK.

Get on with your life. HIV is not your problem.
Andy Velez

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #2 on: January 14, 2012, 07:25:58 pm »
Hi Andy,

thanks for the words of encouragement. I am trying to put this behind, although its very hard. However, in relation to my questions can you please provide some answers. Also, I find it hard to believe that everyone will have a "definitive" result at 12 weeks as seroconversion time varies from person to perosn as no 2 people are alike. Some may have shorter periods while others may have longer. Would this not give a false impression to a lot of people thinking that they are ok when in actual fact they may not be and continue with risky behaviours. I just don't see how 12-13 weeks can emcompass the entire population without some actual weekly continual testing of those who are truly infected.

Offline Ann

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Re: need some advice, high risk exposure + ARS
« Reply #3 on: January 15, 2012, 05:12:18 am »
Life,

1. You would test positive on any generation test within a week or two following the onset of symptoms - a week at most on a fourth generation test.

2. If your symptoms had anything to do with hiv seroconversion, you would have definitely tested positive on your ten week test.

3. The p24 antigen begins to disappear as antibodies are created. The vast majority of people will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. This 22 day time frame is why it is generally said that the p24 is gone within two to three weeks.

The rash that sometimes accompanies seroconversion is nothing like what you describe. It is flat, and more-less just under the surface of the skin, similar to what a meningitis rash looks like. It's more like a "flush" (a redness, like when you're embarrassed) and if you didn't see it, you would not know it was there. It also rarely appears on the limbs. It is usually confined to the torso.

I totally agree with your doctor. You are overreacting. You were never likely to end up positive as the insertive partner following a condom break. In over ten years of answering questions on this forum, I've yet to see the insertive partner end up positive after a condom break and you weren't going to be the first. You aren't the first - you are conclusively hiv negative.

You do NOT have hiv. You do NOT need further testing, despite what the other doctor told you. He probably told you to do that because he could see how freaked out you are and hoped another negative result would ease your mind. And maybe he's just not up-to-date on testing guidelines.

And by the way, a correctly used condom rarely breaks. There are two leading causes of condom breakage.

One is not using enough lube. This is usually more of a problem where anal intercourse is concerned, but it can definitely be a problem with vaginal intercourse as well. Make sure plenty of water-based lube is being used.

Another is having an air bubble present in the tip of the condom. It's easy for this to happen if you're using condoms with a reservoir tip. You need to pinch the tip of the condom between the finger and thumb of one hand, while rolling it down with the other hand. Once it's on, give it a firm stroke from tip to base while watching the tip. If there is air in the tip, roll it back up and try again. Air in the tip of the condom is probably THE most common reason for condom breakage. 

You also need to make sure your condoms do not have an expired "use by" date. Latex degrades with time. Excess heat will speed this up - do not store condoms in your wallet for extended periods of time.

You're so worried about a virus that you were unlikely to have been infected with, but have you also tested for all the other MUCH MORE EASILY TRANSMITTED infections as well? You were MUCH more likely to have picked up something like chlamydia from this condom breakage. STIs like chlamydia and gonorrhea can often be present with no obvious symptoms, so the only way to know for sure is to test.

You are conclusive hiv negative. YOU DO NOT HAVE HIV!!!!

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #4 on: January 15, 2012, 11:54:02 am »
Hi Ann,

Thanks for answering my questions. I am trying to put more faith into my results, but I am having a hard time believeing them with so much conflicting information about how long it could take to turn positive if someone is actually infected. I think I will take another test at 6 months for my own piece of mind. I have been checked for other STI's as well including hep A,B and C. I asked my doctor to check for HSV 1&2 as well, but he told me they normally don't check for it and that lesions would have to be present for them to test for it???? Anyhow, I have gone to another doctor and asked if it could be checked through blood work and he told me yes, and he also said to get tested at 6 months for my main concern. So I am intending to wait until the 6 month mark to get this done so that I can have all the tests completed again.

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #5 on: January 16, 2012, 07:33:43 am »
Ann / Andy / Somebody

I went to the doctor again yesterday due to a white film covering my tongue and he told me it looked like a fungal infection or thrush. I also showed him pictures of the rash that I had during my illness and he said it looked like a maculopapular rash, which is common in primary hiv infection.
Ann you said the rash I described sounded nothing like a primary infection rash, and that it rarely appears on the limbs, which mine did. How can you be so sure that this wasn't related to hiv, due to the fact that everyone is different. Is your opinion based on the fact that my 12 week result was negative. I have extreme doubts about this not being hiv as I have had the 3 most common symptoms that all came and went at the same time and what I consider to be a high risk exposure. Any condom breakage leaving someone fully exposed would be the same as unprotected sex, which I think is high risk, considering the woman didn't even know her own status. I know this is my fault for putting myself in this situation of worry and torment, but I cannot see any other explanation for my symtpoms other than hiv.
I have also looked back through the poz forum and there are some there that didn't test positive until a couple of months or more after their illness. Since my last test was only about 5 weeks after the illness, it seems this could be a false negative result. Could someone please comment, I am really nervous about all this and I am having sincere doubts about the accuracy of my test. Thanks

Offline RapidRod

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Re: need some advice, high risk exposure + ARS
« Reply #6 on: January 16, 2012, 07:40:25 am »
Ann / Andy / Somebody

I went to the doctor again yesterday due to a white film covering my tongue and he told me it looked like a fungal infection or thrush. I also showed him pictures of the rash that I had during my illness and he said it looked like a maculopapular rash, which is common in primary hiv infection.
Ann you said the rash I described sounded nothing like a primary infection rash, and that it rarely appears on the limbs, which mine did. How can you be so sure that this wasn't related to hiv, due to the fact that everyone is different. Is your opinion based on the fact that my 12 week result was negative. I have extreme doubts about this not being hiv as I have had the 3 most common symptoms that all came and went at the same time and what I consider to be a high risk exposure. Any condom breakage leaving someone fully exposed would be the same as unprotected sex, which I think is high risk, considering the woman didn't even know her own status. I know this is my fault for putting myself in this situation of worry and torment, but I cannot see any other explanation for my symtpoms other than hiv.
I have also looked back through the poz forum and there are some there that didn't test positive until a couple of months or more after their illness. Since my last test was only about 5 weeks after the illness, it seems this could be a false negative result. Could someone please comment, I am really nervous about all this and I am having sincere doubts about the accuracy of my test. Thanks
Except the fact that you have tested conclusively negative and you don't have HIV. Thrush is not HIV specific.

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #7 on: January 16, 2012, 07:57:49 am »
RapidRod

How can you be so sure its not hiv? What about the possibilty of false negatives since some people may have longer window periods? How can 12-13 weeks be the magic cut off time for someone having detectable antibodies?

Offline RapidRod

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Re: need some advice, high risk exposure + ARS
« Reply #8 on: January 16, 2012, 08:38:20 am »
RapidRod

How can you be so sure its not hiv? What about the possibilty of false negatives since some people may have longer window periods? How can 12-13 weeks be the magic cut off time for someone having detectable antibodies?

http://www.cdc.gov/globalaids/Resources/pmtct-care/docs/TM/Module_6TM.pdf
Page 11
#4
  In an adult, a positive HIV antibody test result means that the person is infected, a person with a negative or inconclusive result may be in the “window for 4 to 6 weeks but occasionally up to 3 months after HIV exposure. Persons at high risk who initially test negative should be retested 3 months after exposure to confirm results

Offline Andy Velez

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Re: need some advice, high risk exposure + ARS
« Reply #9 on: January 16, 2012, 08:42:23 am »
Whatever is causing your symptoms is NOT HIV. You have reliably tested negative for HIV. The exceptions for testing out until 6 months after a risk are when prolonged intravenous drug use is involved or a depleted immune system due to organ transplant or illness such as cancer. Otherwise 3 months is a long accepted and reliable testing point.

Andy Velez

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #10 on: January 19, 2012, 01:15:37 pm »
Hi Again:

I had another test done 17 weeks past exposure, 10 weeks since illness, and again it was negative. This test was the Abbott Architect Combo Hiv 1/2. So far so good. I will be having another test done again the middle of next month as a final test and hopefully it will be negative and ease my mind. This has been the worst 4 months of my life thats for sure.

Can someone answer my questions below

Would the p24 still be present if there weren't enough antibodies to be detected?

Does the p24 antigen be present with all different types of hiv?

Thanks for answering my questions, hopefully this will all be a bad dream and I can move on with my life.

Offline RapidRod

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Re: need some advice, high risk exposure + ARS
« Reply #11 on: January 19, 2012, 02:42:05 pm »
Hi Again:

I had another test done 17 weeks past exposure, 10 weeks since illness, and again it was negative. This test was the Abbott Architect Combo Hiv 1/2. So far so good. I will be having another test done again the middle of next month as a final test and hopefully it will be negative and ease my mind. This has been the worst 4 months of my life thats for sure.

Can someone answer my questions below

Would the p24 still be present if there weren't enough antibodies to be detected?

Does the p24 antigen be present with all different types of hiv?

Thanks for answering my questions, hopefully this will all be a bad dream and I can move on with my life.
You have conclusively test negative, you do not have HIV.

Offline Ann

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Re: need some advice, high risk exposure + ARS
« Reply #12 on: January 20, 2012, 05:32:24 am »
Life,

Most people will seroconvert and test positive by SIX WEEKS. The three month window period is conservative and is meant to catch the relatively rare person who takes a little longer than six weeks to seroconvert.

You have tested far outside the window period and you do NOT need further testing over this incident. You were never likely to test positive following a condom break as the insertive partner.

You are conclusively hiv negative.

You do NOT have hiv!

If you continue to feel unwell, see a doctor. It's nothing to do with hiv. You do NOT have hiv!

If you read the Welcome Thread before posting like you're supposed to, you will have read the following posting guideline:

Quote

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.


Please consider yourself warned!

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #13 on: February 04, 2012, 10:30:23 am »
Hi Again:
I have decided to get tested again, which will put me almost at the 6 month mark and hopefully this will be the end of it all. I decided to get the test done again because of the doctors advice, even though it may not be needed. I will most certainly post my results when I get them back.

I do have some questions though about previous advice you have given other people. In no way am I disrespecting the advice that you give or the help provided to us all during this trying time, I really appreciate it as I am sure most do.

Ann told me that I would have definitely tested positive if my symptoms were really ARS. However RapidRod replied to a question about ARS and antibodies May 22, 2009 and said " Just because one would have ARS, does not mean they would have enough antibodies for a test to detect "

Also about the rash, mine appeared on my face, neck, trunk and a few on my limbs and it didn't itch. Ann answered a question that said it appears on the limbs and trunk and doesn't itch, but indicated to me that the rash I had doesn't sound like a HIV infection rash. Can't an HIV rash vary as there are many forms of rash with HIV infection, including maculopapular, which the Dr. said I had. Plus all the "symptoms" I had came and went at the same time, which everyone says will happen.

I know I have had 3 negative test results so far and I am glad about that, but sometimes the information is very contradictory and makes people second guess their status, like myself! I am taking the test to allow for the "maximum" window period and hoping things will turn out to be OK, although I am still not that convinced it will come back alright. Everything it too much of a coincidence for me to believe otherwise.

Again no disrespect to anyone on questioning the advice given. Ann, I hope I am "not the first". I guess I'll have to wait and see!!

Offline Andy Velez

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Re: need some advice, high risk exposure + ARS
« Reply #14 on: February 04, 2012, 10:37:59 am »
There's nothing more for us to add regarding your status. Whether you believe it or not you are HIV negative. Go ahead and test if you want to for your peace of mind. As far as we're concerned that is totally unnecessary.

We're not going to indulge in further back and forths about your status. If you come back with more what ifs you are going to find yourself getting the Time Out which Ann has warned you about.

HIV is not your issue. Period.
Andy Velez

Offline Ann

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Re: need some advice, high risk exposure + ARS
« Reply #15 on: February 05, 2012, 07:19:27 am »

I have decided to get tested again, which will put me almost at the 6 month mark and hopefully this will be the end of it all. I decided to get the test done again because of the doctors advice, even though it may not be needed.

Is this the same doctor who told you - quite rightly - that you were overreacting? (Don't bother to answer that - it's a rhetorical question.)


Ann told me that I would have definitely tested positive if my symptoms were really ARS. However RapidRod replied to a question about ARS and antibodies May 22, 2009 and said " Just because one would have ARS, does not mean they would have enough antibodies for a test to detect "

I couldn't possibly comment on an old answer of Rodney's which has been taken out of context.


Also about the rash, mine appeared on my face, neck, trunk and a few on my limbs and it didn't itch. Ann answered a question that said it appears on the limbs and trunk and doesn't itch, but indicated to me that the rash I had doesn't sound like a HIV infection rash. Can't an HIV rash vary as there are many forms of rash with HIV infection, including maculopapular, which the Dr. said I had. Plus all the "symptoms" I had came and went at the same time, which everyone says will happen.

Your rash was raised and blister-filled. I've never, ever once heard of a seroconversion rash presenting in this manner. A maculopapular rash isn't a true seroconversion rash.

You can knock yourself out with continuing on with this unnecessary drama, but unless you engage in unprotected intercourse before your next hiv test, you're going to continue to test hiv negative.

You do not have hiv. If you continue to feel unwell, it's time to start looking for other causes. You have more than conclusively ruled hiv out of the picture already.

As Andy said, you are still under a time out warning.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline lifechanger20

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Re: need some advice, high risk exposure + ARS
« Reply #16 on: February 08, 2012, 09:00:56 am »
Hi everyone:

Just to let you know, my last test results were negative :D which is almost 6 months post exposure. Thanks so much for your opinions and advice, I really appreciated it. This forum truly helped me a lot. I was irrational and terrified throughout this ordeal always saying "what if, what if".This experience has certainly been an eye opener and I intend to make sure I keep my negative status. Take care.

Life.

Offline Andy Velez

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Re: need some advice, high risk exposure + ARS
« Reply #17 on: February 08, 2012, 09:26:46 am »
That's good news about your latest negative result. And that you can now get back to living your life with a committment to protect your HIV negative status by always using condoms for intercourse.

Cheers.
Andy Velez

 


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