Rash / ARS / PEP

[smithjoe1234]

Hi,

23 days ago, I had sex with another man. While I was penetrating, the condom broke. I started PEP 17 hours post-exposure (Truvada and Isentress). About two weeks post-exposure, I got a rash on my groin area (one smaller rash on the upper thigh, and one larger rash on the crevice between my left thigh and the pubic region going down the crevice (probably about four inches long)). After about a week, the rash began to fade (and started to flake a bit as it went away). At this point, it's mostly gone, though there is still a bit of redness. I also experienced (and continue to experience) pain in the groin area (lymph nodes??) and pain in the back of the neck.

Is this ARS? How can I find out what an ARS rash looks like? I read that a rash during PEP is not a good sign (I generally very rarely get rashes.). I am so worried. thank you in advance for your advice.

[RapidRod]

No that is not ARS.

[smithjoe1234]

How do you know?

I rarely ever get rashes, and then BAM! I get one two weeks post-exposure! and it lasts just over a week. (not to mention groin pain, etc).

[RapidRod]

HIV positive for 28 years.

[smithjoe1234]

Thanks RapidRod.

Could someone else give feedback? I appreciate Rod's response, but would just like more of an explanation. Perhaps Ann, jkinatl2 or Andy? You guys always have well-reasoned responses. Do you think this could be and ARS rash? Why/why not?

[Andy Velez]

Neither the presence nor the absence of symptoms will ever tell you anything accurately about your HIV status. Only an HIV test at the appropriate time can do that. In your case you had a very low level risk with a broken condom.

It was a single and apparently very brief possible exposure. As the insertive partner you were at lesser risk than an insertive partner is. All considered I certainly expect you will ultimately test negative. You can test initially at 6 weeks after completing PEP. If the result is negative as I expect, then it will likely be the same for a conclusive result at 3 months.

Your symptoms are something to discuss with your doctor. There is nothing HIV specific about them and I expect you to come out of this ok.

[jkinatl2]

In my opinion, PEP after a condom break with a partner of unknown status is overkill. I am rather surprised that a doctor or ER would prescribe that.

However, you may as well take the pills, which can 0 as I am sure you are aware - cause their own side effects. You will almost certainly NOT get ARS symptoms while on PEP, as the drug's intent is to inhibit viral replication. Without viral replication, your body will NOT recognize the virus, will NOT create antibodies, and therefore you will NOT experience ARS.

ARS is something you experience when the body produces antibodies against HIV for the first time. This is not possible during PEP.

What IS possible, of course, is the side effects from the drugs causing those symptoms. You really ought to report side effects to your medical provider if they get out of hand. Rashes are common when beginning Truvada, and a headache on Isentress is well documented. Along with other medications, I am on the same regimen as you are, so I am familiar with the headache. Usually a over the counter remedy will help.

Having taken PEP, you will have extended your window period by a month. So at the six week point AFTER you finish your last dose, a test will be considered all but definitive. Of course, only a test three months after PEP will be considered a final test.

Even for HIGH RISK situations, and yours was most assuredly NOT, PEP is insanely reliable in thwarting HIV infection. IN my ten years on this forum answering questions, I have yet to see the insertive partner test positive following a condom break - and this is without PEP.

I have every certainty that you are going to be OK.

I know the side effects of the drugs can be disconcerting - think of it this way, five years or so ago you would have been given FAR more toxic drugs, which might have cause a major impact in your quality of life. And before that, they just threw AZT at people, which was often a month of nightmarish proportions. All things considered, this is a VERY gentle regimen.

[Ann]

Joe,

We do not permit people to use PMs as a means of getting around paying a subscription for participation in the Am I Infected forum. You have used up your three free posts.

If you didn't know about paying a subscription, then maybe you shouldn't have ignored the large and lengthy IMPORTANT UPDATE that appears at the top of each and every Am I Infected forum page, including this one.

You are not permitted to use PMs to ask questions dealing with hiv transmission and/or testing anyway.

I have removed your PM privilege.

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

Do NOT use Private Messages to question other members about any transmission, testing or symptom issues. These issues must be discussed in the public forum. Misuse of the PM function in this manner will result in your PM privileges being removed without warning.

Just go test and get it over with. You're highly unlikely to get a positive result.

Ann