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Had unprotected sex. Had rash on forearm, fever and night sweats. Contracted HIV?

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General & Family Physician
Practicing since : 2009
Answered : 6185 Questions
I was traveling in Indonesia for a few weeks and II had unprotected sex with a girl at a karaoke bar. Once back in the US and 2 weeks later I had a rash that looked like poison ivy appear on my right forearm. I never ever get rashes. I also had flu like symptoms including fever and night sweats. My sister met up with me the last week and she had an infection with the same symptoms so its possible she gave me whatever she had but not sure. The rash is what is really concerning me since I never get rashes. I am getting tested for HIV next week which would be 3 weeks after potential exposure. What are your thoughts about my symptoms docto? I am not sleeping and almost sure I have contracted hiv. Please help.

Can you confirm whether or not you received the 3 pictures I uploaded of the rash?
Posted Wed, 3 Jul 2013 in General Health
Answered by Dr. Chobufo Ditah 1 hour later
Hi and thanks you so much for this query. I am Dr. Ditah and feel honored having this opportunity to address your health worries today.
The thought of having contracted HIV is troubling to everyone. It is no surprise that you feel same.

Your symptoms are very very non specific for an acute HIV infection. Honestly, it will be puzzling to the scientific community to hear of manifestations of HIV infection 2weeks after exposure. For this, keep your calm. Even if you were to contract HIV from the unprotected intercourse, these clearly have nothing to do with it at this time.
I have reviewed the pictures you have uploaded. It looks like a local allergic reaction that could be poison ivy. For now, i will treat this as poison ivy or a cutaneous allergic reaction. It is most likely a coincidence that your first rash appears with an episode of unprotected sex around the corner rather than a manifestation of a recent HIV infection. You will need to review whether you have been exposed to any potential allergens or new products that can explain this rash. Simple observation is enough with a cutaneous steroid cream if you wish to.

Why I am so confident that this rash is not caused by HIV infection? HIV is a systemic infection and for you to have a localised cutaneous manifestation on the exposed surface of your hands like this is rare. HIV generally gives diffuse lesions all over the body and not what I have seen. This is just to say, at this time, they are not caused by HIV.

But could you have contracted HIV? The answer is YES. Each time you have unprotected sex with anybody whose HIV status is not known to be negative, the risk of contracting HIV is real. Are these manifestations consistent with acute HIV infection? I say NO. The only way to tell whether you contracted HIV or not is to do the test as you have already planned to and control later if negative to make sure the results are consistent.

Please, you can bare witness to the stress unprotected sex can cause. I will like to plead that you always consider using protection during sex and more so with people you know nothing about. I will like to advise you to stay strong and face the situation. I know it is a difficult thing to do. try and keep yourself busy, get involved with friends, always strive to have company so that this can distract you from always thinking about what will be the outcome of your test results.

I wish you the best outcome as you continue to get answers pertaining to this worry. I wish you good health.
Dr. Ditah, MD.
Above answer was peer-reviewed by
Follow-up: Had unprotected sex. Had rash on forearm, fever and night sweats. Contracted HIV? 19 hours later
Thank you Doctor for your response. A couple of follow ups. Everything I have read online indicates that ARS symptoms come bw 2-4 weeks after exposure. I am curious as to why you say symptoms after 2 weeks would be puzzling? Perhaps what I read is not fact?

Also, I live in New York and woke up with the rash all of a sudden in the morning. There is almost zero possibility it is poison ivy since I live in a city and I woke up with the rash completely randomly. Thanks again for your advice and guidance.
Answered by Dr. Chobufo Ditah 3 hours later
Hi and thank you so much for this precision and follow up.

I understand we often tend to be very hard on ourselves. This is what you seem to be doing to yourself right now.

The classical duration of 2-4 weeks is what is observed in closely followed up patients to describe what the natural history of this disease is. In reality rarely will you get to see someone presenting and being diagnosed with this condition within 2-4 weeks after exposure. The literature talks more of within 2 months and 2 weeks must be the rare lower limit.

Your heightened thoughts and fears about having contracted HIV are making you to find more reasons to convince yourself why you have it rather than not at this point. I understand you and sure I would have behave same if I were in your shoes. Beside, these symptoms need to go on for at least more than 2 weeks before we can start attributing them to HIV. The doctor must be a genius to rush to HIV as primary diagnosis in a patient who presents with flu like symptoms and a rash for 1/2 days. Beside, do you still have the symptoms of night sweats and fevers?

Poison Ivy is used as the classical description of a well localized allergic reaction. Using it in your case if for illustrative purposes. To settle on this diagnosis, you must have a history of exposure to back it up. Else, you cannot say it is poison ivy as is clearly the case with you. I strongly believe this is a localized allergic reaction but what I cannot tell for sure is the cause.

The definite answer to whether this is related to HIV or not will come when we get the results of the test. Stay cal and let us get to this point. I know it is easier said than done but put in more efforts to stay relaxed. If you were to ask me, I will clearly say the likelihood is this test being negative.

I wish you all the best with the outcome of this test.

Please, keep me posted as you get the latest developments. I am interested in knowing what the results are and how wrong or right I am in my opinion.
I wish you good health.
Dr. Ditah, MD.
Above answer was peer-reviewed by
Follow-up: Had unprotected sex. Had rash on forearm, fever and night sweats. Contracted HIV? 8 hours later
Thank you for your thoughtful response Doctor.

I will provide a detailed schedule of events for you and you can let me know if your feedback is still the same.

Had unprotected with girl in Indonesia on May 26th.
Met sister in Bali on May 28th. Sister had viral infection(night sweats, fever, aches and pains) and multiple ear infections after arriving in Bali to XXXXXXX me.
May 30th at 2am I have first sign of fever. From May 31st - XXXXXXX 4th I have fever, night sweats and cold sweats. Fever fades on XXXXXXX 3rd and aches and nasal congestion and other symptoms persist until XXXXXXX 8th/9th. I arrived back in NY on XXXXXXX 6th.
On XXXXXXX 12th I wake up in the morning with a rash all up and down my forearm but only on my forearm. It does not exist anywhere else on my body. I have NEVER had a rash before anywhere on my body (that I recall). I am not prone to rashes and I live in New York City so highly unlikely it is plant related. I am also not allergic to anything that I know of. I guess there is a possibility it was something or something changed but not that I know of.
Rash is fading but still is on my arm today XXXXXXX 17th.

Anyway, this is a detailed list of events. I really do appreciate your help and your detailed responses. Thanks a lot Doctor

Answered by Dr. Chobufo Ditah 52 minutes later
Hi and thanks for this detailed report of events.

My thoughts are still the same. I am even moving further away from these events being linked to an acute HIV infection.Not at this time with this detailed reporting.

Could you have HIV? The answer is YES because of the history of unprotected sex with a person whose status is not known to be HIV negative.

Are these symptoms and the timeline consistent with an acute HIV infection? NO.

What about the rash? For sure I cannot tell what the exact cause is but it clearly looks like an allergic reaction and it is fading away makes it more likely

It has been an exciting exchange with you.
I wish you the very best of outcome on this testing.
No matter the outcome, managing the situation is what matters. At least, the speculation and guessing would have been over.
Please, if there is no more further query related to this, I will kindly suggest that you close the discussion, rate the quality of responses I offered you and also write a short review. I do hope you enjoyed our services and will come back again in future. We value and care for our customers.
Dr. Ditah, MD.
Above answer was peer-reviewed by
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