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condom slip/donation
Sep 2, 2007

Hello,

I recently had sex with my girlfriend who is HIV+. It was protected, however the condom slipped and the lower half of my penis was exposed and I have a small sore on the part of the shaft that was exposed. What is the transmission risk through that sore? Is a 6 month test necessary? Also, are ARS symptoms any earlier than 2 weeks? All the archives I've looked at are so variable when it comes to that. What were your own symptoms? Did you get a splitting headache and/or fever flu like symptoms? My girlfriend's circumstances were similar to your own exposure story. She also was stuck with a needle by accident - happened in an emergency room while she was trying to save a man's life 8 years ago. It was so sad, she cried and cried but today she lives every day continuing to help others. She's quite a woman. Thanks for your time.

Response from Dr. Frascino

Hello,

That the condom slipped a bit, such that the lower half of your penis was exposed during vaginal sex, would not constitute a significant HIV risk, assuming that the "business end" (the head) of your penis remained covered and the latex condom did not break. As for the "small sore," I have no way of knowing how small is "small" or how sore is sore. What I can advise is that non-intact skin does pose a transmission risk if exposed to infectious fluids. If the "small sore" was essentially healed over and your girlfriend's HIV plasma viral load was undetectable, your HIV risk would be extremely low at best. However, if the sore was "open" and your girlfriend's viral load high, your risk would be more significant. If you did have a significant HIV exposure, PEP (post-exposure prophylaxis) may be warranted. I would hope your girlfriend is under the care of an HIV specialist. (If not, she should be!) I would suggest you have that physician examine you and evaluate your transmission risk. He could also prescribe PEP if indicated, based on your girlfriend's current medications and drug resistance profile.

Turning briefly to your other questions:

1. If you had a significant exposure, HIV testing out to six months would be warranted per the CDC's testing guidelines (because your girlfriend is confirmed to be HIV positive).

2. ARS symptoms can vary considerably from person to person, which may well explain the "variable" information you found in the archives. In general acute retroviral syndrome (ARS) symptoms being two to three weeks after primary HIV infection.

3. My ARS symptoms really have no relevance to what your or anyone else's symptoms could be. (See below.)

4. I'm sorry to learn about your girlfriend's occupational exposure, but delighted to hear she has adjusted to her new reality and continues with her "positive" attitude.

Good luck to you both.

Dr. Bob

What are symptoms of ARS? May 23, 2004

Bob,

I am an x-filer who still follows your forum for laughs, information, and curiosity. I realize that mosty people who write in to this particular forum merely think that they were exposed to HIV, and only a very, very small handful actually were. And an even smaller handful actually contract the virus.

My question to you is this: Seeing as how there is so much conflicting information out there regarding HIV and HIV ARS, could you please shed a little light on what you might consider a "typical" case of ARS?

And if I'm not stepping way out of line here, would you mind discussing what ARS was like for you? I completely understand if you don't feel that this is something for the masses, but there are many positive benefits to hearing things firsthand. Regardless, I will continue to donate to Concerted Effort, and wish you all the best!

Response from Dr. Frascino

Hello,

I don't believe there is such a thing as a "typical" case of ARS or a "compassionate" conservative. ARS symptoms vary greatly from person to person, and may be so mild as to go essentially unnoticed or be so severe as to be debilitating. I can give you the frequency in the form of percentages of various signs and symptoms of primary HIV infection. Perhaps that will help. Fever 96%, enlarge lymph nodes 74%, sore throat 70%, rash 70%, muscle aches 54%, diarrhea 32%, headache 32%, nausea and vomiting 27%, enlarged liver/spleen 14%, weight loss 13%, thrush 12%, neurologic symptoms 12%. Remember, however, that symptoms, even all of the above listed symptoms, do not equal HIV disease. There are many illnesses that can cause these symptoms. The only way to know if you've contracted HIV is to get tested.

My ARS included seven of the symptoms listed above.

Thanks for your willingness to donate. Details about the Foundation can be found at www.concertedeffort.org.

Stay well.

Dr. Bob



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