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Can Coughing, Congestion, Aches, etc After Unprotected Anal Sex Be ARS?
May 21, 2008

Dear Dr Bob,

Recently, I was involved in two risky encounters during which I had anal-insertive unprotected sex with another man. Two weeks ago, this occurred, and he went down on me as well, and I penetrated him for less than 5 minutes. The second time was five days ago and was a similar experience, except he did not make out with me on this second occasion and appeared to be very tired before, during, and afterwards. I received a small paper cut on my forefinger several hours before the second experience, as well and after he ejaculated, believe my forefinger may have come into contact with his semen. Last time I was tested a few months ago, I was HIV negative, and I have had no other sexual experiences in 6 months besides these two. While this sex partner claims he is HIV negative, he readily allowed me to bareback him, and he travels very frequently throughout the world and thus has experiences with a variety of men. Twelve hours after my second experience with him, I had a sore throat and became very congested and have been achy, tired, and coughing up a lot of mucus and phlegm. I also quit smoking two weeks ago and never had the cough when everything comes up. I am concerned that me becoming sick so soon after these experiences may be ARS, especially since I have not been sick with a cold or anything else in over a year. I suppose it's also possible he may have had a cold when we met on the second experience, and he simply gave me that. I know it's too soon but am going to get an HIV test tomorrow and also request the acute reactivity test. If you have any thoughts about the risk level of these sexual experiences based on the information I have provided, it would be greatly appreciated. I am not going to see this person again, either way, due to the fact they are likely high risk. Thank you, Dr. Bob!

Response from Dr. Frascino

Hello,

First off, people are not "high risk;" unprotected sexual acts are! You report two risky unprotected anal-insertive encounters. These activities, your activities, are what are risky! It takes two to do the unsafe Hokey Pokey and you were a willing participant. That's point #1.

Point #2. Symptoms are unreliable in predicting who is and is not HIV infected. The reason for concern and testing is that you had unsafe sex. Period.

Point #3. HIV-antibody tests taken prior to the three-month mark are not considered to be definitive.

Point #4. We must assume all our sex partners could be HIV positive and take the necessary precautions to prevent STD/HIV transmission.

Point #5. I'm glad you gave up smoking, because if you didn't, it would indeed kill you in a very painful and undignified manner.

Good luck.

Dr. Bob



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