Still terrified about ARS symptoms.


Hi Dr. Bob,

I wrote to you earlier "Very worried about ARS symptoms." and I would like to thank you for your quick response. I went to see my Dr. again 2 weeks after exposure because I was still very worried. He checked my tongue which was slightly coated and attributed the problem to antibiotics. At that time I had no fever and no swollen nodes.

Unfortunately in the days since, I have remained very tired, weak and have had intermittent muscle pain. I have only managed to gain back a slight amount of weight (1-2 lbs) despite regaining my appetite and no longer having diarrhea. I have also developed an on again off again rash on the palms of my hands and soles of my feet. It is worst when I carry things or walk for long distances. At other times it can be gone all together, but it has appeared at least once every day for the past week. I have also begun to develop a painful swollen lymph node on the left side of my neck. It is visible and there is an external bruise on it (I have been feeling it alot). I am worried that my armpit and groin lymph notes may also be swollen but I can't be sure.

Firstly, I was wondering how worried I should be about these symptoms and the fact that they are all appearing within the 2-3 week range. Secondly I wanted to ask if I should be checked for HIV again this week. I have read that detecting HIV during the ARS stage can greatly increase chances in battling the disease. What are your opinions on this?

Thank you so much for all the help, I will be making a big donation shortly.



  1. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. Your particular symptoms are much more consistent with anxiety than HIV.

  2. I would advise waiting until the three-month mark. Statistically the odds are all in your favor that you did not contract HIV from this broken-condom event. If testing were warranted during the window period, I would use the FDA-approved nucleic acid test: APTIMA HIV-1 RNA Qualitative Assay. You can read more about this test in the archives.

Finally, I again encourage you to seek help for your anxiety.

Good luck.

Dr. Bob

Very worried about ARS symptoms. Nov 29, 2010 Hello Dr. Bob

About 10 days ago I had sex with a "masseuse." I was careful to continue checking the condom, but it broke. I pulled out right away, I may have been in for approximately 10-30 seconds max. I also had about 30 seconds of unprotected oral sex.

Within 2 days I was urinating frequently, almost every hour and my penis felt irritated. My eyes and anus were also itchy. I saw my doctor a week later and I tested negative for STDs and HIV. He prescribed a large dose of antibiotic to eliminate chlamydia or gonorrhoea which I took right after testing due to stress.

The next day, my mouth and tongue became irritated and started bothering me. I became extremely stressed due to the fear of HIV. I have not slept much or eaten much despite my negative tests and reassurances from my doctor that these shouldn't be symptoms of HIV at such an early stage. Since, I have experienced some itchy, dry skin on my hands, torso and legs. My feet were swollen for one day and I have become extremely fatigued and am feeling weak. I have had some diarrhea and have lost almost 10 pounds. I also have Addison's disease which is making matters worse because I don't cope well with stress.

I have a few questions: 1) I know an HIV test at 1 week after exposure is not conclusive at all, but can I take any solace out of it? Is it indicative of anything at all or completely useless? 2) Can ARS symptoms in the mouth (redness on sides of tongue and sore gums) take place as soon as 6 or 7 days after exposure? 3) Can ARS symptoms as early as one week in cause weight loss of up to 10 pounds?

Also, I would like to say to anyone in a situation like this that it is best to come clean to their significant others. It was hard for me to admit my terrible mistake but even though my girlfriend was extremely upset and may never forgive me, it has made this experience more bearable by easing some of my guilt. I appreciate your quick result as I am a wreck and spend up to 6 hours a day checking symptoms of ARS and HIV. This site has been a lifesaver in trying to stay calm and I really appreciate the service you offer.

Thanks so much for the help!

	Response from Dr. Frascino


  1. All negative HIV tests can be considered encouraging. However, as you undoubtedly realize, a one-week test is way, way, way too early to be considered very helpful. It is essentially a baseline test.

  2. ARS symptoms vary considerably from person to person. Your symptoms are not worrisome for or suggestive of HIV ARS.

  3. Unlikely. Your weight loss is easily attributable to your diarrhea and that you "have not eaten much."

I absolutely agree with your wise comments about leveling with your significant other!

I would suggest you contact your doctor and ask for help with your anxiety during the three-month HIV window period. Anti-anxiety medication and/or psychotherapy (counseling) can be extremely beneficial. You should get a single HIV-antibody test at the three-month mark.

Good luck.

Dr. Bob