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What Are The Chances Of HIV Transmission Through Protected Sex?

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Posted on Tue, 15 Sep 2015
Question: I started having what my doctor is now calling a "fever without focus", excessive sweating including night sweats and occasional chills on 8/13. Fever has varied from 100.5-103.8, rectally. I really have no other symptoms. On Friday, 8/21, saw PCP and he said it's not the flu so he's done CBC, chest xray and urinalysis with results due back on Monday or Tuesday.

I had VERY CAREFULLY protected sex with a sex worker on 7/27, which is just over 2 weeks before the fever started. The condom did not break, it was, frankly, pretty much not touching other than what you absolutely had to do and at no point did she touch me without the condom other than while putting it on. Per CDC and others, I'm getting the impression that this is basically not even an exposure worth considering, but HIV ASR it appears to be a prominent cause for Fever without Focus. Am I still extremely unlikely to be infected?
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Answered by Dr. Noble Zachariah (3 hours later)
Brief Answer:
Unlikely to be ARS

Detailed Answer:
Hello,

Welcome and thanks for your query.
I understand your concern.
It is unlikely to be ARS due to HIV and fever is not the main feature of ARS.
As your doctor suspected, it is an infection probably bacterial, the site of which he is not able to pin down as you have no other symptoms. Hopefully the basic first line investigation your doctor has done will reveal the answer.
One likely site is the urinary tract.
In the meanwhile if possible, keep a record of your morning and evening temperatures to see if it follows any particular pattern. Had you traveled recently to any area where you could have picked up an infection or were you in contact with any one having fever?
Do get back with further information.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Noble Zachariah (35 hours later)
Thanks for the response. We are still awaiting the CBC and the urinalysis tests, but the chest x-ray came back clean.

The doctor DID give me a 5 day course of Azithromycin 250MG tablets. I'm taking the last one tonight and it certainly hasn't helped. In fact, I'm quite certain that my fever goes up each night after taking them. Highest I've seen was 103.9 on Saturday and 103.8 on Sunday (rectal). Morning temperatures are more like 100.8-102.3. The antibiotics HAVE made me a bit nauseous, but not very.

To answer your travel question, I initially thought I probably got this after traveling to XXXXXXX FL on Monday and Tuesday (8/10-8/11). No one I meet with there got sick, but I thought maybe the airplane? However, no one else got sick in XXXXXXX after I was there on 8/12 and 8/13 (I was unusually warm on 8/13 in XXXXXXX and had the first chill that night). Nor did anyone else get sick at an all day meeting I attended with about 100 people on 8/18 - I've gotta believe this isn't contagious, at least not by just being around people.

I guess I DO have another symptom - canker sores. I've never really had them before and I would have thought they started prior to the "non-exposure". I've thought they were due to vaping more than usual - i.e. the heat on my lips, but basically wasn't paying attention when I first got them. They mostly go away quite quickly and with no real pain. Basically only have a bit of chapped lips at the moment.
I guess I never really mentioned the fatigue either. I'm sleeping about 16 hours a day right now. I sleep about 9:30 - 8 and then can stay up for 2-3 hours before I just have to go back to bed. After a 2-3 hour nap I'm up for 2-3 hours again...

Results came back with Dr. prodding. I haven't seen them, but he said the urinalysis cultures didn't grow anything and the CBC results really don't point him in any direction. He says overwhelming probability is still viral of some kind. I'm going to see him in the morning unless I'm miraculously better. I did tell him about the "non-exposure", but got the feeling he tends to agree with you that it's not much of a probability - which would be more of a relief if anybody had any idea why I'm feeling so bad. Guess he'll figure out what else he wants to test for tomorrow.
doctor
Answered by Dr. Noble Zachariah (11 hours later)
Brief Answer:
Thanks

Detailed Answer:
Thank you for the feed back.
I agree it is an unusual type of fever.
It may be worth testing for diseases like Typhoid which are transmitted through food or vector borne diseases
Hope they will be able to pin it down and you would get well soon.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2319 Questions

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What Are The Chances Of HIV Transmission Through Protected Sex?

Brief Answer: Unlikely to be ARS Detailed Answer: Hello, Welcome and thanks for your query. I understand your concern. It is unlikely to be ARS due to HIV and fever is not the main feature of ARS. As your doctor suspected, it is an infection probably bacterial, the site of which he is not able to pin down as you have no other symptoms. Hopefully the basic first line investigation your doctor has done will reveal the answer. One likely site is the urinary tract. In the meanwhile if possible, keep a record of your morning and evening temperatures to see if it follows any particular pattern. Had you traveled recently to any area where you could have picked up an infection or were you in contact with any one having fever? Do get back with further information.