Assessing HIV Infection Risk and Symptoms After Protected Intercourse

Q: Assessing HIV Infection Risk and Symptoms After Protected Intercourse

Dear readers： 1. What is the probability of me contracting HIV given my situation? A. If you consistently use condoms and perform post-coital cleaning, the risk is low. 2. Do my symptoms resemble those of acute HIV infection? A. Skin symptoms and fe

HIV Infection Risks and Symptoms

Hello Doctor: I had vaginal intercourse with a condom the entire time, but after ejaculation in the female-on-top position, my penis became flaccid while still inside the vagina.
When I withdrew, the condom was caught by the muscles at the vaginal opening, so it did not come out with the glans (the condom seemed to be stuck at the upper vaginal opening).
I washed my penis and the urethral opening with hot water and soap within three minutes afterward.
(What is my risk of infection?) Fifteen days later, I experienced a fever for a few hours (axillary temperature around 37-38 degrees Celsius) that subsided on its own (fever started at 10 PM and resolved by 12:30 AM), and I did not take any antipyretics.
After that, I did not have any further fevers.
Five days later, which is twenty days after the incident, I developed irregularly raised rashes on my arms and legs, with about three on my right arm, two on my left arm, one on my chest, and two to three on each leg.
Photo: https://www.flickr.com/photos/126700115@N03/albums/72157657718360398.
Seven days later, which is twenty-seven days after the incident, I had a sore throat for about one day, followed by a large amount of thick yellow-green phlegm in the morning.
I have the following questions: 1.
What is the probability of me contracting HIV given my situation? 2.
Do my symptoms resemble those of acute HIV infection? 3.
Is it possible for acute HIV infection to cause a fever that lasts only two hours and then subsides, along with a sore throat producing a large amount of thick yellow-green phlegm? 4.
There are foreign research reports indicating that, in men, the inner foreskin can also be a route for HIV infection besides the urethral opening.
Is there a significant risk of infection if vaginal secretions on the condom come into contact with the inner foreskin? Thank you.

Luo Tàozhě, 20~29 year old female. Ask Date: 2015/09/03

Dr. Liao Zhongxin reply Internal Medicine

Dear readers:
1.
What is the probability of me contracting HIV given my situation?
A.
If you consistently use condoms and perform post-coital cleaning, the risk is low.
2.
Do my symptoms resemble those of acute HIV infection?
A.
Skin symptoms and fever can be concerning, but many diseases have similar initial symptoms.
It is advisable to consult a nearby hospital or clinic for anonymous testing.
3.
Is it possible for fever from acute HIV infection to resolve in just two hours, and can a sore throat produce a large amount of deep yellow-green phlegm?
A.
Many infectious diseases present with fever and cough.
If you are still worried, you should consult a local healthcare facility for evaluation and testing.
4.
There are studies indicating that, in men, the inner foreskin can also be a route for HIV infection, so is there a significant risk if vaginal secretions on a condom come into contact with the inner foreskin?
A.
If the foreskin is intact, it can harbor bacteria.
If there are ulcerative wounds, the risk of sexually transmitted infections (including HIV) is higher, and caution is warranted.

By Dr.
Liao

Reply Date: 2015/09/03

More Info

When assessing the risk of HIV infection after protected intercourse, it's important to consider several factors, including the nature of the sexual activity, the integrity of the condom, and any potential exposure to bodily fluids. In your case, you mentioned that you had protected vaginal intercourse, but there was a situation where the condom was partially retained inside the partner's vagina after withdrawal. This scenario raises some concerns, but let's break it down.

1. Risk of HIV Infection: The risk of HIV transmission during protected intercourse is significantly reduced when a condom is used correctly and consistently. However, if the condom was compromised or if there was any exposure to vaginal fluids, there could be a risk. In your situation, since the condom was still in place during withdrawal, the risk of HIV transmission is likely low, especially since you cleaned the area shortly after. Nevertheless, no method is 100% effective, and if there was any breakage or slippage, the risk could increase.

2. Symptoms and Acute HIV Infection: The symptoms you described, including fever and rash, can be associated with acute HIV infection, but they are also common to many other viral infections. The acute phase of HIV infection typically occurs 2-4 weeks after exposure and can include symptoms like fever, fatigue, rash, and swollen lymph nodes. However, the transient fever you experienced (lasting only a few hours) and the subsequent rash do not definitively indicate HIV infection. Many other conditions can cause similar symptoms, so it is essential to consider other potential causes.

3. Fever Duration and Symptoms: It is indeed possible for acute HIV infection to present with a brief fever. However, the presence of deep yellow-green phlegm and throat pain suggests a possible respiratory infection, which is not typical for acute HIV. Acute HIV symptoms can vary widely among individuals, and while some may experience prolonged fever, others may have milder or shorter symptoms.

4. Risk from Prepuce Exposure: Regarding the concern about the inner foreskin being a potential site for HIV infection, research indicates that the inner foreskin can indeed be more susceptible to HIV infection, particularly if there are micro-tears or abrasions. If vaginal secretions came into contact with the inner foreskin, there could be a risk, albeit lower than direct exposure without a condom. Maintaining good hygiene and ensuring that any cuts or abrasions are properly treated can help reduce this risk.

In conclusion, while your risk of HIV infection appears low due to the use of a condom and subsequent cleaning, it is crucial to monitor your symptoms and consider getting tested. The window period for HIV testing is typically around 3 months for the most accurate results, but some tests can detect HIV sooner. If you remain concerned about your symptoms or potential exposure, it is advisable to consult a healthcare professional for further evaluation and possibly an HIV test. Regular testing and open communication with sexual partners about health status are key components of sexual health.

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