Let me start with HIV testing first, since you mention ELISA stage.
(See below) You can and should get tested right away ? now is the best
time. The standard antibody test MAY not show up yet, meaning if you
get a negative result, you should be tested again in several months,
and again several months after that! Typically antibodies show up 3
months after exposure, but it may take up to 6 months. There is a good
test, called the P24 test, but it may not be readily available. Below
I have listed how to find a clinic in your area. Call these clinics
and ask if they can run a P24 test. This test can pick up the HIV
antigen earlier than the conventional test.
?The second type of test is P24 antigen testing. It is primarily
used to screen the blood supply but in some places it is used for
testing for HIV in individuals. P24 antigen is a protein that is part
of the HIV. Early in the infection, it is produced in excess and can
be detected in the blood serum by a commercial test. The P24 test can
detect HIV infection before the HIV antibody test can. Therefore, P24
antigen testing is used in diagnosing HIV early in the course of
?p24 testing may be used to detect early HIV infection and to screen
donated blood for HIV. Since p24 levels rise and fall with HIV levels,
the test may also be used to monitor anti-HIV therapy and to evaluate
disease progression. The advantages of the p24 test are that it can
detect HIV infection days earlier, before antibodies develop, and that
it is a quantitative test that tells the intensity of HIV expression
in the body, which is a measure of how fast the disease is
ELISA stands for Enzyme-linked immunosorbent assay, the testing
methodology, and really does not refer to HIV incubation periods.
ELISA can be used in testing for the presence of antibodies and
antigens other than HIV as well.
?The ELISA is almost always the first screening tool; it is
inexpensive and very sensitive. In most cases, a blood sample is
tested, but other types of ELISAs that use saliva and urine have also
been developed. The actual ELISA takes 3.5 to 4 hours, but most test
sites send samples to outside labs, where they are tested in batches,
so you may have to wait one to two weeks for results.
Beyond the "window period," discussed above, ELISA tests are very
rarely "false negative." This means if you have a negative test
result, and you were tested at least six months after the last
potential exposure, you are really HIV negative. An ELISA test may
rarely be "false positive." False positive ELISA results can occur if
someone is tested right after events that temporarily stimulate the
immune system, such as viral infections or immunizations. They could
also occur because of lab error, or because of the test's very high
sensitivity, discussed below.
For these reasons, positive ELISA results must always be confirmed
with a Western Blot or IFA (below), and at reputable test sites this
is commonly done automatically -- meaning you don't have to come for
another blood draw.?
?The Enzyme-Linked Immunosorbent Assay (ELISA for short) is a
biochemical technique used mainly in immunology to detect the presence
of an antibody or an antigen in a sample. It utilizes two antibodies,
one of which is specific to the antigen and the other of which is
coupled to an enzyme. This second antibody gives the assay its
"enzyme-linked" name, and will cause a chromogenic or fluorogenic
substrate to produce a signal. Because the ELISA can be performed to
evaluate either the presence of antigen or the presence of antibody in
a sample, it is a useful tool both for determining serum antibody
concentrations (such as with the Human Immunodeficiency Virus, HIV
test or West Nile Virus) and also for detecting the presence of
Get tested as soon as possible ? both for your peace of mind (a
negative result) and to get treated should you have a positive result.
Look for an STD clinic in your area. I used Google and the search
terms STD clinics + NYC. Simply change NYC for your area to find a
location to get a confidential blood test.
If you decide not to get tested, please advise any partners that you
may have been exposed to HIV and always use a condom.
?Why Should You Be Tested: Pros And Cons
?If you know you are HIV-positive, you can take advantage of immune
system monitoring and early treatment and intervention.
?By taking the test, you can find out whether or not you can infect others.
?Regardless of the result, testing often increases your commitment to
overall good health habits.
?If you test negative, you may feel less anxious after testing.
?Women and their partners considering pregnancy can take advantage of
treatments that potentially prevent transmission of HIV to the baby.
?If you test positive, you may show an increase in anxiety and depression.
?When testing is not strictly anonymous, you risk job and insurance
discrimination. You can prevent this by ensuring that you test at an
anonymous testing site.
Whether or not to take the antibody test is an extremely personal
decision. We cannot make that decision for anyone. We can only advise
you of the implications of a positive and a negative result in your
life. The decision is yours.?
Early Symptoms of HIV
?The first thing that happens after infection is that many people
develop a flu-like illness. This may be severe enough to look like
glandular fever with swollen glands in the neck and armpits,
tiredness, fever and night sweats. Some of those white cells are
dying, virus is being released, and for the first time the body is
working hard to make correct antibodies. At this stage the blood test
will usually become positive as it picks up the tell-tale antibodies.
This process of converting the blood from negative to positive is
called `sero-conversion'. Most people do not realise what is
happening, although when they later develop AIDS they look back and
remember it clearly. Most people have produced antibodies in about
?AIDS: Recent evidence indicates that very early therapy will
improve prognosis and perhaps even eradicate HIV; however, primary HIV
infection is not being recognized because the diagnosis is not
considered. To aid in early HIV diagnosis, the natural history of
Acute Retroviral Syndrome (ARS) is outlined, including clinical
presentations. It is known that a large proportion of patients seek
medical attention during the acute retroviral infection stage at which
time the patient most commonly suffers from either fever, sore throat,
fatigue, weight loss, and/or myalgia. Although data are limited, there
is a strong case for starting antiretroviral therapy as soon as
possible after a patient is diagnosed with ARS. Duration of treatment
has yet to be determined. Recommendations for an initial diagnostic
and therapeutic approach when a patient presents with possible ARS are
?The symptoms usually last 3 to 14 days and go away on their own,
just like the flu. It is estimated 50% to 90% of persons infected
will get this syndrome. The most common symptoms are fever (fever
means 100?F or higher), sore throat, swollen glands in the neck,
armpits and groin, muscle and joint pains, rash and/or night sweats.
Less common symptoms include weight loss (10 to 15 pounds), diarrhea,
nausea, headache, and, very rarely, yeast infections of the mouth
(thrush). Respiratory things like runny nose, sinus infection,
coughing, sneezing, etc. are not generally considered symptoms of this
The symptoms do not generally last longer than 14 days and will rarely
occur 6 or more weeks after exposure. The symptoms may range from
mild to severe, but mild symptoms will typically last a shorter period
of time than severe ones, and the symptoms that are going to occur
usually do so all at once. After this period, you most likely will
not get another HIV-related illness for 10 or more years; however,
there have been rare cases where the person went directly into AIDS
All of these symptoms may be caused by other factors, including the
flu or stress. You cannot diagnose HIV based on symptoms, only by
testing; however, if you experience these symptoms after a high-risk
encounter, you may want to see your doctor.?
?Some people, but not all, develop symptoms within a month or two
of exposure to HIV. These people may have a flu-like illness with such
?Loss of appetite
?Swollen glands (enlarged lymph nodes )
?Achy muscles and joints?
?But about two-thirds of people who become infected with HIV
develop some early symptoms, usually two to four weeks after they were
infected. This illness is termed "acute retroviral syndrome" or
"primary HIV infection." The syndrome is similar to the flu. The most
common symptoms are fever, sore throat, swollen lymph nodes and a
rash. The rash usually consists of small raised or flat lesions
scattered all over the body, sometimes on the palms and soles. Ulcers
can also develop -- particularly in the mouth, but sometimes on the
skin and genitals.?
?Many people do not develop any symptoms when they first become
infected with HIV. Some people, however, get a flu-like illness within
three to six weeks after exposure to the virus. This illness, called
Acute HIV Syndrome, may include fever, headache, tiredness, nausea,
diarrhoea and enlarged lymph nodes (organs of the immune system that
can be felt in the neck, armpits and groin). These symptoms usually
disappear within a week to a month and are often mistaken for another
viral infection. During this period, the quantity of the virus in
the body will be high and it spreads to different parts, particularly
the lymphoid tissue. At this stage, the infected person is more likely
to pass on the infection to others. The viral quantity then drops as
the body's immune system launches an orchestrated fight.?
?The earliest symptoms of HIV infection occur while your body
begins to form antibodies to the virus (known as seroconversion)
between six weeks and three months after infection with the HIV virus.
Those who do show early HIV symptoms will develop flu-like symptoms.
This can include: fever, rash, muscles aches and swollen lymph nods
and glands. However, for most people, the first symptoms of HIV will
not be apparent.?
?Acute Infection: Early symptoms of HIV, (one to four weeks) can
mimic that of mononucleosis-like symptoms. Symptoms include, swelling
of the lymph nodes, headache, fever, loss of appetite, sweating, and
sore throat. Often times this can be mistaken as having the flu or
another viral-type infection. Some people may develop skin rashes on
the chest, abdomen and/or back.?
This well done chart outlines the symptoms and time of duration of
Pictures of HIV rash
?A photograph showing an urticarial rash, in this case seen in a
patient that is HIV positive. Cutaneous manifestations are common
clinical findings among HIV positive patients, mostly due to the
alterations in the immune system. The causes may be bacteria, viruses,
fungi and other non-infectious agents, such as a reaction to drugs.?
? Tinea Versicolor is due to a Yeast Infection of the skin.
The yeast that causes the rash is found on almost all of us. However,
it only affects a few people. It is not known why only some people
develop the infection.?
Secondary syphilis can cause swollen lymph nodes and a rash.
?The most common symptoms include:
?a rash of flat, red lesions over the whole body (including the palms
of the hands and soles of the feet)
?broad-based papules (lumps or warts) in warm, moist sites
?mucous patches or snail-track ulcers in the mouth, appearing from 3-6
weeks after the chancre develops
Active bacteria are present in the sores, so physical contact (sexual
or nonsexual) with the broken skin of an infected person is not
recommended as transmission of the disease is possible.
After several weeks or months the rash seems to heal itself.?
?The primary stage is marked by the formation of a painless
herpetiform ulceration at the site of inoculation.
The secondary stage is classically described as the inguinal syndrome
in men, characterized by painful inguinal lymphadenitis and associated
?Tender inguinal lymphadenopathy, usually unilateral, is the most
common clinical manifestation.
?Lymphatic drainage from the penis is through the inguinal lymph
nodes; thus, heterosexual men are affected most often in the inguinal
?Homosexual men and women who are receptive to anal sex may develop
perirectal and pelvic lymph node involvement. In women, these nodes
may also become involved as a result of lymphatic spread from the
cervix and posterior vaginal wall.
?Early in the course of the disease, the nodes appear fleshy and show
?Later, suppurative granulomatous lymphadenitis and perilymphadenitis
occur with matting of the nodes. Frequently, these nodes coalesce to
form stellate abscesses.
?Histologically, these abscesses are nearly diagnostic, but the
clinical appearance may be similar to those seen in other infections,
including cat scratch fever and mycobacterial granulomatous
Here is an STD symptom comparison chart:
Worried1, I urge you to see your doctor or an STD clinic
immediately. You may or may not have HIV or another STD. Many
conditions can mimic ARS (acute retroviral syndrome), and you need to
have yourself diagnosed. You ask if it could be strep. Is that why
you took erythromycin? Did you tell the provider who prescribed
erythromycin your concerns over HIV or another STD?
If you visit an STD clinic or your own physician, you can be sure an
entire STD workup will be done, including tests for gonorrhea,
syphilis, herpes, HIV and Chlamydia. You will be asked the names of
your sexual partners if positive, so be prepared to provide names and
phone numbers ? they must be tested and treated (if needed) too.
I can?t tell you the probability of HIV or any other STD,
especially if , as you say, you engaged in risky behavior. I can tell
you that risky behavior is, well, risky (And fatal)! If you have
escaped this time with nothing more than a strep infection, or an STD
that can be cured with antibiotics, please don?t expose yourself to
the risk of HIV or herpes again!
I hope this information has proved useful. If any part of my answer is
unclear, please ask for an Answer Clarification, and allow me to
respond, before rating. I will be happy to assist you further, before
Please see your doctor and ease your mind by being tested.
ARS + HIV
Early symptoms + HIV + ARS
STD + swollen lymph nodes + rash