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Fatigue and other mild symptoms
Jun 17, 2002

I know this is not the proper forum to answer am I infected Questions, but I really admire the way you educated people about HIV transmission and the way you seem to sincerely care about others.

Im a 26-year-old heterosexual male. I have been in a relationship for about 5 years. In this time on various business trips I have had intercourse with escorts. I always practiced safer sex, but many times I received unprotected oral sex.

About 2 months ago I had what I believe to be a high-risk exposure. I was having sex with two women (sex-workers) at the same time in a hot tube. I received protected oral and protected vaginal sex. After having protected sex with one of the women for about 20 minutes we stopped for a minute. While we were taking a break in the hot tube my condom broke. I was not having sex at the time it broke, but we were still in the hot tube. Can HIV travel and survive in hot water? I know this may sound like a crazy question but about 6 weeks after this incident I started have some mild symptoms that I cant explain.

Six weeks after this exposure I got a cold (dont know if it was the flu) that lasted about 4 days. I was very tired, had a very sore throat, sores in my mouth (I have always gotten sores in my mouth for as long as I can remember, they always go away in a week or two), I woke up two night sweating (Not poring sweat, just sweating a little), I had severe diarrhea (I have had diarrhea 1-2 times a week for the past 6 years) and I felt tiered and my arms hurt. Now three weeks later I have a rash on my chest, it has been there for 2 days it is very small (about inch by inch). It is dry and has two small raised bumps. I also have redness around my nose and forehead (its very light and I have had it about 5 years) and I feel really dizzy a lot (I have felt this way about 5 times a week for the last 3 years). For the past few years I have also noticed what appears to look like 2 small light colored dots on the head of my penis (can these be freckles?). I never got a fever after this last incident.

Before thinking anything about HIV I went to the doctor because I felt tiered a lot. After giving me basic blood work he said I was not anemic. The only problem I had (beside being 30 lbs over weight) was my cholesterol was 305. During this time I had unprotected sex with my girl friend many times.

Now two weeks ago she got a swollen and very sore throat. A few days after that she began coughing. She is still coughing and complaining about headaches. She never got a fever. Im very worried because of the timing of all these symptoms. I know it is impossible to diagnose somebody over the Internet but I just to ask a few brief questions:

1 Is a rash as small as mine consistent with the rashes found during ARS? 2 Could some of my symptoms that I have had for a long time be associated with stress? (Diarrhea, redness in face, extreme dizziness, mouth sores, dry mouth) 3 Is it possible these long-time symptoms exist because I have been infected for years? (I have never been tested) 4 I think I had cold-like symptoms, what is the difference between cold and flu symptoms. 5 Was my risk in the hot tube a high-risk exposure?

I would be very grateful if you can find the time to answer my questions. I would also like to know how to make a donation to you organization.

Response from Dr. Frascino

Hello,

Two sex workers at the same time in a hot tub? Hmmm . . . sounds like a movie I once saw.

The activities you describe - protected oral and protected vaginal sex - are indeed considered safe. Having the condom break while you were "taking a break" is not worrisome. Just having an unprotected Mr. Happy in a hot tub with a couple of hookers is not considered a risk. HIV does not survive well in hot tubs, let alone have the capacity to backstroke over and infect you underwater!

As for your symptoms, no they do not sound like HIV seroconversion to me. Also remember, if Busty and Lusty were with you in the hot tub 2 months ago, they couldn't possibly be responsible for 1) sores in the mouth that you have gotten as long as you can remember, 2) intermittent diarrhea you've had for 6 years, 3) redness on your nose and forehead for 5 years, 4) dizziness for 3 years, and 5) freckles on the penis for a few years.

To answer your questions:

1. No, your rashes are not consistent with ARS. 2. Yes, stress/anxiety frequently cause symptoms like the ones you describe. 3. Do I think you've been infected for a long time? Your symptoms are not at all suggestive of HIV to me, but of course the only way to know for sure is to get tested. 4. The terms cold and flu are often used interchangeable these days. Flu is technically caused by influenza virus and colds are caused by a variety of other viruses. 5. Your hot tub fun was definitely NOT high risk. In fact, it was about the lowest possible risk imaginable.

You're right. I can't diagnose anyone over The Internet, but I can let you know your risk was extremely low and that your symptoms are not consistent with ARS or established HIV infection. Your girlfriend's symptoms are also not suggestive of HIV. Have her see her doctor. It sounds like she may have sinusitis or bronchitis.

Donations to The Foundation can be sent to:

The Robert James Frascino AIDS Foundation 779 Altos Oaks Drive, Suite 200 Los Altos, CA 94024

Don't forget to follow up with your doctor about your elevated cholesterol. Getting down to your ideal body weight will probably help the cholesterol problem, increase your energy level, and most importantly, make you look better naked as you frolic in the hot tub!!!

Stay well.

Dr. Bob


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