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Fatigue and AnemiaFatigue and Anemia
           
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Fatigue, Muscle Soarness
Sep 9, 2002

Hi Doctor, These bulliten boards are an absolute GOD SEND for inquiring guys like me (and hypochondriacs... also like me :) When I had Molluscum Contagiosium a year ago, I flipped out because I was sure it was a sign of HIV. Coming to these boards helped calm some of my fears. I've tested negative consistantly since then. Well now I have another concern. I spent the summer in New York City. I was pretty good the whole summer, but during the last two weeks, I became buddies with this guy who lived out in Connecticut. Well the long and short of it is that we had unprotected anal... I recieved. He never ejaculated in me. Also, he NEVER recieves and lives in a rural part of Connecticut. (I tell myself these things to help myself feel better about what happened. But basically... IT WAS A MISTAKE). Well now I am flipping out again... primarily because of muscle aching that has lasted for two weeks (about 3 weeks after last recieving unprotected anal) and fatigue that sets in at 5PM everyday about. What could be the problem? HIV???? Is this anemia? Is anemia ever NOT HIV related? Ok, ALso, I read some stats about HIV among young gay men. Tell me what you think. I read that 1 out of 10 young gay men between the ages of 18 and 25 has HIV. DOES THAT SOUND RIGHT?????

I read ANOTHER stat on HIV (that made me feel a little better). Tell me what you think. The chances of catching HIV by recieving unprotected anal from a POSITIVE partner is 1 in 50. (WOW... thats pretty good!)

The chances of catching HIV by giving unprotected anal to a POSITIVE partner are 1 in 500. COULD THAT BE?

Finally, another thing that occurs to me. I cut my finger pretty badly on a shaver earlier this summer that belonged to my shady gay roomate. What is the likelihood of catching it from that? If there is HIV infected blood somewhere, does the HIV ever die in there? Or is it contaminated indefinitely?

SINCERELY, JOE

Response from Dr. Frascino

Hey Joe,

Thanks for your kind comments. Yep, unprotected receptive anal sex is indeed a mistake. The fact that there was no ejaculation decreased the risk somewhat. The fact that the other guy lives in rural Connecticut really doesn't impress me one way or the other. You just never know about those farm boys! (Just ask the sheep and cows who reside on the farm!)

OK, your symptoms . . . . You get tired at 5 p.m. everyday. Ummm Joe, almost everyone gets tired at 5 p.m. It's quitting time at the office. Remember Dolly Parton's old song, "Working Nine to Five?" Muscle aching is really not all that suggestive of an acute seroconversion reaction without other symptoms - fever, rash, nodes, etc. Is this anemia? No, probably not. Anemia can cause fatigue, exercise intolerance, rapid heartbeats, shortness of breath, headaches, difficulty concentrating, and lots of other problems. But I doubt this is really your problem. Is anemia ever not HIV-related? Absolutely. Anemia can be caused by genetic abnormalities, blood loss, medication-induced, nutritional deficiencies, and a whole host of other causes.

The statistics you read may well be true. The 1 out of 10 young gay men probably refers to a specific population. For instance, young gay black men living in cities have even a higher rate. The odds ratio of 1 in 50 for acquiring HIV from receptive unprotected anal sex is either pretty good or pretty bad, depending on how well you like those odds. Also, it's quite dependent on many factors - viral load and the presence of rectal mucosal trauma, to name a couple.

Finally, the shaver cut. HIV does not survive very long outside the body, so you are probably not at significant risk from the cut. By the way, why are you living with a shady roommate? Can't you find a sunny one?

OK, Joe, bottom line: You'll need an HIV test at 3-months. Let's hope that Mr. Connecticut's only previous unprotected exposures were with Elsie the Cow (and before you ask, no you can't catch Mad Cow Disease this way).

Also Joe, remember what your mother told you, "Wear your rubbers." OK?

Good luck.

Dr. Bob


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