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STRANGE FATIGUE/MALAISE
Apr 6, 2003

Dear Dr. Bob:

Thank you for all of the work that you do. The people who you help are really appreciative.

I have a question. A little over three weeks ago I had unprotected oral sex (giving and receiving)and protected vaginal sex with a woman of unknown HIV status. Three days after this encounter, I came down with severe flu-like symptoms (fever, bad muscle aches, weight loss) but they subsided after about four days or so. I felt fine for a couple of weeks, but these past few days I have been feeling a strange sort of malaise; a mild headache similar to the headache you would get if you had a fever. I go to take my temperature and it is normal. I also feel like I have less energy at work and at the gym. Could the early flu like symptoms have been early ARS after 3 days? Is my current malaise and fatigue possibly HIV related? Like I said, the vaginal sex was protected, but I am awaiting an STD test result from my doctor because I fear I contracted chlamydia. My doc, however, thinks I'm fine. Could one get chlamydia from receiving oral? Please HELP!! if you can because no one has given me a straight answer to my questions. I am going to take a DNA/PCR HIV test this Saturday and while I know it won't be conclusive, maybe I can get an answer?

Thanks for reading this and I really hope you can reply soon. I am really over anxious about all of this.

Thanks again.

smc

Response from Dr. Frascino

Hello SMC,

First off all questions having to do with possible infection need to be submitted to our Safe Swx and HIV Prevention forum, not this forum which is reserved for those folks who are already confirmed to be HIV positive. Other "am I infected" and "worried well" folks -- if you submitted your question in this forum and you are waiting for an answer from me, please note you'll need to resubmit your question to the other forum.

Secondly, I'm gay, but I'll try to give you a "straight" answer nonetheless. I'll post a brief response here but all future similar questions must go to the other forum. OK?

Your risk of HIV is extremely, extremely low. Protected vaginal sex (latex condom) is safe, and from recent reports, oral sex appears to carry a much, much lower risk than we previously thought. Next, your symptoms appearing 3 days following a potential exposure would not be related to HIV. ARS usually takes longer to develop. Can you get chlamydia from oral sex? Yes, you can. Your STD screen should pick that up.

So, to sum up, your risk was nearly non-existent and your symptoms, not really indicative of ARS (too early). Your malaise may be due to anxiety over fear of HIV. Follow up with your doctor for your STD screen. I agree with him: You are most likely fine. And, I doubt the need for that PCR test. Good luck.

Dr. Bob


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