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Need your Help
May 13, 2003

Dr. Bob, First of all I would just like to say that you are an incredible person. Your respsonses are compassionate and despite your terrible misfortune you continue to stay positive. I know if I test positive (i am certain i have hiv) i can fight it and it's because of reading your responses.

I need your help and please don't disregard this question because this is an HIV only forum because I really need some advice. Exactly 6 weeks ago I had too much to drink and I engaged in vaginal intercourse with a brazilian prostitute (Rio). I was wearing a condom however it broke and I was exposed to not only her secretions but her menstrual blood (a lot of it!!) I have inside her about 10 seconds before I realized what happened. Well at the time I didn't think any thing of it. I proceeded to continue my week long alcoholic binge. 2-9 days after the incident I got a very high fever, severe diarahea, I couldn't eat anything, experienced weight loss of 8 pounds and had two night sweats (4th and 5th day) 2 1/2 weeks after the exposure I noticed a slight pain in my groin and one in my armpit. After i got back to the US I examined my body (and continue to do so) up to 10 times a day. I don't know if the pain in my groin and armpit is because of me putting pressure on it but I will say that when I tried to make them nodes sore a couple of days ago (applied pressure) it was a different kind of sore. Anyways the pain in my groin and armpit lasted around 3 days. At exactly five weeks after possible exposure I got a rash on my left arm that went away in approx. 10 hours. Also I have noticed a couple of red spots on my hands showing up out of nowhere. I am almost certain I have HIV. I didn't get any headaches, fever during the so called acute window period but why else would i get a rash and have swollen lymph nodes? I am really scared and I want to know what should i do. I have 2 more years of college to go and I am thinking about waiting until I graduate until I test. I have barely been able to get through this semester and I atleast have a slight chance of being negative. I want some advice because you are a stronger man than me, should I wait? I have heard that HAAT treatment should be started later after infection anyway. Please help.

Response from Dr. Frascino

Hi,

Thanks for your kind words, but tell me again why I should answer your "am I infected" question in a forum thats dedicated to those who are confirmed HIV-positive? Yes, you need advice, but if you want me to reply, please post your question to the proper forum. Your question belongs in the Safe Sex Forum, not here. Other "worried wells" and "am I infected" folks who have posted questions here, please note youll need to repost them to my attention in the Safer Sex Forum, OK?

Well, you may be certain you have HIV, but Im certainly NOT certain! And how could you waste a whole week in Rio on an alcoholic binge? I love that city the Ipanema beach, the Samba, the gorgeous Brazilians doing the Samba on Ipanema beach, etc., etc., etc. OK, so your exposure lasted 10 seconds and involved vaginal secretions and menstrual blood. Yes, that does constitute a risk, and I would recommend testing at the 3-month mark. The statistical odds are still way in your favor for NOT having contracted HIV!

Your symptoms? Well, you were traveling in South America and binging on alcohol. Consequently, contracting a diarrheal illness with some fever and sweats is not all that uncommon. Your rash sounds nothing like HIV seroconversion rashes. And for goodness sake, stop torturing your poor lymph nodes. You examine them 10 times per day? And you tried to make them sore?? Are you sure you only have 2 more years of college, because activities like that really arent very smart, now are they? Should you wait 2 years to get tested? Of course not! HAART Highly Active Antiretroviral Therapy (not HAAT, by the way) is indicated when CD4 cell counts fall into a range where the degree of immunodeficiency becomes a risk. Initiation of therapy is based on that risk and level of immune system impairment, not time. Do yourself a favor, college guy: Wise up and get tested! The odds are still very much in your favor. Even in a worse-case scenario, knowing you are HIV-positive (and getting appropriate care) will not kill you. Not knowing can. Write back with your results. I have the feeling youll be smiling. And remember, future questions like this must go to the Safe Sex Forum.

Good luck. We are all rooting for you!

Dr. Bob


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