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I am worried
Aug 7, 2001

Please excuse me for writing such a long E-Mail but I would really appreciate your advice! I understand that you recommend asking such questions to Mr. Ryan in his forum, but I have been quite depressed and very tired and I have lost interest in many activities I usually like since the beginning of July. I beg you to answer to my question as soon as possible because I really admire your competence. I have been worrying about maybe being infected with HIV for already 4 weeks. Please let me tell you the background: I am 22 years old, male, and I had a date with a girl (21) in university in mid-April. We ended up fooling around in bed. This was the first time that I had a sexual experience (although no penetrative vaginal, oral or anal sex). She always kept her underwear on and I had my underwear and my clothes on but it may well be that for a few moments my erect penis was coming out of my underwear and got exposed to her vaginal secretions that soaked her underwear while kissing around in bed. So maybe you would call that "unwanted grinding of a naked penis against wet underwear". I know that there has never even been a case of infection through real "grinding" because I read almost all of the postings and the articles at "The Body". And she always had her slip on, there was no insertion or direct skin-to-skin contact between my penis and her vagina. I also had contact to her vaginal fluids on her underwear with my fingers while fooling around in bed, but according to your postings there has also never been a case of infection due to fingering. I think I can rule out the possibility that there were fresh sores or fresh hangnails on my fingers.

My first question is: Is it true, as I read on another website, that the vaginal fluids have to get INTO the tube of the penis to possibly cause infection or would "superficial" contact be enough? So these are the facts.

It came to my mind that in the past I had repeatedly experienced headaches. There was no fever or sore throat. Nothing of that lasted longer than a few days. The first headaches and some tiredness occurred 5 weeks after the encounter and lasted about 2-3 days, but that was after a flight from USA to Europe, so I think it was a Jet Lag. But I thought maybe I was going to catch the flu (which luckily I didn't). Several days before the flight and the headaches I also caught a cough that occurred each evening around 10 p.m. and lasted for about an hour. This cough started after being in a cool place in Canada where I lost my voice which I regained after maybe 3 days. The cough lasted for about 1-2 weeks. But I know that a cough is not usually a symptom of ARS. 2 weeks (during which I felt fine) after the headache and tiredness described above (i.e. 7 weeks after the encounter) I again had a headache that lasted for I think about 2-3 days, but no fever, no sore throat or anything else I could remember, maybe a little tiredness that may have been caused by the headache and a lot of computer work. The cough had already disappeared. The headache now sometimes occurred in the morning after waking up and then got less during the day or even disappeared after taking aspirin pills, sometimes came back during the day. But I didn't feel like if I had the flu. And after 2-3 days it was over.

Now I am constantly worrying about a possible infection with HIV, although I have the feeling that I should not. I just can't seem to stop thinking about possible symptoms that I might have experienced but already forgotten. I permanently think of the low risk I have but that this means that there IS a risk. I know that it was an extremly low-risk encounter and it is not recommended by the CDC to get tested in such cases, true? Also the girl told me that she never had any STD's and that she doesn't get herself into situations where she could easily pick up any. She didn't understand my worrying. But she was the only person i got intimate with in my whole life until now (I am 22 years old). I really don't want to get tested, because I would definitely start worrying again after each similar low risk encounter that I might have in the future and so I would talk myself into getting tested again each time. This would lead to nowhere so I don't want to get tested if it is not really necessary because of a real risk. I know, as I already said above, that headaches and a little tiredness alone are not really symptoms but if you told me that you would not worry and that you would not want to get tested if you were in my situation this would help me really out of my depression. Thank you for reading this and please answer very soon!!! Thank you very much and please excuse that I ask these questions to you in this forum. Keep doing such a good job!

Response from Dr. Frascino

Hello,

First off, I must know what was "unwanted" about it?

Your right: Questions about possible infection must be asked in Mr. Ryan's forum on Safe Sex and HIV Prevention, if you want to get a response. Since you complain of feeling "very tired," I'll offer at least a very abbreviated response in this forum dedicated to HIV-related fatigue and anemia questions, and recommend that if you have any additional concerns related to possible infection or safe sex, you ask them in the Safe Sex Forum. OK?

Your chances of being infected from "unwanted grinding of a naked penis against wet underwear" - zero, zip, zilch, nada - just as the CDC suggested and also just as you anticipated.

Your symptoms are not suggestive of an acute seroconversion reaction, just as you anticipated.

Your problems - fatigue, loss of interest in activities, constant worrying - are the result of anxiety and depression, again just as you anticipated.

You don't need an HIV test. You need a counselor who can help you cope with your irrational fears. This was your first sexual experience!?! Sex is a wonderfully fulfilling, extremely enjoyable, highly desirable, and as far as I'm concerned, essential aspect of human nature. You've obviously read about risk behavior. Now you need to decide what level of risk you're willing to accept. Every time you cross the street or drive a car, you accept some degree of risk. You can drive within the speed limits, wearing your seat belt, or you can choose to not use your seatbelt and drive at reckless speeds with your eyes shut and one leg hanging out the window while talking on your cell phone with one hand and applying styling gel and combing your hair with the other. You choose the level of risk. So it's back to the Safe Sex Forum to learn as much as you can. Find a counselor to help you cope with your fears and to find a level of sexual risk that you're comfortable with and willing to accept. Hopefully, your future sexual adventures will be pleasurable, guilt-free, safe, and "wanted."

Dr. Bob


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