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Worried well-or unlucky < 1%

Jul 19, 1999

Dear Mark, I note your kindness in responding to this sort of query, so here goes: 5.5 years ago I had 3 massages from the same sex worker. On each occasion she rimmed me without protection. I had never experienced this before, but enjoyed it, and thought it risk free as presumably only her saliva was involved(although her tongue tended to become insertive). On the last occasion, 1 or possibly 2 days later, I discovered a painless swelling on my rectum, looking rather as if a blood vessel had swollen. I thought perhaps that the vigour of her actions had caused a hemmorrhoid to develop. By the next day it had gone. 4 years ago I changed jobs and, at a routine medical, blood( not visible to naked eye) was found in my urine. Various prostate, bladder(internal examination)and kidney tests were performed-nothing was discovered. Some 2 weeks later the consultant told me that the final test on my urine cytology was "mildly abnormal"-excess number of normal cells. Further monitoring continued for a year with no development and my consultant said no further monitoring was necessary. I had met and married my wife just before this medical and therefore put all this behind me until now. I am now experiencing clinical events including, small red/purple "blood-like" spots, about 25 of pinhead size on my scrotum, a non-healing lesion(-red circle, white centre),on my lower leg,pain in my ears and neck, slight nausea, and a flare of acne especially on my neck ( I am 47).Worst of all, my wife has a similar,more nodular,non-healing lesion on her left leg also. She has also complained of swollen glands. Could I have had an unusual ARS? Was my encounter much riskier than I thought? Your views would be much appreciated.

Response from Dr. Holodniy

That act would be considered very low risk. You don't indicate whether you ever received an HIV antibody test, or whether you had any further high risk exposures. What you describe would be considered very nonspecific and not related to ARS. MH



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