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Very worried about possible HIV infection
Oct 16, 2011

Dear Dr. Fawcett,

Thank you so much for all that you do. You don't understand how much I appreciate this site and your care. I am 19 years old and had unprotected vaginal sex with a questionable female mid-July (around 11 weeks ago). A few weeks later I experienced symptoms of some fatigue, nausea (especially in the morning) and overall malaise. These symptoms are still persistent, to an extent. What worries me more, though, is that around September (8 weeks after exposure) I noticed a decrease in appetite and that whenever I slouch I feel as if I can feel my liver enlarged. When I try to poke under my right rib I can feel some pain. It also is now uncomfortable for me to sleep on my right side, which was never the case before. I also believe I have some yellowing in my eyes (jaundice). I went to the doctor about a month ago and was tested for all STD's and HIV. I came back negative on all STD's and also negative on the HIV test. This test was performed 11 weeks after my possible exposure. Since I am young and reasonably healthy, is it possible that my body is better at fighting HIV so the antibodies take longer to form or something? I haven't had time to do in-depth scientific research and it seems hard to find answers to specific questions such as mine, but I appreciate your help. Also, if I am experiencing these symptoms and my test came back negative BUT if I actually had HIV, would waiting for a positive test decrease my chance of fighting the infection because I started anti-retroviral medications later? Is it possible to rid myself of the virus if I "catch" it early, but not as early as 72 hours as in PEP?

Thank you so much. I look forward to hearing from you and finally receiving a knowledge from an expert.

Response from Dr. Fawcett

Thanks for your question. I'm glad you are following up with testing and that it is coming back negative. I assume your doctor also tested your liver function which is standard with basic lab work and which would reveal any problem that could explain the tenderness. Unfortunately being young doesn't give make you less susceptible to acquiring HIV. A significant number of new infections are occurring among young people. As you noted, it is recommended to start PEP within 72 hours in cases of known exposure, although antiretroviral therapy is effective when initiated at a later time. Happily, your testing thus far indicates you are negative and will stay that way. A negative test six months after exposure is considered definitive in the US. Finally, the best advice: use protection.

-David



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