Dear Dr Bob, I am so sorry to clog up your inbox. I haven't written in a few weeks :) I am desparate for your answer. You and your work is an amazing gift. If I could tally up the hours (yah, hours) I have read your posts and archives over the last three months it'd be quite the number.

I had some risky sexual exposures between 100 and 120 days ago. (I am female, had vaginal sex w/male, condom broke one of the times, also had protected anal sex a few times and had several UNprotected times of me giving him oral sex) (I know the combined risk of all these is relatively low)

In the meantime: had 2-3 weeks of feeling exceptionally rotten in the beginning (11 days post first possible exposure) and the dr said "virus" (severe fatigue, overall ROTTEN, headache, sore throat, jaw pain, etc) Blood tests were all w/in normal range (no mono or strep) except slightly elevated white blood count. Went back a few days later b/c still feeling so rotten and WBC back to normal range. Tried to let it go. Went back to dr a month later, they said possibly a "cousin virus to mono" and said you're fine (did not repeat blood test, I was there for my yearly exam). Tried to convince myself it was guilt and shame for my actions but a few weeks later went to a different dr who said "sinus infection" based on my continued headache, ear pain (fluid in both ears), sore throat w/evidence of long time drainage, jaw pain. Ended up getting 2 consecutive rounds of different antibiotics only to NOT FEEL ANY BETTER. So now it's time I could test and know the answer of the at home test would be difinitive (dr office not an option b/c way too small-town and no clinics around to test). I broke down and went to an ENT dr yesterday (2 hours away, yah I'm in BFE) b/c my throat, ears and jaw are still bothering me so much. He could not find any reasons why I would be having these pains, pressure, discomfort,(no fluid in the ears or anything) so his explanation was muscles that are still inflamed from my "virus" this summer (July). He has put me on a 6-day course of prenisone (Methylprednisolone, actually)

Here are my questions:

1. can the methylprednisolone affect my test results?

2. While giving my 5 yr old son a bath 2 weeks ago I saw I had cut my finger and was bleeding (I was wiping up the kitchen immediately before going in to wash him and somehow nicked my finger and didn't realize it. I was cleaning in the kitchen he was in there playing and was washing him all his body parts, pouring water on his head, etc before I noticed the blood) I realize he would have only been exposed to a tiny bit of blood and if I were + the risk would be low,BUT now he has an odd rash on his bottom. There's a lot of small pink/red dots all around his bottom and 2 large red spots right in his "crack"... I AM TERRIFIED I HAVE INFECTED HIM. He sometimes has open owies on his bottom from not wiping properly at school. Can you please tell me what the ARS rash looks like? I have read your archives and know the risk of infecting w/bathtub is NON EXISTENT but what if there is fresh blood in the water that gets in his eyes/nose/ears/open owie?

PLEASE HELP ME. I am going nuts. Also- do you agree that all this pain could be caused from muscles that just haven't been able to calm down after a "virus"??? . Can I test now w/the prenisone and know it's an accurate result? And what about the ARS rash? Please please dr Bob. Somehow I have made it through this 3 month waiting period, and I must know. I am terrified and scared but wonder if maybe I just did get some run of the mill virus then coupled w/my non-stop worry and guilt and shame I have let my body get to this point? I am a single mom out in the sticks, scared out of my wits.

Thank you so much. I anxiously await your answers. I promise I will donate but it cant be til November. I have to pay my divorce lawyer w/this month's check and that one's gonna hurt :)

Sincerely, One Terrified Mama

Hello Terrified Mama,

If you think you've spent a lot of hours reading posts over the last three months, just imagine how many hours I've spent responding to questions and posting my replies!

Responding to your specific questions:

It's possible that methylprednisolone could affect specific antibody formation. (It would depend on the dose and duration of treatment.) I'd suggest waiting a few weeks after the last dose before taking your HIV-antibody test.

The HIV-transmission risk to your son, with or without "owies," is nonexistent.

I can't diagnose the cause of your symptoms over the Internet.

I've discussed the rash associated with ARS many times before in this forum. (See below for a sample of what you can find in the archives.)

Guilt, stress, anxiety and fear are certainly contributing to your symptoms.

Thank you for your desire to make a donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my good-health karma that your definitive HIV test will be negative.

Good luck.

Dr. Bob

ARS rash always symmetrical? May 16, 2009 Hi Doctor,

I'll keep this brief as I know you're busy. I had a very risky episode in Thailand a month or so back (full sex) and a few weeks later came down with what I thought was flu (fever, nightsweats and chills, serious sinus pain), but of course it started the worry off.

Ok everyone complains about this, so I conviced myself I was being stupid and I'd just got sick from the plane (I'd flown now to China) - however then I developed a rash (mainly smallish flat red dots, but a few bigger ones and a huge one on my chest) on my left upper chest, left shoulder and a few down my left arm.

I found some posts on here which say the rash is (always?) symmetrical (so I should have it on the right side too right?), but as I couldn't find any reference to this on any other websites, I just wanted to check if this was fact.

I'll get tested in 3 weeks when I return to the UK, but I would really love to try and calm myself a bit before I get there :)

thanks!

Response from Dr. Frascino

Hi,

The erythematous maculopapular rash on the face and trunk (and sometimes the extremities, including the palms and soles) is often symmetrical but doesn't exclusively have to be. The symptoms associated with acute retroviral syndrome are extremely variable from person to person. The reason to test (or worry) should be based solely on HIV-risk exposure, not the presence, absence or character of symptoms.

Good luck with your upcoming HIV test.

Dr. Bob