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Broken condom, central Africa, symptoms, early testing. Hotline?
Feb 18, 2002

Dear Dr. Kull,

you site is very helpful, but is there a hotline that you can recommend where I can get answers to my questions? Thank you so much.

I really need your help, please. I am going absolutely crazy, cannot function or sleep. I have earlier posted the questions below but things have become worse: I now have red sores on my face and blisters underneath my tongue. Is it possible to have most if not all symptoms of AVS between 2 to 6 weeks after possible exposure but test negative after 4 and 5 weeks (Eliza test)? Thank you very very much.

About six weeks ago, in a drunken stupor, I had sex with a girl in central Africa. The condom broke during intercourse. It happened immediately after we changed positions, with her on top of me. I heard the condom break and immediately withdrew, a matter of seconds. I removed the condom and immediately replaced it with another. While no money was exchanged for the sex, I know nothing about the girl, other than that I met her in a club. I understand from this site that the risk of infection in the event of a broken condom is relatively low. My first question is whether this risk would be different in my circumstances, i.e. (i) that the condom broke right at the top, thereby probably exposing the top of my penis, (ii) while I was under and (iii) that it occurred in central Africa.

I believe that during the last four weeks I may have had the following symptoms of AVS: sore throat, excessive sweating during the night as well as during the day (hands, feet, knees but not arm pits), perception of feverish flashes, stomach ache, loose stool, swollen, painful glands in throat and armpit, blisters inside and outside of lip, unusual red spots on upper body and around eyes and muscle pain in arm. I feared at one time that there were discolorations inside my throat, but am no longer sure. The swollen painful glands and sore throat remain. Today I noticed a new reddish spot on my cheek (a quarter inch in size) with a slight change in skin condition that I cannot explain. My second question is whether you believe these symptoms are consistent with AVS.

I know that a HIV test is not conclusive until at least three months after possible infection. But I was thinking that if I do have symptoms of an infection (such as AVS), signs of an infection would become clear from a blood test (?). I have already taken two Eliza HIV tests (in Uganda the last one after five weeks after the possible exposure). Both tests came back negative. My third question is: what is the significance of these tests at this stage? Is there any reason for me to feel relieved with the results?

Thank you very much for your advice. Cheers and God bless.

Response from Mr. Kull

The Centers for Disease Control and Prevention has a helpful hotline to answer HIV-related questions:

CDC National AIDS Hotline: 1.800.232.4636 (English, Spanish and TTY)

Have you seen a doctor about your symptoms? That would be an important first step in any case. Many regions of Africa have the highest prevalence of HIV infection in the world, so the odds of coming into contact with HIV are greater when having a heterosexual exposure in Africa. It is impossible to guess the likelihood of infection in your case based on some of the nuances, but the odds of infection for the insertive partner with condom breakage are low. This does not mean that you should not get tested and that you should pursue medical attention for the symptoms.

RMK



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