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Woo Hoo in Asia Face the Test and Yourself
Aug 25, 2003

Dear Dr. Frascino,

Feel free to edit this message as you think necessary for conciseness, but I do hope it is posted in some form, since I believe it may benefit a number of people like myself.

First, let me say that I think this is a great site with a plethora of useful information.

However, secondly, let me caveat that point and add that as you say in so many of your responses, if you are really concerned and have reason to be, then there is no substitute for getting yourself tested.

I am a married heterosexual male in my mid 30s, living in Asia, in good physical condition, although mental health is another matter

Sexual History: Early in the 1990s I had unprotected sex and contracted herpes. Due to the initial infection and/or my stress that followed, and perhaps genetic predisposition, I contracted psoriasis. The herpes appears to be dormant and does not bother me, whereas the psoriasis is mainly a minor scalp irritation and only troublesome when I consume excessive amounts of alcohol, which is all too often in expat lifestyle in the tropics.

One would have thought that after my unpleasant experience, I would have learned my lesson and then limited my sexual behavior as well as always having protected sex, but it did not. I continued to have unprotected sex with more than one un-monogamous relationships. I sincerely believe excessive alcohol consumption is a serious risk factor to contracting HIV or any sexually transmitted disease unnecessarily. Due to my behavior, I had a number of HIV tests in the States, and each time I felt like I was walking to the gallows. Fortunately, it was always negative. Then I got married and told myself, no more, and moved to Asia.

After being in Asia for sometime and during a particularly stressful period, I fell victim once again to my nemesis alcohol, and acted irresponsibly to my family while out for a business evening with clients in a typical Asian bar offering business of a different sort. Believe me, Asia is a temptress for heterosexual males. It is all too easy. Fortunately, perhaps due to finally getting clue, I used a condom at least for vaginal sex. However, I was also given oral sex, and while being a receptor I think I was also a giver. You cant get HIV through oral sex can you??? Who knows, it is all such an alcoholic blur, I cant recall if I used the condom right? I know I used at least two, before finishinganyhow.

Immediately outside the bar I felt immense guilt which cleared my head, what had I done, again! This time it was not just irresponsibility to myself, but also my wife and infant child. I felt horrible.

A couple of days later I developed a rash in my groin, which although is fairly common here in Asia with the constant humidity, set off alarm bells. Then 12 days after the possible exposure I got tired and sick, I know it was 12 days because later because through the use emails and receipts of this or that I worked out the time frame of events backwards a whole year after the fact! I had flu like symptoms for a solid week, fatigue, runny nose, cough, sneezing, perhaps mild fever, etc... This was June, the rainy season in Asia and thus the flu season. In addition I was not getting enough sleep for a number of weeks due to work, and being under a great deal of stress. Nonetheless I started to wonder, did I expose myself and contract HIV or something else?

I searched the Web, and found that while HIV transmission was believed not possible due to oral sex, Gonorrhea and Syphilis were transmittable in this manner, and they have similar symptoms, especially an initial rash. I immediately got two 14 days regimes of doxycycline for me and my wife, easy to do here without a prescription, the harder thing was coming up with a story for why we should both take it! The rash gradually went away.

Additionally, at that time, I had some people visiting me and I was playing rugby and football, and generally partying it up with the boys while still under the weather. Maybe I should have rested more? Anyhow, for about a month I had a nagging cough and sneezing, although loads of other people did too, since this flu bug in Asia 2002 was particularly bad in the lungs in addition to the usual pollution.

Then after 10 weeks of the potential exposure I developed strep throat. I had been to the dentist who had some problems with their equipment and within 48 hours of my visit, my throat felt like it was sawed in half. I dealt with it for a couple of days, then got a groin rash while sweating away with fever in bed and went to the doc, was given penicillin and it went away. The groin rash persisted a little longer.

I tried to keep the thought of HIV infection out of my mind citing that risks rates were low, but then I keep getting fungal infections in the groin every so often. The more I stressed, the more I drank, the more they seemed to occur every few months. Was it being caused by an HIV compromised immune system?

My wife got pregnant and while in Europe on vacation over the holidays was checked by an OBG-YN and tested negative for HIV. I was relieved, however, my whole family got sick with some form the flu going around everyone stuffed indoors in the cold climates and unfortunately she had a miscarriage. She became pregnant again a few months later, and either due to her own stress or due to bad sperm from my copious amounts of alcohol and stress, or something else, she again had a miscarriage. Then I worried about the miscarriage, does HIV infected male sperm cause miscarriages? Time frame was now a year since the incident. My paranoia was starting to get the better of me, To the Web! Could it possible that I got HIV through unprotected oral sex? Yes, while an extremely low probability, yes it is possible. I didnt know that before.

I found lots of info, and I kept searching for a number of topics: Recurrent groin infections + HIV.

What is this about psoriasis and HIV? Psoriasis + HIV

Then I noticed my tongue was white, had it always been like this? White coated tongue + HIV. Oh my God, do I have Thrush?

Then I read about xerostomia dry mouth, it couldnt be too much alcohol, since I was always drinking the same amount. Dry mouth + HIV.

This went on and off for a few weeks. Then the final straw was while I using a flashlight to examine my white coated tongue, which seemed to be getting worse as I slept less, then I saw what looked like red patches on the roof of my mouth. Erythematous Candidiasis + HIV

I started to stress more, I couldnt sleep. I thought about being HIV+ day and night. I thought about my poor daughter growing up without a dad and what if I had also recently infected my wife?

I finally came to grips with what I had done, looked myself in the mirror, walked to the hospital, and got tested after a whole year had elapsed. I thought I would pass out while getting blood drawn. I had to wait three days for the results in this particular Asian country. In the meantime I was going out of my mind, my mouth was completely dry, I couldnt concentrate at work or sleep. Once again I felt like I was walking to the gallows. However, I told myself even if I was positive I would fight it and live as long as possible for my family and try to make it for what mistakes I had made.

Fortunately, I tested negative for HIV-1 and HIV-2. Immediately, my health improved. I slept better, my tongue was less white, and my whole personal health and disposition improved. In retrospect I sincerely believe that in my particular case, stress and alcohol consumption contributed to what symptoms could be perceived as those reflecting HIV+ status. Stress and alcohol were inducing psoriasis in my groin which was also possibly allowing for fungal infections. Stress and alcohol was also causing dry mouth / white coated tongue. Perhaps due to stress and alcohol consumption, I may have been also putting my body at risk for some other disease, like diabetes. Who knows?

The lesson learned is that there is no substitute for getting tested, IF you firmly think and have reason to believe that you may be at risk. The limbo situation of thinking you may be infected, while being too afraid too get tested and face oneself in terms of what one has done is worse than not knowing. This is especially true these days, since from what I have learned from my recent hours of searching the Web is that HIV+ status is certainly not an immediate death sentence. While I certainly will not pretend to be a doctor, I am convinced that the stress one causes oneself affects the immune system in a vicious cycle where more one stresses about being HIV+, the more it impairs the immune system causing more HIV+ like symptoms. Can anyone say, psycho-symptomatic? If you get tested and are HIV+, then one must get the will to fight. I realize this is easy for me to say now, but when I was walking to get the test results just a couple of weeks ago I was honestly convinced I was going to HIV+. If you get tested and are HIV-, then remember to practice safe sex and not put yourself in harms way again. Either way, getting tested and knowing is better than not knowing.

Dr. Bob, can you please give me that donor address once again. I made a pledge to myself to make a donation and surely want to follow through.

Response from Dr. Frascino

Hello Ex-pat WOO HOO in Asia!

Thanks for taking the time and energy to share the details of your story with others. I hope others will heed your advice, because there are an amazing number of WOO-HOO's out there just waiting to be connected up with an equally amazing number of worried wells who, like yourself, were wrongly convinced they were positive!

The Foundation information is listed below:

The Robert James Frascino AIDS Foundation 779 Altos Oaks Drive, Suite 200 Los Altos, CA 94024

Your donation is warmly appreciated.

Stay well.

Dr. Bob



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