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my doctor claims that girls like me don't get HIV...
Jan 13, 2004

Like many on asking you questions, I am concerned that I may have HIV. Here is some background...

I am a 23 girl, heterosexual, and just graduated from college. I have had sex (as in intercourse) with 10 people, much of it unprotected.

Also, I am bipolar. In the midst of my first manic episode, before I was diagnosed, I had three unprotected one night stands. That was about a year and a half ago. The one that really stresses me out was a guy who had blotches all over his chest. They were pale in color and totally flat, about the size of a quarter with irregular borders. If I recall correctly, some were kind of connected... but I might be making that up. He claimed that it was from a sunburn (which sounded dubious even at the time) but as I am reading, it sounds like that could be a symptom of HIV. As odd as this sounds, it kind of looked like that skin condition where you lose pigment (vitiligo, or something). Which sounds more likely to you?

About a year ago I resolved not to have sex unless I was in a committed relationship, and to always have protected sex. I haven't had sex since. But in the last 2-3 months I have been haunted by my past indiscretions (particularly the one above) and am freaked out by some health problems that I am having.

About a month ago, I got a bad cough that I can't shake. It started off as a dry cough, then went to the phlegm-y variety with congestion in my chest and nose, and is currently in the process of going back to a dry cough. Strangely, I haven't really felt sick (ie no headache, sore throat, etc.) To be fair, I should also tell you that I'm a smoker. I also have had a white tongue on and off. I also have herpes (healthy girl, I know), and for about a week my vag has been red and itchy, but without any visible bumps. I'm not even sure that it is an outbreak, but I haven't had one in a year and recently read that having an outbreak can be associated with HIV. As far as other random health concerns: I have been experiencing a dull pain in my left deltoid on and off for about a year; have frequent diarrhea (which is nothing new); shortness of breath; and today the vision blurred in my left eye, which seemed to be localized on one part of my eye ball, only lasted about 5 minutes, and was mildly painful... but there didn't seem to be a lash or anything there. It was also tearing a little.

What really threw me off, is that I asked my gynecologist about taking an HIV test several months ago and she seemed genuinely surprised. She said that it would be fine, if I wanted to, but that she didn't see the point since she just "doesn't see" white, upper middle class, college girls with HIV. Is she right? Am I just paranoid? Based on what I am telling you, do you think it is worth it to get tested?

I vacillate between being so sure that I have HIV that I am on the verge of a panic attack and thinking that I am being a hypochodriac (based on equal parts guilt about my sexual past and general neuroticism).

In sum, I basically want to know how at risk you think I am based on my sexual history, possible symptoms, and the sketch ball I stupidly slept with. Thanks in advance for any help you can offer.

Response from Dr. Frascino

Hello,

You pose a variety of complex questions (and symptoms); however, my response is quite simple and direct. If you've placed yourself at risk (in your case, having unprotected sex), then the possibility of an STD (including HIV) exists. The only way to determine if you've contracted HIV is to get an HIV test three months (or longer) after the potential exposure. It really is that simple. Symptoms should not and cannot be used to diagnose HIV.

So what about your gynecologist's remarks? Well, she says she "just doesn't see white upper middle class college girls with HIV." That doesn't mean they aren't there. It would be more accurate to say she doesn't recognize them. And that is to her discredit. She just couldn't be more wrong. I'm sure she'll eventually learn her lesson the hard way. A nice, white, middle class college kid will wind up severely ill as a result of her mistaken impression that HIV only affects non-white, lower class, high school flunkies! I can introduce her to some HIV-positive white upper and middle class college girls, if she so desires.

So are you being a hypochondriac? Perhaps. Your symptoms are not suggestive of HIV. Should you be HIV tested? Only you can decide. I can only advise you if there is potential risk. In your case, unprotected sex with 10 people, including a "sketch ball" (what the heck is a sketch ball anyway?) does constitute a risk.

Should you panic? No. that never helps anything. What you definitely should do is quit smoking. It's by far the most worrisome thing health-wise that you mentioned to me!

Dr. Bob



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