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Timing of ars symptoms... INFORMED question (4th attempt)
Mar 25, 2004

Hey Dr. Bob,

I know persistence will pay off!

The following symptoms (& timing) followed an oral sex encounter where I went down on a woman of unknown status:

* 2 canker sores on my tongue -- began 4 days after exposure and lasted for 4 days. * Throat ulcerations and swollen neck glands -- began 8 days after exposure and lasted 7 days. * Mild fever and chills which started the same day as the ulcerations and swollen glands, but lasted only 20 hours (ulcerations and swollen glands persisted without a fever thereafter). * Drenching night sweats -- began 10 days after exposure and lasted 5 days. * Non-itchy, semi-painful mosquito bite-like red bumps on my hands and elbows (and a little bit on my feet) -- NONE appeared on my trunk or face -- began 17 days after exposure and lasted nearly a week.

I NEVER experienced thrush, nausea, weight loss, loss of appetite, diarrhea, loose bowel, vomiting, etc. But obviously, I have been in living hell ever since I realized I could have contracted this virus.

I do realize that my encounter is very low-risk and that my ARS-like symptoms occured a bit on the early side of normal (perhaps you could confirm this just for kicks...)

You seem to be an amazing man, but do you have the guts to tell me how DEAD-ON my actual symptoms are? I don't think you do. You just don't have the heart to post such responses on this board; lest the people whose nerves you are trying to calm become even more rattled. You inspire hope and you educate your readers on safety and mental health, but don't generally make it a policy to paint the dark side of this picture for your readers too. You readily answer the easier, less educated, less researched, borderline ridiculous questions posted on here... but how about this one?

Forget about timing of symptoms and low-risk of exposure. Is my constellation of symptoms a dead-ringer for ARS, and, either way, how often (in comparison) do you encounter people like me who turn out negative versus those who turn out positive?

I get my 4-week results next week, and will follow up with 8 & 12-week tests. No matter what happens to me, expect a donation when I get my tax return next month.

Thank you for doing what you do.

- Calm & Concerned.

Response from Dr. Frascino

Hello Calm and Concerned,

You state I inspire hope and I educate readers on safety and mental health. OK, I'll agree with you there. The purpose of this forum is to provide scientifically sound information in responding to various queries. Whether that "calms" or "rattles" nerves is a secondary byproduct of providing scientific fact.

Next, you state I "don't generally make a policy of painting the dark side of this picture for our readers." What? This forum is not a Steven King horror story!

So let's start with your challenge: Would I have the guts to tell you how DEAD-ON your actual symptoms are? Yes, I would. However, to say that in your case would be a lie. Your constellation of complaints is, in fact, not worrisome for HIV ARS. Forget about timing of symptoms and low-risk exposures? Why the hell would I do that? If you want someone to ignore pertinent facts that would lead to logical conclusions, then go ask the Bush/Cheney team to respond to your question. Science is not selective on which pieces of critical information to include in an analysis. Your risk is extremely low "going down on a woman of unknown status." The timing of your non-specific symptoms is not consistent with HIV ARS. Is this DEAD-ON for ARS???No, I think not!

How often do I encounter people like you who turn out negative versus positive? That's easy. In my 23 years of experience with this disease, for folks with minimal risk (like yours) and non-suggestive symptoms (like yours), the number that has turned out to be positive is exactly zero.

My advice is that if you want to get HIV tested, do so at 12 weeks. Testing prior to that is not considered definitive, so why bother? Next, please note your "living hell" is self-inflicted, and if you feel trapped there, consider getting some counseling.

Regarding the choice of questions I choose to "readily answer" you describe these questions as "easier, less educated, less researched, borderline ridiculous . . ." since I've now chosen to answer yours, I suppose logically that would mean your question fits right in? Right?

Finally, as you probably know, I've been HIV-positive since January 1991. I've written honestly about my own experiences coping with the challenges posed by cohabitating with this unwanted invader. The picture I paint is one of reality, a reality you only fear, but one that I actually live. If that's not gutsy enough for you, do try some Stephen King, OK?

Dr. Bob



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