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Opinion needed, new saliva test
Mar 30, 2004

Dear Robert I am writing to you and my hand are shaking this is my story in brief: On October 30, 2003 I had a sexual relation with a sex worker it was a safe sex using condoms in vaginal and oral sex. I did also kiss her breasts. on January 11, 2004, I had sex with a sex worker in an exotic vacation. This was also protected sex with a blow job and vaginal intercourse. we did have a shower first, but what worries me is that there was some blood on the condom from her vagina after we did the vaginal sex. I dont think that the condom was broken. During the same week, on January 17th, I had another relation with a sex worker. Everything was fine. We had a shower, a blow job and vaginal intercourse and all of it was with using a condom. Since I came back from that vacation I am feeling very stressed and the idea of me getting HIV is not going of my mind not even for 1 second because of the following symptoms: On about January 25th, I started having a rash on my skin, there are no blotches or severe redness but my skin is dry and I feel a pain when my clothes touch my skin or when I squeeze it. I have had the same problem last year but with ELOCOM and ATARAX it did not last two long, and I felt that it was itchier. Now I am still feeling the itch, and I went to the doctor yesterday and she gave me again the same medicine and this is my third day I am using it. There is some small improvement. I started to feel fatigue, and also I felt some tingling in my fingers and in my foot, I sometimes feel that there was something walking in my brain. What worries me the most, is that on February 10th, I had a severe headache and coughing, and throat pain, It was one sided on the left. I even felt the pain only in my left throat. It did last about 6 days an it was gone. It was after a trip where I was exposed to the sun on the left side. Since then I had some runny nose but I used to have the same due to the allergy and sinus problems that I have. I went to see the doctor on February 6th, and we made a general blood test that tests everything in the body and there was nothing in the test and it did test the nodes. The Doctor said that there is nothing, and I should not worry. This was 20 days after my last exposure to HIV on January 17th. The worries did not go and I went and did an HIV test 14th of February and the test was negative. This was 27 days after the last exposure. The other symptom that worries me is that on February 8th, after 21 days of my last exposure, I started to have a small pain in my penis. I felt that it was cold on the top. Unintentionally I started touching it more often and reverse the skin back. Now I am feeling sometimes the urgency to urinate sometimes. And I feel that the small blood vessels in the skin are hurting when I reverse it. It also became dry. During my last visit to the doctor 2 days ago she said that there is only some dryness in the skin and she told me to apply ELOCOM to it. And it does not have a form of sexually transmitted disease. The last thing is that sometimes I feel that some cold stuff is coming out of my body, when actually there is nothing coming out as sweat. I feel it when hit my legs on the floor it feels like a coming out of my legs. I am currently not able to sleep and even my appetite is going down. I am so stressed, can you help me with this please. I feel that my life is going away. I am now 78 days after my last exposure. Please let me know also about the new saliva test that was approved 7 hours ago. Is this good. I will for sure donate for the foundation because you are a great person. Please help me with the anxiety I am not able to function.

Response from Dr. Frascino

Hello,

All of your sexual experiences were protected and the condom did not fail; consequently, there was essentially no risk of HIV transmission. None of your symptoms are suggestive of HIV ARS; however, they are very classic for severe anxiety insomnia, decreased appetite, feeling stressed, "something walking in your brain," etc. I absolutely agree with your doctor: HIV is not your problem. Yes, you probably have dry skin that itches, just as you did last year. This is not worrisome for HIV disease. Your fears of HIV are irrational and unwarranted. Ask your doctor for a referral to a psychiatrist. You are in desperate need of counseling.

Regarding the recently approved saliva HIV test (OraQuick HIV 1/2), it appears to be very good. A negative test can be considered definitive; however, a positive test still needs to be confirmed with a blood test.

Feel better; get some counseling soon.

Dr. Bob



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