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ARS-like symptoms at 3 weeks after exposure
Apr 4, 2004

Dear Dr. Bob,

You are the greatest! Thank you so much for helping so many lost souls like myself cope with their anxiety.

My story is probably quite standard. Three weeks ago I had unprotected receptive and insertive oral sex (no ejaculation) with a man I met at a NY gay bar. I asked him about his status later, and he told me (somewhat reluctantly) that he had tested negative last summer. I am inclined to believe him, but I am not quite sure, and anyway, he is not obliged to tell me the truth. That was my first sexual experience (I am 23 and I know that's really late!), so I really freaked out about HIV. I know the risk is low, but I am also having pretty disturbing symptoms. A week after the event, I began to feel very tired and developed a sort of reddish rash on my trunk (that may not be a big deal since I often get those due to sensitive skin). I felt really anxious about all that, and started getting night sweats, which I have never had before. They might be due to anxety but who knows? Anyway, now we come to the most disturbing of my symptoms. Yesterday I came down with a flu-like condition - sore throat, stuff running down my throat, painful lymph nodes in my neck, and an enlarged and slightly painful (salivary?) gland under my chin, as well as low grade fever - 98.8 (I know that's almost normal, but my temperature is usually lower than that, and I also feel quite feverish). I went to my doctor today, and she noticed my ears were slightly sore, too, and said my lymph nodes felt normal. I know these could all be symptoms of a cold, but because they show up exactly three weeks after possible exposure, I am totally freaked out. I tested negative at 11 days (will test at 3 months) and now I am waiting for the results of a viral load test done at 17 days (six days ago), but I know this won't be conclusive either. That's why I really want to hear your expert opinion about whether my symptoms are worrisome or not.

I am a poor grad student in the US from Eastern Europe, but if I test negative, I will make a modest donation (unfortunately, if I test positive, I'll have to save my pennies for treatment!)

Dr. Bob, you are the best!!! You deserve all the praise that's been given to you, and more!

A very worried admirer

Response from Dr. Frascino

Hello Very Worried Admirer,

First read through the archives of this forum that pertain to oral sex. That should help reinforce what you already know: That the risk of HIV transmission from oral sex is extremely low. Next, I don't recommend testing before three months, as the results are not definitive. As a "poor grad student," you definitely shouldn't waste your limited resources on tests that are not helpful or conclusive. Next, symptoms, no matter what they are, do not equal HIV disease. Your chances of having contracted HIV are extremely low. Your chances of having contracted a common cold are excellent.

Try not to worry. The odds your three-month test will be negative are all in your favor. Write back when you get your results. We'll all be sending you good luck and waiting to hear you very relieved WOO-HOO yell!

Dr. Bob



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