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Desprate Idiot needs your advcie - PLEASE!

May 24, 2004

Dear Dr Bob,

I dont know what to do anymore. You are my last resort and my donation to your foundation will be made. I am losing my mind coping with the testing window period. Here is my story: I had protected sex with a sex worker about a month ago. I am married and immediately began to feel a deep sense of dread at what I had done. If I turn out to be negative then this waiting period is a huge life wake up call and my fantasies to be with another woman will never become a reality again. Could I have ruined my life?

I got tested with Orasure two days after and was negative but I understand that this is not conclusive until the three-month window. I approached the sex worker and paid her to take a HIV test about a week after the incident and she too was negative. However, lately I have been feeling nauseas, lots of diarrhea, dry mouth, heartburn and fatigue. These symptoms exist on a day-to-day basis at present. I understand from your forum that symptoms are not necessarily a sign of infection but I cant help but panic when they arise. Waiting for the window period is excruciatingly painful, as I fear the sex worker may have contracted it within the 90 days of her test. I have spoken to the CDC and they informed me that if I take a 25-day test and it is negative then it would be a good sign and should relieve any fear or tension on my part. Is this true Doc? Would a negative 25 days test put the odds in my favor that I have not contracted the virus? I am pretty certain the condom did not break but what if the worker was a vindictive woman who put a hole through the condom with a needle. Would the condom have broken if this were the case? After I pulled out she began to rub the tip of my penis with the condom on. Why would she do this? Was she trying to infect me through a hole she knew existed? We did it in the cowgirl position. Would it be possible for her vaginal fluids to have dripped off the condom and into minor cuts I have in my bum area from wiping too hard after No.2s? I know this sounds stupid but I worry about it every day. I want to take a PCR test at 28 days but I understand you do not recommend this but I dont know if I can cope with the 90 days otherwise. This is destroying me mentally, physically and my marriage. I have not told my wife, as she would not understand. She has told me previously that if she ever found out I cheated on her the marriage is over this is not what I want. I love her very much!

Your website has eased my concerns and anxiety a lot but I was hoping you could tell me specifically to my situation that I dont have anything to worry about. Please help Doc? I am going absolutely insane over this the fear consumes me every minute and when I dont feel well from the symptoms above I am assuming I am positive. Am I just stupid and paranoid? Please help!

Desperate idiot!

Response from Dr. Frascino

Hello Desperate Idiot,

"Protected sex," even in the cowgirl position, does not pose a risk for HIV transmission, if a latex condom is used properly and does not fail. As for vindictive hookers poking holes in condoms, I think you've been reading way too many conspiracy-theory psycho-thrillers.

You are correct that the two-day negative OraSure test is far from conclusive. I do not recommend PCR testing for routine screening, due to the rate of false positives.

In all honesty, what is "destroying you mentally, physically, and your marriage" is not HIV or even fear of HIV, but rather your guilt and anxiety surrounding your indiscretion. You state that after the cowgirl had her ride, you "immediately began to feel a deep sense of dread at what you had done." Your symptoms are most likely related to your guilt, anxiety, and depression. I know your wife told you that if she ever found out you cheated on her, the marriage would be over. However, I still recommend telling her the truth. We are all human; we all make mistakes. Couples that confront problems together are often strengthened by the experience, even though the process may be rather painful. Consider showing your wife this post. Your love for her and your remorse over your indiscretion are clearly evident in your comments. Ultimately, if you have difficulty patching things up couples' counseling might be beneficial.

I don't think you are a "desperate idiot," but rather just a human being who loves his wife and who made a mistake. Your HIV risk from this episode is nearly nonexistent. The problem you have to confront is your guilt over your behavior.

Good luck. I trust that all will work out well for you.

Dr. Bob



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