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Nov 22, 2004

Dear Dr. Bob,

I am a bit alone and in the dark. I am living in Spain and had an experience with an escort in September. The vaginal sex was protected although there was minimal oral contact by me with her and her as well, but she did primarily use a condom(during ejaculation as well). About three weeks later I came down with a mild flu-like symptoms-body aches, mild fever, night sweats that lasted for 2-3 days followed by some gastrointestinal discomfort(mainly cramps, but some loose stools). I did have one swollen lyphmnode in the groin that I recall having in the past before the encounter. I did not have a rash. I need some advice from someone that I trust. I am scared and concerned and full of old-fashioned guilt. An advice would be appreciated.

Could you please tell me a bit more about HIV rash-is it noticeable, does it involve multiple areas and coming and going. Furthermore, does lymphnode swelling occur in more than one place and generally in both sides? I would also like to know how to donate because I am impressed by your knowledge and compassion.

PLEASE HELP- worried hombre studying in Spain!

Response from Dr. Frascino

Hello Alone-in-the-Dark-in-Spain Guy,

First of all, your HIV risk is extremely minimal. Protected vaginal sex is indeed protected if the latex condom was used properly and did not fail. Oral sex carries a low risk for HIV transmission, and your oral contact was itself "minimal."

Briefly turning to your questions about symptoms, the HIV ARS rash is red and non-itchy with slightly raised papules that are generally symmetrical and usually involves the face and trunk, but can also occur on the arms, legs, palms, and soles or be completely generalized. There are also a variety of other "rashes" that can be associated with ARS. Swollen lymph nodes may be generalized, but most commonly are noted under the arms (axillary), on the back of the head (occipital) or in the neck (cervical). Yes, it generally occurs on both sides; however, as I have often said, "HIV symptoms" are notoriously unreliable.

Overall your risk is extremely low; however, if you are concerned, I would suggest HIV testing at the three-month mark. The odds are very much in your favor that you did not contract HIV from this walk on the wild side. Try not to let guilt and fear ruin your time in Spain. You followed safer sex guidelines. For that, you are to be commended.

Good luck on your test. We'll all send you our best karma! You can send us some authentic gazpacho!

Donation information for my foundation can be found on the Foundation's Web site.

Dr. Bob

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