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sorry to bother again - common cold cofactor? donation for trouble
May 9, 2005

Hi Dr. Bob. I feel guilty for bothering you again, so I made a $100 donation. I'd have given more, but I just graduated from college and dont' have much money. I fear that I'll be spending a lot of it on ART.

Anyway, the circumstances are this: -two weeks ago I hire a pro. She has a common cold. -She performs oral sex on me with a condom for a short period. I feel weird, and tell her to stop. I take the condom off , but I adjusted my foreskin with the hand that took the condom off. I think I touched my penis head, but not the urethra. -I immediately wash my dick off with soap

I'm not stupid enough to think that the nausea, chills, lethargy, etc, during the first week are related to HIV. However, I did feel some tingling in my urethra. I only had one discharge these past two weeks, and that was after a sexy dream, so it may have been precum. I've been tested for gonnorhea/chlamydia, and my culture test came back -ve, the other hasn't come back yet. My urination has been generally trouble free for the second week since the incident, and even during the first week, I think it was bad because of dehydration.

I have had a persistent sore throat all of the second week, and occasional pain/discomfort under my armpits for two days now. I've also got occasional pain in my lower gut and hear my groin, but I've felt that since week one. I've also got some sinus trouble, which I know isn't consistent with ARS. My family doctor, who I saw 9 days into this, says my neck lymph nodes aren't swollen like I thought. My neck pains are mosty gone. Though she did take a swab out of my throat, so it's not just my imagination. I've got an appointment with an infection disease specialist in two days. Maybe I can convince her into giving me a p24 or PCR, but I doubt it. My family doctor gave me some lozepram, so at least I can sleep now. I'm no longer as fatigued. I've got no rashes so far, and my temp is normal.

I know you say oral sex is very low risk for transmission, and under my circumstances, even lower. -But would the girl having a cold make a difference? (because of some mucous in the saliva maybe? wouldn't the mucous contain more CD4 cells if it was infected? those make HIV. And mucous is more salty, thus maybe negating the protection saliva provides?) -If I do get the clap, does that mean I have an increased risk of also having got HIV? -The walk-in clinic doctor said that 'with such an inefficient delivery method for HIV, even a three month test wouldn't be definitive.' Is he right?

How that I've hit the two week mark, I live in constant fear of getting a fever and or rashes in the subsequent few weeks. How am I gonna get through the next ten weeks?

I know you've got bigger problems than that, and I'm sorry for asking. I feel kinda selfish, but I've never been this freaked out before. I've read almost the entire archive.

I know you hear this all the time, but I feel like I'm going to be the first person to write you back with a boo-hoo instead of a woo-hoo in ten weeks. Either way, I'll let you know.

Thanks for your time.

Response from Dr. Frascino

Hello,

From what you've told me, I'd say your HIV risk is essentially nonexistent. That your pro had a common cold does not increase your risk of acquiring HIV. For your degree of risk, most specialists wouldn't even recommend testing. The walk-in clinic doctor gave you a bum steer. The efficiency or inefficiency of the "delivery method" does not affect the duration of the window period.

Your problem is not HIV, but rather fear of HIV. I see no need for p24 or PCR tests. Likewise, I see no need for an infectious disease consultation. However, you do need help with your anxiety. I'd suggest you ask your doctor for a referral for counseling. I believe you correctly identified your problem when you wrote ". . . I've never been this freaked out before." Get help for your "freak out," not unnecessary HIV tests. A single test at three months to calm any residual fears is all that should be considered. And even that test would be primarily only for peace of mind.

Thank you for your donation. Reread the archives and this time pay attention! You should find considerable reassurance there from the numerous testimonials. OK?

Good luck.

Dr. Bob



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