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Praying for a woo-hoo!
Sep 22, 2005

Praying for a woo-hoo!

Dr. Bob, my situation sounds very similar to many of the others on your site; but I still feel it necessary to email you my sordid story and ask for some good karma. On Friday, July 22nd, I met a guy and subsequently had unprotected insertive anal sex which lasted less than 45 seconds. Looking at worst case scenario, which I typically do, Im assuming he was +. On my way home, I felt EXTREME guilt and began obsessing about how stupid I was, how atypical this behavior was for me and WHAT IF I became infected with HIV. On the following Monday, I began searching the net and reading about ARS, symptoms, window period, my risk per exposure, etc AND marking my calendar up with dates for testing and watching for potential symptoms. Basically scaring myself to death. On August 19th, I developed a post nasal drip, a sore throat and a slight headache. I chalked this up to a recent camping trip the previous weekend where it was extremely hot during the day and froze my butt of at night due to the extremely frigid a/c. The post nasal drip subsided after 2 days and the sore throat continued. Also on August 19th, I began feeling a dry mouth and experiencing erratic sleep patterns, sleeping on average of 4-5 hrs per night, waking up every hour or so which continued nightly. I also began to feel warm allover but no temp. I have also began having sweats during the daytime which is only isolated to the upper rear buttocks and which still continue. The sweating typically disappears in the late afternoon. Then on August 23rd, I had minimal temperature elevations, primarily in the afternoons, with a max of 99.7 which continued through September 1st. I also have white-coated tongue which I attribute to feeling dehydrated and stressed. I lost 4 pounds, which I attribute to dehydration. On August 29th I went to my GP, who has minimal experience with HIV, and he diagnosed me with strep and gave me a 10-day regime for amoxicillin. I took a HIV EIA test at 5.5 weeks post exposure which came back negative which I understand is not conclusive or definitive until at least 12 weeks post exposure. All other tests for STDs and HEP B & C were also negative. Ive had some intermittent joint and muscle tension in my elbows and forearms but nothing major. On Monday, September 5th, I woke up several times feeling warm and the upper front and back of my tee shirt was slightly damp from sweat. This light sweating continued roughly 4 days. On September 10th, I noticed 6 slightly raised, tiny whitish bumps on my hands. Of course, I have NEVER looked so closely at my body and freaking out at the slightest thing I feel is abnormal. Yes, Im sure youre saying that this guy is ultra obsessive-compulsive, which my friends totally agree, including a friend of a friend who is + and believes these symptoms are all related to stress and anxiety. Last nite was the first nite that I actually slept 7 hours straight. I was ecstatic.

I continue to have a very minimal intermittent sore throat, dry mouth with white-coated tongue, and daytime sweats as mentioned above. Additionally, the inside of my elbows feel warm to the touch. I havent felt fatigued, even with the massive lack of sleep.

From some of the responses on the site:

- a "sore throat" combined with this minimal temperature elevation is not suggestive of HIV seroconversion or acute retroviral syndrome.

- Coated tongue which is NOT related to HIV infection, is white or creamy in appearance and is associated with dry mouth, smoking, drinking and drug use.

- Dr. Sullivan mentions that the majority of individuals will have developed antibodies by day 27, post-infection.

I understand that you cant give me a diagnosis over the net and that symptoms do not equal infection.

1) Am I being hysterical? 2) Can all of these symptoms be indicative of stress and anxiety? 3) Are these symptoms indicative of infection? 4) For some interim peace of mind, would you recommend I take an additional HIV EIA at 8 weeks? 5) Should I have any other tests run besides a 12 week HIV EIA or try to locate a physician who has experience treating HIV patients?

Thank you for your website. It has helped me to dismiss some fears and is helping me to re-evaluate my priorities in life. I have mailed a check to The Robert James Frascino AIDS Foundation 1000 Fremont Ave., Suite 145 Los Altos, CA 94024 .

Fearful One in Florida

Response from Dr. Frascino

Hello Fearful One in Florida,

Since I know you are extremely worried, I'll proceed directly to your specific questions first:

1. Hysterical? Yes, absolutely.

2. Symptoms caused by stress/anxiety? Yes, absolutely.

3. Indicative of HIV? Nope!

4. Additional interim HIV tests? Nope! (Since they are not definitive, I doubt they will give you peace of mind.)

5. Other tests at 12 weeks? Nope! An EIA is all that's necessary.

6. Locate a physician experienced in treating HIV? Nope. Unless your 12-week test is positive, which, at this point, is highly unlikely.

Fearful One, I'm sure you have read the estimated risk statistics for your 45 seconds of unprotected insertive anal sex. Remember those statistics are based on the sexual partner being confirmed HIV positive (as opposed to just "assuming the worst"). So your risk would be even less.

Regarding your symptoms postnasal drip, dry mouth, erratic sleep, "feeling warm," muscle tension, six slightly raised tiny whitish bumps," etc. I agree with your friends: these are classic symptoms of stress and anxiety, not HIV! Your 5.5-week negative test is very encouraging, but not conclusive. So my advice is to ratchet down your level of anxiety and worry. It's way out of proportion to the actual degree of risk! Get tested at the three-month mark. The odds are all in your favor. Yes, my good-luck karma is on the way!

Thank you for your willingness to make a donation to my foundation, The Robert James Frascino AIDS Foundation (www.concertedeffort.org). Your generosity and compassion are warmly appreciated. I also believe helping others in desperate need, rather than focusing on our own potential problems, is a very good way to rack up excellent cosmic karma with the higher powers!

Good luck.

Dr. Bob



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