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Fear from Las Vegas
Sep 23, 2005

In mid-July I spent some time in Las Vegas. I gambled, took in the sites, slept with a barely known woman, etc I fear that what happened in Vegas may not stay in Vegas. I have been in a monogamous relationship for the past two years and made a mistake. I am a male with a circumcised penis that has been HIV/STD free all my life. The individual I had this encounter with was a married woman with a child. The encounter happened like this. First, too much alcohol I had known the woman for a day but nevertheless, cant be certain of her status. Second, it began with unprotected oral sex. She performed fellatio for 2 minutes and was not rough. She didnt seem to have any oral ulcerations of any sort. Third we began to have unprotected vaginal sex. This lasted only a couple of minutes, as we both realized that we were not practicing safe sex. She had plans to begin trying to have another child. Though a nice girl, I didnt want to be her babys father. The sex was not really rough and I had not noticed any ulcerations when I manually felt her vagina. Additionally, she was well lubricated. Unfortunately with my inhibitions out the window, I allowed the whole encounter to occur without any initial thought of HIV or other STDs. However, as a married women with a child, I didnt think she was exactly the high-risk type. After the encounter, I asked her if I had anything to worry about, as in STDs. She said she had not slept with anyone except her husband since she has been married.

Since then I have had some symptoms that have raised some concern for me. I have had some tingling throughout my body, some of which has been in my lower legs, feet, and hands. Secondly, I have developed a rash at about a month from the encounter. The rash has appeared on my chest, stomach, triceps, and forearms. The rash is raised; some of which are pustules. The rash has been present for nearly three weeks now. It hasnt necessarily gotten worse, it just hasnt went away. When the body tingles occur, it seems to happen where the rash is. Third, at about 7.5 weeks my lymph nodes under my arm has appeared to have some swelling (or at least I think swelling). Though they seem to me to be swollen, they are not really sore or uncomfortable, nor have I developed a fever. I havent had any flu-like/mono symptoms, fever, sore throat, weight loss, or fatigue.

Questions: 1. Can you please assess my exposure risk? 2. Do my symptoms, sound like anything to be concerned about? I am mainly worried about the rash and tingling, since I have never really had either. 3. I have read numerous forums at this point and I have received some mixed answers. I understand that it is common practice to acknowledge the 3 month mark as a test with definitive results. However, I was reading a forum that was discussing that HIV antibodies can be highly detectable around the 3 week mark and then taper off to undetectable levels for three months. Is there any truth to this? I had a negative HIV test at three weeks and felt good but then conceded to the fact that I should really wait until three months to get the woo hoo.

This has been on my mind constantly, and I am desperately looking for some closure on this issue. I really want to get back to a normal life. Question 4. Is there any tests that I can take now, this the 8th week since the potential exposure.

In closing, I make these remarks for your humor. I am a republican, with conservative views but I am on board with you about the concerns of our nation. Things havent necessarily been great for us, Americans. I do believe, regardless of leadership, we will endure. After all, we have great people in this nation. Though, conservative, I believe our nation is too hush,hush when it comes to things like sex, HIV, and STDs. Individuals like you truly make the difference. Your loyalty to your cause is remarkable. Thank you. I saw your foundations address on another posting and will be sending a donation. Since I am a republican, Im sure I will take advantage of that tax-deductible contribution. Just kidding.

Thank you. Sorry for the lengthy note.

Response from Dr. Frascino

Hello,

1. The estimated risk per act for acquiring HIV form unprotected insertive vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. For insertive oral sex with the same parameters, it's 0.5 per 10,000 exposures.

2. Nope.

3. Nope, no truth to that. Your three-week negative test is encouraging, but not definitive. Tests taken prior to three months from the time of exposure are not considered to be conclusive.

4. Nope. I would recommend you wait for the three-month mark and take and ELISA test.

Wow, a conservative Republican who actually appreciates my twisted sense of humor?!?! Don't tell Karl Rove. He's likely to put out a smear campaign on you. You might be Swift-boated!

Thank you for your tax-deductible donation. Hmmm . . . perhaps "compassionate" conservatives really do exist!?!

Stay well.

Dr. Bob



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