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Please help me - European WW

Dec 6, 2005

Dear Dr.Bob,

I am so thankful I found this website and your forum - you have given me hope where before there was only despair. A donation will be on its way shortly for your very worthy cause.

My risk was protected vaginal sex, unprotected cunnilingus, and brief finger rubbing of my anus with a sex worker of unknown HIV status from sub-Saharan Africa (where the rates of HIV are huge). I know this places me at a relatively low risk of infection but I was extremely drunk at the time and therefore not too sure that the condom was used properly.

The last few months for me have been a living hell and it has probably been your forum that has got me through this period. Symptoms I have experienced are a sore throut on more than one occasion, headaches, a fever blister, overall itchiness a few days after the exposure, occasional sensitivity in my lymph nodes in my neck, and, worst of all, an itchy rash under both armpits. At first all of this totally freaked me out and I was convinced I was HIV+. Initial research on the web only confirmed my worst fears, until I found your forum and realised that these symptoms could be associated with any number of general illnesses/allergies and not necessarily HIV. I started feeling a lot better... until recently when the irritation under my armpits came back (it seemed to have gone away earlier when I applied a hydrocortisone cream to it). I went for my 12-week HIV test the other day and the doctor also did a general check-up on me and found that I had mild gingivitis and some type of inflammation on the roof of my mouth. This coupled with neck & shoulder pains and a general feeling of disorientation has all those fears flooding back again. All this is happening 12 weeks post exposure.

I went for a blood and urine test at 5 weeks after exposure for every STD under the sun, including HIV, and came out negative on all accounts then. I realise that this HIV result was not definitive or conclusive, hence going again for a test at 12 weeks.

Two questions: 1. Reading the archives, if I remember correctly ARS typically appears 3-4 weeks after exposure and usually lasts for 1-3 weeks in duration before going away. My rash under my armpits first appeared 5-6 weeks after exposure, seemed to go away when treated, but now is again irritating me a bit and is occasionally itchy again. My armpits seem dry and easily irritated. Is it normal for an ARS rash under the armpits to be itchy and go away once treated but come back again a few weeks later (or maybe linger and not go away at all)?

2. Is it possible to be still experiencing ARS 12 weeks after exposure?

I will be getting my 12 week results on Friday so please, please, pretty please send me your good luck karma. It seems these last few days before the truth is revealed are proving the hardest of all.

Best wishes, European WW

Response from Dr. Frascino

Hello European WW,

Certainly the most worrisome thing about your history is ". . . I was extremely drunk at the time and therefore not too sure that the condom was used properly." The rest of the details are far less important. Because you are uncertain if the sex-capade was protected or not, you've potentially placed yourself at risk for STDs, including HIV. Your five-week negative STD screen effectively ruled out "every STD under the sun;" however, as you indicated, the five-week negative HIV test is not definitive. Consequently, I agree a 12-week test is essential. HIV testing should be performed solely because you placed yourself at risk, regardless of whether you have symptoms or not.

To specifically address your concerns:

1. Is it normal for an ARS under the armpits to be itchy and go away . . .?" The rash you are describing is not "normal" or even typical for ARS at all. See a dermatologist if you have itchy pits! This is not HIV related.

2. Almost anything is possible. I mean Dubya actually got elected to serve in 2004. That still seems incomprehensible to me, but that's another story. I will say that it is not typical, common or likely that ARS symptoms would persists for 12 weeks.

Thanks for your donation ( We will direct the gift to our Sub-Saharan Africa Program to provide crucial HIV services and promote HIV awareness/prevention.

Good-luck karma is on the way!

Dr. Bob

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You answer some stupid question but never answer mine

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