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$500 donation coming..."It all adds up...SCARED!!" again..
Mar 14, 2006

I'll spell out as quickly as possible. POTENTIALLY unprotected vaginal sex with prostitute. Started off with condom, not sure about the finish. I don't remember removing the condom but that doesn't mean I didn't. Let's say for "safety" measure it was unprotected. Oxymoron I know. She had put lube on my bare Johnson, wiped it off and then put the condom on. I am worried that caused it to slip. I vaguely remember her standing and showing met her leg after we finished. In a drunken stuper I probably told her "nice pose" in Spanglish. It was Tequila, Tequila, Corona, Tequila, Tequila, and so on...bet you can guess where I was doc. Within a week had a light sore throat and fatigue. White patch on one side of throat, mild fever and severely swollen tonsils. Within a few more days night sweats, loss of appetite (possibly due to guilt and anxiety). I am a very calculated person so you can imagine how the 5-6 weeks of continued swollen tonsils, fatigue, and sweating has been. It's been nothing but obsessing about how "right on the money" my risk, symptoms, and timing of exposure to symptoms. Webs-sites don't help matters (except this one). Here are my questions.

1. I've got it down. 5 in 10,000 chance if unprotected vaginal sex with infected person. Would you say these odds are decreased by the following? Tested clean for chlamydia/gonorrhea 2 weeks after exposure. Tested positive for Strep Throat 3 weeks after exposure. Treated with 4K milligrams of Augmentin per day for 10 days (I'm a big boned guy). Redness went away but swollen tonsils, glands and night sweats persist (guilt?). Also had what I think was jaundice prior to Augmentin regimen. Co-workers told me I looked distinctly yellow. This is usually a common symptom of Mono but want to make sure can't be HIV/seroconversion related. HIV usually doesn't involve the liver, correct?

2. Will be tested for sure at 3 month mark. However, would you recommend an earlier test? I have read treatment during the seroconversion and acute HIV period can prove beneficial in the long run. By waiting 3 months (given a positive reading) could I have more permanent damage? 6 weeks now since potential exposure and most energy is back, night sweats and swollen tonsils only major problem....besides extreme guilt and anxiety of course!!

Thanks again doc for your response! You hear it all the time but only prayer and your concise yet witty responses have kept me from losing it.

I can't wait to WOO-HOO and tell everyone "Knowledge is Power" after I test negative at 3 months! I'll be sure to write that note in May with a second $500 "celebratory" donation!

Response from Dr. Frascino

Hello Tequila-Tequila-Corona-Tequila-Tequila-Guy,

"Potentially unprotected" sex ???? OK if you say so.

I'll proceed directly to your questions:

1. The estimated per-act risk statistics for acquiring HIV assume your partner is confirmed to be HIV positive. These statistics would not be "decreased" by testing negative for STDs or positive for strep throat and/or by taking antibiotics.

As for the liver, you are correct: primary HIV disease would not cause acute jaundice; however, hepatitis certainly could!

2. HIV-antibody tests taken prior to three months are not considered to be definitive or conclusive. Consequently, I don't recommend them. If someone is concerned about primary HIV infection or acute retroviral syndrome (ARS), more sophisticated tests may be considered. The jury is still out on whether or not treatment during ARS is beneficial in the long run. Stay tuned to this site and we'll keep you posted as more information on this topic evolves.

I think the title of your post is correct "It all adds up SCARED again!!" Luckily being scared and actually having HIV are two very very different things. I believe all the facts add up nicely to the conclusion that you are indeed scared and not that you have contracted HIV.

Thank you for your very generous donation. A gift of that magnitude can provide antiretroviral drugs to two people in sub-Saharan Africa for a whole year! On their behalf, please accept my heartfelt thanks. I'll also send my very best good-luck karma that your HIV test is negative. (Statistically the odds are very much in your favor.) I'll look forward to your celebratory WOO-HOO. (And I'll bring earplugs because I'll bet it's going to be sonically impressive!)

Good luck.

Dr. Bob



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