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Apr 27, 2006

Doctor,

I believe that you and everyone else on this site are doing a great job and are a wonderful resource. This site and others like it have helped me get through a very difficult time in my life. I will be sending a donation to your wonderful foundation.

I had a few questions regarding a possible transmission of HIV. I had a high risk exposure in December of 2005, where I had sex with a woman that I had just met at a club. I am pretty sure that we used a condom, but I can not be certain that it stayed intact. I am also a uncircumcised. I was not worried until 10 weeks after the incident when I started to feel all types of symptoms;

1) The most troubling was a massive headache which lasted for a day 2) Then I started having issues with walking which continue to this day. I have been researching this issue and it seems that trouble walking can be a symptom of HIV? 3) A week after the headache I started to have pain on the right shoulder blade, which crept into the right armpit then to the left shoulder blade and into the left armpit. The pain lasted for almost 8 days. 4) Two weeks ago I started to feel burning sensations inside of my mouth, know I still have the same burning sensation but the lining on the insides of my cheeks seem to peel off. (I am on long term antibiotics, so I am not sure if this is a result of that) 5) I also have what feels like a dry throat, and know I see red bumps on the back of my tongue (not sure if they are elevated taste buds) 6) I have had issues with the GI tract (all started after the incident) and have been to the doctor for that, I have had a ultrasound and a CT scan, which all came back good, except for some sludge in the gallbladder. 7) Recently I have been unable to sleep, but I am not sure if I can just blame it on stress. 8) Pain in the center or my right calf close to the knee, feels bruised but the pain has been there for over a week now. 9) I have had a low grade fever (~99.3) that comes and goes over the entire course of this, but never over 100.

I have tested at the 40 day for a full STD panel (HIV 1/2) and everything was negative. At the 80 day mark I tested for HIV 1, which came back non reactive. My concern is that all of my problems started 10 weeks after the incident. I mean what are the odds given that it would have to be female to male, condom was used (not sure if it stayed intact), and I did not have any symptoms till 10 weeks after the incident.

I want to go get tested, but I am not sure if I can handle any bad news. Do you think testing is required again?

Response from Dr. Frascino

Hello,

The real question here isn't whether testing is "required again," but whether testing is required. Testing done prior to the three-month mark is not considered definitive or conclusive, as you probably know from reading this forum. And, as you can see, even though your negative results on days 40 and 80 are very encouraging, they did not stop your worries. So, we are back nearly to square one to test or not to test. You feel you've had a potential "high risk exposure." (I would argue that if a condom was used properly and stayed intact, the risk would be nearly nonexistent.) Consequently, you should get HIV tested at the three-month mark, whether or not you've experienced any symptoms. So yes, I would recommend one test at three months or longer after your potential exposure.

Regarding your "symptoms," they are not worrisome for or suggestive of HIV ARS.

Bottom line: with your minimal (perhaps even nonexistent) exposure, symptoms inconsistent with HIV and repeatedly negative HIV tests out to 80 days, I do not believe you'll have to handle any bad news. But you do have to learn how to cope with your irrational fears of HIV and your anxiety.

Good luck on your three-month test. I'm quite confident it holds nothing but good news for you.

Dr. Bob



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