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ARUBA Q#3
Jun 22, 2006

This is my 2nd time, please help me releive some anxiety. Almost 6 weeks ago I had a sexual with an expensive escort from an escort service in Aruba. We had Sex for a time, and the comdom broke. I ejaculated in her, and never knew the condom broke until after the sex. I became a bit nervous, because I was in her for a while w/o knowing how long it was broken. She told me not to be nervous, because she had been tested and came back clean a very short time ago. She began to tell me a story about her life, and it was very believable; She had no reason to make up that hse has a son, just got to Aruba, and she had just got into this business. I believed her, and went back home to my wife and child with no worries. Later that week I got paronoid. Went to see the doctor, and at the 2 week mark I had a hiv test done, without the presence of ANY symptoms. I came back clean of EVERYTHING. She told me not to worry and go back to my life. Since then I have slept with my wife, and I get paronoid when ever she does not feel right. I still have had no symptoms since, though I did have a huge sinus infection that went on for 3 weeks, and still lingers. She came down with a sinus infection as well, but she has had NO symptoms either. My anxiety is killing me. Everytime I see a mark on me I think it may be a rash. Could paronia cause redness around the torso and irritate a little. Q2: Is it likely that an escort would lie about her hiv status, and be so confident about it? Q3: Does Aruba a high level of hiv? Or Suriname, where she is from? Q4: Would me and my wife have at least few symptoms or fever by now (4 weeks for her)? We have none, definetly no fever or pressence of swollen Lymph Nodes.

I did go back to the doctor after 3 1/2 weeks for a yearly physical, and everything look great, but I did not do another hiv test; the Doctor gave me xanax instead, and told me to come back at 3 months if you need more reasurance.

Just the other day my wife and I came down with harsh sinus infections. Now I am oaronoid again, even thought I read sinus infectins and acute hiv are not related. Is this true?

I am going to get tested agian this week, should I worry as much as I do?

Please answer my questions.

I have learned so much from this experience. I do well in life, and will make big contributuions to finding the cure, especially the money I will save if we both come back clear.

Thank you for your support and answers.

Response from Dr. Frascino

Hello,

1. Yes, anxiety can cause a whole host of symptoms. Just have a read through the archives and you'll see what I mean.

2. I have no way to answer such a hypothetical question! You seemed to believe her story, so . . . .

3. There are no published statistics that I could quickly locate on HIV/AIDS prevalence in Aruba. (I'm presently traveling and don't have access to all my reference materials. Sorry.) You could Google this statistic and search it down that way. Or perhaps check on the WHO (World Health Organization) or UNAIDS (United Nations AIDS) informational Web sites.

4. ARS symptoms can be variable from person to person. Generally speaking they would manifest themselves two to four weeks after acquiring the virus; however, you cannot rely on symptoms in diagnosing HIV.

I agree with your physician's recommendations: Xanax for anxiety and a three-month HIV test to calm any residual fears.

Finally, I see absolutely no reason for you to be paranoid or worried about intercurrent sinus infections. They are not related to HIV ARS. I also do not feel retesting this week is warranted. Testing prior to three months is not considered definitive, so why do it?

Just to put an estimated statistical risk on your failed condom experience, I can tell you the estimated per-episode risk of unprotected (or broken condom) insertive penile-vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. Your estimated risk would be even less, because we do not know the HIV status of your Aruban tryst. Overall, the odds you did not contract HIV form this experience are astronomically in your favor.

Thank you for your willingness to make a donation to The Robert James Frascino AIDS Foundation. Your gift is urgently needed and warmly appreciated. In return I'm sending you my very best good-luck/good-health karma that your follow-up HIV tests will remain negative.

Good luck. Be Well.

Dr. Bob



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