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Fifth Post:Final Year Med Student with Paralysing Fears?Can I get a Woo HOOooo?

Jul 14, 2006

I ll try to keep this succint: I am a med student from Asia reading in london fifth year of med school, feel like an idiot for reading a post dated version of Kumar and Clark that conveniently didnt include oral sex as a risk factor of HIV nor saliva....Is HIV present in Saliva?... Need your risk analysis on an escort who performed unprotected oral sex on me for 4.5 mins, 2 days before exposure I had visible healing 9-10 cracks on my penis foreskin that I fear may have led to an astronomical increase in risk due to the whole happily residing langerhaans visible blood on penis or bleeding escort gums...I have no prior STDs ...I feel like an idiot..I want to get back to concentrating on my studies...dont want to let down my parents...3 weeks post exposure the HIV antibody is -ve,my only remnants of symptoms is 2-3 soft 1-1.5 cm lymph nodes in posterior triangle, unilateral 3 weeks post exposure, have sent my blood blood for p24 today, all liver enzymes normal,no anaemia, no Hep A or Hep B not had a fever since exposure just lymph nodes +slight wasting in left quads(it just slooks smallers than the right) + occasional burning sensation in my feet and forearm(is this HIV neuropathy at early onset 3 weeks post exposure?)...and been saying hail marys like there is no tomorrow....risk of exposure Bob?...I am dead scared of my stuipidity more so than the virus...Will donate..youre a top geezer....

Response from Dr. Frascino


"Top geezer???" Hmmm . . . as in eccentric senior citizen??? Perhaps there is some new London slang ("top geezer") that I'm not aware of.

First a few facts:

1. You can't contract HIV from saliva without extraordinary circumstances, such as the presence of blood in saliva, etc.

2. Oral sex, particularly insertive oral sex, carries a minimal risk for HIV transmission.

3. HIV testing prior to three months is not considered definitive.

Med. Student, I'm a bit concerned you're in your fifth year of study and you are still so concerned by such a negligible risk! Yes, I would rate your risk as "negligible," even with your 9-10 cracks on your foreskin (ouch). These "visible healing" cracks do not translate into "an astronomical increase in risk!" Next, your fears about visible slight wasting of your left quadriceps and occasional burning sensation of your feet and forearms are not HIV related. I would be willing to bet they are anxiety-induced symptoms. What you describe is nothing remotely similar to HIV-associated distal sensory polyneuropathy or HIV-associated wasting.

If you're worried, get an HIV rapid test at the three-month mark. It will be negative. Also, use this real life experience as a lesson on the power of anxiety and irrational fears. Also please take some time to learn more about HIV transmission, recommended diagnostic testing and HIV-related symptoms. Use this knowledge to educate your peers and patients!

Thanks for your donation. I'm going to consider that geezer comment a compliment!

Dr. Bob

Very Worried 19month after
Dr. Don Frascino. Just when I thought I was out my stupid fears pull me back in...

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