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HELP! NEED UR OPINION
Jan 11, 2007

I recently found out that a person I had sex with was newly diagnosed with HIV and untreated. WE each engaged in open mouth kissing,and oral sex with no ejaculate involvement. During foreplay, my penis went partially inside his rectum. It was there for no longer than 30 seconds. I stopped and got a condom and used the condom for intercourse. I ejaculated outside of his body with the condom off after intercourse, and he never ejaculated. This was around 11/26/2006. On 12/3/2006 I was diagnosed with Strep throat, and either a stomach virus, or vomiting and diarrhea associated to the strep. I was given a shot of penicillin and the strep throat cleared up, and i recovered from the stomach virus over the next week. I was fine for the month of December, went on a vacation for new years, and came back with another sore throat.. went to doctor on Monday, Dr. said it was not classic signs of strep and the rapid strep test was negative, but treated with Zithromycin Tripak. Throat is improving with the Tripak. I have a history of being PARANOID about HIV exposure. I am in the medical field and I analyze every thing that goes on with my body. Partially because I am homosexual, I always wonder when I get a sniffle, or anything, if it could be HIV.. so.. that being said.. I noticed yesterday a cubital lymph node that is slightly swollen, but mostly really tender to touch. It is the ONLY lymph node that is palpably swollen in my body, but I thought it unusual, and at my elbow of all places??? So.. long story short, and I apologize for rambling, do you think that i was exposed to HIV, and that there is a chance I have contracted it?

Response from Dr. Frascino

Hello,

It seems a bit incongruous to me that you, being "in the medical field" and "parnoid about HIV exposure," would put your "penis partially inside his rectum" without a condom. Yes, I'm glad you came to your senses and pulled out after 30 seconds and then donned a condom! Also, you are very worried now, because you "found out" your partner was HIV positive. We must assume all our partners are potentially HIV positive and take all the necessary precautions to prevent HIV (and other STD) transmission. It's worth remembering that 25% of the estimated 1 million HIV+ Americans have absolutely no idea they have contracted the virus! OK, I'll get off my soapbox now. I do realize mistakes happen in the heat of passion when we tend to think with the little head instead of the one on our shoulders. And I'm not trying to be judgmental. I just want to point out to all our readers what a preventable illness HIV can be once armed with the correct information and a true commitment to staying safe.

Because your sex playmate was newly diagnosed and untreated, he may well have had a very high viral load, increasing his contagiousness. Consequently, you did place yourself at some degree of risk for HIV and other STDs by having unprotected insertive anal sex. That risk is potentially increased by his possible high viral load and decreased by the brevity (30 seconds) of your exposure. HIV testing is definitely warranted.

Your symptoms are not worrisome for or suggestive of HIV ARS. Please note the lymphadenopathy (swollen lymph nodes) associated with HIV disease is generalized and not painful.

My advice is to get an ELISA test at the three-month mark. If negative, the CDC would also recommend a follow-up test at six months, due to your partner's confirmed HIV-positive status.

Good luck!

Dr. Bob



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