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Im really scared,I need your help
Jan 14, 2007

Hello and thank you for your time in answering my question. It is greatly appreciated.

I'm male, 30 year old, medical student. I was with a man of unknown HIV status on December 1st, 2006, it was my first time with a man. Actually, it was my first sex experience at all. He was inside me about 10-20 seconds unprotected, there was no ejaculation. Then he gave me oral and we kissed. After about 2 days i experienced a pain in my left chest wall '' 6th - 7th intercostal space'',at first I thought it was because he hugged me so tight, i kept checking for any lymph nodes so many times every day, but it was not any palpable lymph nodes. After about 10 days i had another sex experience with another man, we kissed long time before he penetrated me unprotected for about 20 seconds, there was no ejaculation. Then, he gave me oral and we kissed again. I kept searching for any lymph nodes every day, until 2 weeks ago i felt 2 left axillary lymph nodes, about 1 cm each, mobile, non tender, and soft . 2 days ago i found another one, a right supra-clavicular lymph node, it was soft, mobile, non-tender. Since the first day i had sex with the first man, I have not experienced any other symptoms. I'm experiencing acute anxiety over this experience, I certainly am overwhelmed with guilt, which in turn is manifesting as a vicious circle of fear, obsession, and the flashing images in my head that my test result would be positive.

My questions are :- 1- Could the cause of these palpable lymph nodes be HIV infection ? 2- What is the possibility of being HIV + because of these 2 experiences ? 3- Is there any other possible cause than HIV ?

Thank you ,

Response from Dr. Frascino

Hello,

Since you are already "overwhelmed with guilt" and "experiencing acute anxiety" as a consequence of your actions, I won't lecture you on the topic "shouldn't medical students know better?!" OK?

Your HIV risk is two episodes of brief unprotected receptive anal sex without ejaculation with partners of unknown serostatus plus two episodes of "oral sex." These activities do place you at some degree of risk for STDs, including HIV. The estimated per-act risk for acquiring HIV from unprotected receptive anal sex with an HIV-positive partner is 50 per 10,000 exposures. Your actual risk would be less, because we do not know the status of your partners and there was no ejaculation.

To specifically answer your questions:

1. Yes, it's possible, although statistically very unlikely.

2. See paragraph above.

3. Yes, many. The vast majority of cases of adenopathy (swollen lymph glands) have absolutely nothing to do with HIV.

My advice:

1. Get a single HIV test at the three-month mark (from your last potential exposure).

2. As a sexual newbie, you need to learn much more about safer sexual practices and STD/HIV prevention techniques. Use the resources of this site, the archives and related links to gain this essential information.

3. Consider getting some counseling to help with your anxiety, guilt and "vicious circle of fear." You should also explore underlying reasons why you took such risks while being clearly cognizant of the potential catastrophic consequences. Understanding your behavior could help you avoid such risky business in the future.

Good luck!

Dr. Bob



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