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Lost my footing and center

Jun 12, 2007

Hi Robert,

How are you? I just want to say from the bottom of my heart a big thank-you. Your courage and compassion is a boon to everyone here, and the courage you have to face the world and touch the lives of people everywhere is inspirational. In my diary, I carry reminders of people who inspire me for everything that I do, and in those pages is a print out of your response to one particular question. In that response was a desire to help, comfort and heal that person, and in that post was a compassion for another. It is this compassion that I try to put into everything I do and everyone I come into contact with; thank-you.

I want to apologies in advance if I say anything that will offend yourself or any of your readers. I want you to know that it is not the intention, and is only a current reflection of how I feel.

Im one of the most centered and balanced persons you'll ever meet. I was previously never flustered, always approached a situation calmly when warranted and was always the one my friends and family came to, to talk. I was the problem solver. I was the person who believed there was always a choice to either laugh or cry, and I always chose laughing. I'm the person that has happiness written into my DNA - people always commented that they've never seen me down and that having me around made them feel better.

I come from well to do family who have always pushed me to achieve more, do better, and I always have. I've won sport premierships, I've gotton myself into law school in a top university, and Ive won awards from my schools, and have always been the person that the students came to for help. I'm good to my family and am unbelievably close. I love them dearly. I'm the one that remembers all their birthdays, anniversaries and the one that they talk to when they need help.

But then in August 2006... I met someone from the Internet. A man. It was something I shouldn't have done. The relationship last 5 months... and we had a lot of sex. Protected anal (receptive), and unprotected oral (insertive and receptive) ... a lot of it. He didn't tell me he was HIV+ until the second week into the relationship. Fortunately, we had always been protected sans the oral sex... but this was my first exposure into the HIV world. I was scared, and I spent as much time as I could to research about this terrible disease. Discovering this site, I kept wondering whether I had this terrible affliction. And for this reason, I stayed in the relationship for the most wrong of reasons, so I could get as much information as I could regarding were we always safe, did the condom ever break? He told me he doesn't believe he ever put me at risk... but this is also the same person who told me that unprotected oral sex does not carry a risk at all. This is also the same person who brushed his teeth, then proceeded to give me oral sex afterwards.

He was also the first person I had a sexual relationship or any sexual encounter with.

It has been 9 months now since my first sexual encounter with him, but I know... I know... I have HIV.

I developed a runny nose a few days after he told me he was HIV+ and was lethargic, but that was about a week into the first sexual encounter. I put this down to mental stress and the seasonal shifting from winter to spring. (I suffer from hay fever every year.)

In January, I discovered I had HPV on the tip of my penis and around my anal passage. We had always been protected. Thoughts of what-ifs kept entering my mind. What if the condom had broke? What if something happened? We were protected and I still got HPV... what if? What if? What if?

I have been on treatment for HPV since January 2007, having them frozen off and using Aldara when finally in May 2007, the doctor said that he believed the warts were in remission and that my body was taking control of it.

Wind back 2 months to March, I was sucking on a sour candy and it created a burn in the middle of my tongue. I looked in the mirror... and noticed bumps around my mouth and tongues. These turned out to be completely normal, but there is something that worries me greatly. On the side of my tongue, is what appears to be what looks like OHL.

I did my research. Could OHL appear within a year of HIV infection? What does it look like? What appeared to be milky plaque on the lateral borders of my tongue turned into white plaques as I used a tongue scraper to try to remove them every time I brushed me teeth and cleaned my tongue. I know this will sound stupid, but every time I eat Salt and Vinegar chips or rinse my mouth with mouthwash, my tongue seems to react, and the white plaques on the side of my tongue go crazy... going really white and obvious. Ive tried to reason that maybe its a tongue biting habit but Ive been conscious of not biting my tongue for weeks now and the thing seems to be getting progressively worse. The doctor who looked at my tongue (but didnt look at the sides I couldnt bring myself to ask her) couldnt see anything out of the ordinary and I had my teeth cleaned recently and I was waiting for the dentist to say something like, theres something that you should get checked out, but those fateful words never came. Since then however, in my mind the plaques look a lot whiter and have gotten worse. Ive reproduced some photos below:

Add to this my recent constant diarrhea (or slightly hard slightly soft stool) that has occurred for the past 2-3 weeks, my sore throat (from my siblings who were sick), a general feeling of not feeling well and vomiting after I ate spaghetti bolognaise my family made (no one else got sick) and lasagna from the school deli... it just seems overwhelming that the odds are stacked up.

Despite all this, I won't get tested. I'm afraid. I'm so, very afraid. My doctor has recommended this to me when he tested me for everything else but the blood test. I said no. I got scared when I got HPV because I didn't know what it was. I don't know how I would be able to handle it if I was diagnosed HIV positive. I don't think I would be able to have the inner strength.

I think about the doctor who'll have to tell me the bad news. It must be hard for him. I think about my happy family. I look at them around the dinner table at night and listen to their happy banter and stories and it kills me that I could be the cause of so much pain for them. I could never do this to them and put them through something like this, because I love them too much. I would rather die suddenly then to put them through finding out their son had HIV.

I look at myself and I hate myself. It kills me so much that this was something I did to myself. I am supposed to be the person who can solve any problem and the person who is balanced. I feel scared. I feel a deep, deep shame and I feel like I don't deserve to be a part of society. I feel tainted and I feel violated.

I am so, so, very angry, not at others but at myself. How can I help others if I can't help myself?

And I despair, because I feel like I have lost the very thing that kept me balanced... my ability to be optimistic... because it was this optimism that made me want to wake up every morning. It was this optimism that let me walk down the street like the luckiest guy in the world and it was this optimism that let me see the best side in every situation and want to save the world.

How can I do any of these things when internally, I'm such a wreck? How could I have done this to myself?

I'm so, so sorry Dr. Robert ... because I'm not this type of person that this letter makes me out to be. Sometimes, I look forward to sleep, because it is in my sleep that I forget my stupidity and thoughts that Im probably HIV positive.

And I'm sorry because I feel like I'm wasting my time and energy and being so selfish constantly questioning whether or not I have HIV. I'm supposed to be out there, helping people and saving the world, but I feel like being diagnosed with HIV will limit my ability to do that and the time I have to do it.

Mostly, I'm so sorry for the pain that I'll cause. My family has put so much into me and has given me so much for me to repay them this way. I have good friends who are so close, but yet I am so scared to tell them my fears because I'm the guy who doesn't fear anything. I'm the guy who they depend on and I'm the guy who loves everyone and everything and would never put himself in such a situation as I have. Im also scared of what it will do to who they think of me even though I know that theyll always be there to support me.

Sometimes, I wish I could just forget.

Response from Dr. Frascino


There seems to be a vast discrepancy between the person you describe yourself to be and the person you actually are. On the one hand is the centered, balanced problem solver who approaches every situation calmly and has happiness written into his DNA; the law school student with the close-knit family and many trusted friends who everyone relies on. On the other hand, we have a person racked with irrational fears who feels shame and who feels unworthy to be part of society; someone who feels violated, tainted and very angry and who would rather die suddenly than have his family find out he has been infected with HIV. All of this internal strife and conflict is related to your first sexual encounter, which, unfortunately, you seem to feel ashamed of for several reasons:

1. It was an Internet hookup.

2. It was man-on-man action.

3. The guy turned out to be HIV positive.

4. You contracted HPV, despite using condoms for receptive anal sex.

So now you've had your HPV successfully treated, but remain too fearful to get HIV tested, because you know . . . you know . . . you know . . . you have HIV. Here we go again! Another case of guilt and anxiety being translated into a definitive self-diagnosis of HIV/AIDS, despite any evidence whatsoever.

My strong opinion is that you are not HIV positive; however, only an HIV test can provide absolute proof. Let me review a few facts:

1. Your HIV risk unprotected oral and protected receptive anal sex is minimal at best. Assuming the latex condom was used properly and did not fail, your risk would be oral sex, which carries minimal risk.

2. HPV is the most common sexually transmitted disease. An estimated 20 million Americans are infected. It is very easy to acquire by mere skin-to-skin contact and can be transmitted by oral sex. HIV, on the other hand, is quite difficult to transmit and has a much lower overall incidence and prevalence. It is also much more difficult to transmit orally.

3. The 12 photos you sent of your tongue appear normal. I do not believe you have OHL. However, photos are never a completely adequate substitute for an in-person physical examination.

At this point you need to do two things:

1. Make an appointment to see a psychiatrist. You need help to confront your unwarranted HIV fears. In addition I believe you need to address multiple other issues related to guilt, anxiety, unrealistic expectations and perhaps even sexual orientation.

2. Get an HIV rapid test. Accurate results are available in as few as 20 minutes. The odds remain astronomically in your favor that you did not contract HIV.

Despite your last comment, "I wish I could just forget," this is not an option. It's time for you to confront and deal with reality. Stop trying to be everybody's "Mr. Perfect" and just be who you really are. Ultimately that's the road back to optimism and true happiness.

Good luck.

Dr. Bob

PLease give some light to this desperate Brazilian
Combivir Crixivan PEP Regimen

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