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I need your expertise.
Jun 18, 2007

Donation on way, but question (wrong forum before, sorry). I asked the folks over on medhelp.org and they have recommended me not even get a test. But you seem to be far more knowledgable and I wanted your 2nd opinion. I wanted to know what you thought about my symptoms and getting tested. Here's what I posted over there: "About 5 weeks ago I went back to the hotel with a girl in the philippines. We had protected vaginal sex, unprotected oral (both ways, very briefly cunilingus), and deeper vaginal fingering. protected sex occured twice. A day or two after the incident, I noticed a red rash in the pubic hair region above penis. The rash seemed to spread to a small portion of my scrotum a couple of days later. Came home and was extremely stressed about the rash, work, and car problems. I was getting little sleep and smoking many cigarettes. A week after the incident, I began to develop geographic tongue (still there, much milder 5 weeks after the incident). Without reading much, I had a negative HIV test 2 weeks after the incident. About 2 weeks after the possible exposure, I developed a few ring worm rashes on thigh (had these as a kid, they are subsiding). 4 weeks after incident, developed a intermittent general low to moderate itch all over the body that though has seemed to decline a bit. I think I see tiny red spots randomly around my body (5 to 7), may itch more than other areas. I do not think I ever had a fever, sore throat, though I can feek my neck lymphnodes, they are not painful (can one feel them if they are not swollen?). I do not think I have had any flu like symptoms and do not feel more fatigued than the lack of sleep I am getting thinking about this all the time. Are these symptoms of acute HIV? I cannot wait 6 months to get an opinion, although I will get tested then."

I didn't mention she was a CSW (am still embarrased). I also got a 2nd opinion on the (maybe 6 small) rashes (1 on the inside of my knee, a few on the side of my thigh near butt) and the doctor told me it was nummular exzema. I received an ELISA test about 36 days after incident (shoulda waited to 6 weeks, I know, I was anxious). Came back negative. I also think I've been sneezing a bit more than usual (itching has seemed to stop), although I've never gotten allergies bad. Given my risk, should I test again now? Or wait 13 weeks?"

Exzema has since gone done a bit with hydrocortisone. Most of the people told me there was almost zero chance of me being infected (forget HIV) and I wouldn't need another test. I'm still nervous about this, though. Donation on way, thanks a bunch Doc.

Response from Dr. Frascino

Hello,

Glad you and your question found the correct forum!

Your HIV risk is exceedingly low. Protected vaginal sex would indeed be "protected" if the latex condom was used properly and did not fail. That would leave oral sex, which carries a very minimal risk for HIV transmission.

Your symptoms are not at all worrisome for HIV ARS (acute retroviral syndrome) or HIV disease. However, it must also be mentioned that "symptoms" are unreliable in predicting who is and is not HIV infected.

Your negative HIV tests at two weeks and again at 36 days are encouraging, but not definitive, as tests taken prior to the three-month mark are not considered to be conclusive.

My advice is simple:

1. Stop worrying. Get a single HIV rapid test at the three-month mark. The odds you did not contract HIV are astronomically in your favor.

2. Stop smoking! If you don't, cigarettes will indeed kill you.

Finally, how does one "feek" one's neck?

Thanks for your donation (www.concertedeffort.org). In return I'm sending my good-luck karma that your definitive HIV test will remain negative. I very strongly suspect it will!

Good luck.

Dr. Bob



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