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anxiety over HIV worry
Jul 18, 2007

I am thankful to find your site. I am a mid 30's male, with ulcerative colitis, I take imuran for that. I have always had a problem with anxiety and sometimes depression. I recently this year had a staph infection, and tried to come back on me, It responded well to antibiotics and then the antibiotic ointment. Approximately a year and a half ago, I had a one night affair, with a woman of unknown HIV status and I know she is married and has another partner alos(afterwards, I learned this). I read your stats on one time encounters and seems low probability. But about three months ago, I worried about getting caught, even though it was a year ago, my guilt began to build. I confessed and my wife and I are working that out. But, I noticed I have had diarrhea for approx a month and ongoing. It is different that my colitis (no blood), but not all day or anything. Just maybe once a day. I also sweat BAD, always have. But at night I don't remember until recently waking up in the night and sweat around my collar. My wife keeps the thermostat on 75 which seems hot to me and Humidity stays high here. I am scared that I maybe having a paranoia but also I am scared I may have something to worry about. MY wife would forgive me of an affair, but endangering our family (children also), she would not. I worry about Imuran affecting the test? Possibly a false positve. Then I would go into coma. Also, I don't know if Imuran would help a staph infection return. I have been taking it about 4 years. I also don't know what, if any, causes could cause the night sweats and diarrhea that seem to be coincedental? I am afraid to be tested now, If positive, my life and my families life would be over. I also could not live with myself if I have endangered my wifes health. Please give me your take on this.

Thank you Scared and Love my wife.

Response from Dr. Frascino

Hello,

My take on your situation is that you need counseling. You're a wreck! Anxiety, depression, guilt, worry, paranoia, fear . . . your life is a psychiatrist's wet dream!

Let's look at the facts. Your HIV-transmission risk is a "one night affair with a woman of unknown HIV status." Your "symptoms" are not worrisome for or suggestive of HIV ARS (acute retroviral syndrome) or HIV disease. You've already leveled with your wife, which I applaud you for! And it seems you and she are working through the problem, another good sign. So you are left with ongoing worry that you might have contracted HIV and are afraid to be tested. It seems to me you have very little choice. Your life is presently quite miserable due to your anxiety, depression, etc., etc., etc. The only way to address that problem is to get an HIV test. The odds are astronomically in your favor that you did not contract HIV from this single indiscretion.

Regarding ulcerative colitis, this autoimmune disease often requires immunosuppressive agents, such as corticosteroids and/or Imuran for control. Depending on the dose, strong immunosuppressive drugs may alter the body's immune responses, including its ability to make specific antibodies. This theoretically could give a false-negative (not false-positive) result. If you have been taking significant doses of Imuran, corticosteroids or other immunosuppressive drugs for your ulcerative colitis on a regular basis, I would suggest you get a DNA PCR rather than HIV-antibody test. DNA PCR measures a fragment of the actual viral particle rather than testing for the presence of anti-HIV antibodies (ELISA and Western Blot tests). The DNA PCR therefore does not rely on the body's immune response (production of anti-HIV antibodies) to determine if HIV is present or not.

Good luck.

Dr. Bob



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