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follow up: hiv or something else?
Aug 4, 2007

Dr. Frascino -

Thank you for responding to my question on Aug 3rd. I very much appreciate it! I have a quick follow-up if I may.

The guy who gave me oral did it for about 5 minutes (deep throat style). I had a scrape on my penis shaft near the head (due to severe frottage two weeks earlier). I don't think there was blood from my penis, but maybe bodily fluid from the scraped skin being stretched with my erection.

Barebacking-ectasy-guy was wearing braces so I'm not sure if he had any cuts.

Does this change your original response?

I'll send more of a contribution because of this follow-up.

thank you.

Response from Dr. Frascino

Hi,

Does your additional information change my original response? Nope! Not one bit. My assessment of your risk and my recommendations remain exactly the same. (See below.)

Good luck.

Dr. Bob

hiv or something else? Aug 3, 2007

i received oral sex from a 22 year old guy who does extacy and wanted me to do bareback, but i didn't. i did kiss his anus, and he told me he had an enema earlier. i put his cock in my mouth for about 10 seconds cause then i remembered i had a cut in my mouth.

he said he is hiv neg but refused to take a test with me.

8 days later i got a white puss-filled pimple on the outer lip.

over the past month i've had neuropathy feelings, swollen lymph nodes in the groin, neck, elbows as well as high anxiety, depression, stomach problems (gurgling in intestine and esophogus), white tongue, body aches especially in the shoulders, knees and feet, and some dry skin. i have a red line (2-3") on my left shoulder blade that doesn't go away. have not had a daytime fever, but have had night sweats for about three weeks. i can't sleep at all. wake up at 3am each day.

have redness around chest hair follicles, and have dry white stuff around the follicles under my scrotum.

doctor put me on anti-axiety meds, and seems to help a little. also use tylenol to help me fall asleep. been using ibuprofen to help with inflamation.

had hiv rna and ELISA done 13 days after exposure, and came back negative. i'll be doing another ELISA at week 6 (2 weeks from now).

in three weeks, my lymphocyte count went from 25.9% (or 1.5abs) to 20% (or 1.1abs). my wbc remained constant, neutophils went up to 74, monocytes, eos and baso all decreased...but all of these readings are still within the reference range given by the clinic.

FT3 is normal at 3.0 but FT4 is 1.8 (higher than 1.6 range). TSH is at 2.49 which is normal.

what is the likelihood that i am experiencing acute hiv? or can i be experiencing some kind of gastrointestinal or other virus that i may have got from him?

i will be sending a contribution shortly. thank you.

Response from Dr. Frascino

Hi,

HIV or something else? I'd say something else! Definitely something else!

I agree: barebacking-ecstasy-guy does indeed sound like a risky dude; however, 10 seconds of oral sex and an anal smooch carry only a negligible HIV transmission risk at best.

Symptoms are notoriously unreliable in distinguishing who is and is not HIV infected. Many of your symptoms sound anxiety/depression-related. Your negative PCR RNA and ELISA at 13 days are encouraging, but not conclusive. My advice is to relax! Get a single rapid HIV test at the three-month mark. The results will undoubtedly be negative, but this may well be the most effective and efficient way for you to put your irrational HIV fears permanently to rest. I would also suggest you consider getting counseling to help you cope with your fears, anxiety and depression.

Thank you for your donation (www.concertedeffort.org). In return, I'm sending you my best good-luck, good-health karma that your three-month definitive test remains negative.

Good luck! Be well!

Dr. Bob



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