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Dec 9, 2007

Hi Dr Bob,

I sent in a question several times now but I havent been one of the lucky ones. I hope this time I'm seen.

About 14 days ago I had an unprotected encounter with a sexworker in Macau. Without boring you with details and excuses, it included about 5 minutes of unprotected vaginal intercourse and a BJ. I know from reading other forums that the odds are in my favor.

However, I continue to have difficulty letting go of the possibilities and am seeing signs of the worst case everywhere. It's strange that I spent so much money in Macau hoping against the odds and expecting the near impossible to send me home with a pocket full of cash. But, now I'm hoping with the odds but fearing the improbable worst case scenario.

I remember when I first started reading the forums (right after the exposure) wondering why people couldn't see that all the symptoms were nothing to be concerned with. Now, about 14 days later I find myself one of those people. So, here's a breakdown of my symptoms. Please humor me and if possible clue me in to how they don't fit in to the ARS, or if they do, just share with my some reassuring insights.

I had sex on the 20th of November; I woke with a wicked sore throat and a cough on the 28th; I've had night sweats for the past week and on the 29th it developed to cold chills throughout the day (with continued night sweats); I've been completely without energy as of the 29th; I had diarrhea on the 29th (1 day) and on the 30th felt a little nausea; I have felt hot since the 28th but today took my temp and had none (97.7); I started getting occasional dull headaches on the 28th; I've had ache muscles and joints with the occasional cramp for about a week. On the 1st I started itching around the neck and face.

I know it is more likely that these symptoms are due to a month of partying (drinking, smoking, etc) and the absolute shame and stress from sticking my Johnson where it didn't belong especially unprotected. I've done embarrassingly foolish things before and felt a physiologic response to the mental anguish. I guess it's just that no matter how much the odds are in my favor I still may lose this one. Whether it's 1/100 or 1/1mill someone has to be the unlucky one. If this wasn't the case there would be no HIV. Im a bit stuck on the fear that I may be that 1.

In the end only time and a couple cardio intense 20 minute tests will tell, but until then do you have any thoughts/advice/reassurances - a reality check about my symptoms and the level of my risk?

Thank you for your time and advice

Response from Dr. Frascino


Actually if you just reread your post you'll find you've provided your own reality check! I absolutely agree with your assessment and conclusions: You are indeed ". . . stuck on the fear" and only an HIV test outside the window period can give you the definitive reassurance you desire no matter how astronomical the odds are. So what should you do? I'd suggest:

1. Continue reading the archives. The information and testimonials there should be both enlightening and reassuring.

2. Fear and anxiety are your major problems at the moment. You may need help with these (counseling, anti-anxiety medications, etc.).

3. Reality check: A "month of drinking, smoking, etc." will indeed exact a toll on your health.

4. Reality check: You've "done embarrassingly foolish things before and felt a physiologic response to the mental anguish." Well, here you are again. Perhaps it's time to confront why you do "embarrassingly foolish things" in the first place. Counseling could help.

Good luck!

Dr. Bob

Just a big Thank You!
Elisa "confirmation"?

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