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Meningitis and HIV
Dec 15, 2007

Hi Doc,

Though I must have written countless times, you have not answered a single question. I know you are very busy and appreciate the work you do and the help you extend to all who visit this forum. I really hope you will find the time to answer this.

Two days after a potential exposure (multiple unprotected blowjobs from high risk partners), I developed a very stiff neck (where it was very painful to try to touch my chin to my chest) along with a feeling of malaise. This resolved in 24 hours, but I continued to have pains predominantly in my upper back on the right side (I guess where the ribs are and the part that aches when one gets the flu). This lasted for at least a week.

Could this be the viral meningitis associated with acute HIV infection?

Apart from that, I did feel like crap on and off for the next two weeks with nausea every now and then.

I have been reading that if meningitis resolves within 24 hours, it is a sign of severe infection and that viral meningitis in adults means one may not experience fever, photophobia, etc. Is this true?

I know that the typical window period for ARS is 2-4 weeks, but I did have a very hard weekend of partying (alcohol/drugs) combined with a total of only 5 hours of sleep over 2 nights, so could that be a reason for early symptoms?

The day after my exposure (a day prior to the neck stiffness), when I was still recovering from the partying, someone at home touched my body and said that it seemed like I had a fever - I didnt think much of it, but wish I had checked.

I will be making a donation very soon!

Thanks,

Thom

Response from Dr. Frascino

Hello Thom,

Unprotected blowjobs are not considered a significant HIV-transmission risk, whether or not your partners were high risk.

Next, I doubt your symptoms were "meningitis." More likely they were related to your partying like a rock star and lack of sleep. One thing that's for certain: Your symptoms are not HIV related, as they occurred two days after your suck-a-thon. Acute retroviral syndrome symptoms related to HIV primary infection take weeks, not hours or days to become manifest.

My advice is:

1. Clean up your act, even if you actually happen to be a real rock star.

2. If you remain concerned about HIV, get a single rapid HIV test at the three-month mark. HIV-antibody tests taken prior to three months are not considered to be definitive.

Thanks for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'll send you my good-luck karma for a definitive negative HIV test.

Good luck.

Dr. Bob



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