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Neg at 6-weeks after oral sex- still worried...
Jun 11, 2008

Dr Bob, I am a gay male and I hooked up with four different men over a weekend while I was visiting NYC. During these encounters, there was no anal sex whatsoever, and there was both receptive and insertive oral sex, and mutual masturbation. Nobody ejaculated in my mouth, and I think I may have tasted pre-cum once. I maintain good oral hygiene... I asked all of the individuals there HIV status and they all told me that they are negative. 8-9 days later, I got sick with a fever, sore throat, swollen lymph nodes in throat, with my left side being tender, and fatigue. This lasted for 4-5 days and subsided. My doctor, Dr. Dan Bowers, who is an HIV expert in Los Angeles told me that he thought I had strep or a viral infection, and that the lack of a rash or swollen lymphs in odd locations (armpits, groin, behind ears, etc) was a good indicator that I was not dealing with ARS. I got this illness after a weekend of 5 hours of sleep a night because of various birthday parties, and one day after a 6-hour cross country commercial flight after burning the candle at both ends all weekend. I also consulted another friend of mine who is an internist in NYC and he resonated the same answers... I drove myself crazy for 6 weeks thinking I had contracted HIV, feeling my lymph nodes 10+ times a day, taking my temperature multiple times a day, paying insane attention to every sensation in my body, etc, and all were normal without fail every time... I took a Home Access test at 6 weeks which came back negative, and I also had a standard blood draw test done with my doctor, which was an ELISA through LabCorp that came back non-reactive at 6-weeks, 3-days. I am a huge hypochondriac, and I am having a hard time believing my test results... I know that 6-weeks is not considered conclusive by everyone, but I have heard conflicting information in this department. I am an otherwise healthy 25 year old, and I am freaking myself out about this. I don't want to wait until the 3-month mark to know conclusively, as I will probably drive myself nuts with worry. I asked my doctor if he would recommend an HIV-1 RNA PCR, but he said that he wouldn't at this point... What are your thoughts on this? Thank you in advance.

-Dave

Response from Dr. Frascino

Hello "Huge Hypochondriac" Dave,

You report only getting five hours of sleep a night "because of various birthday parties." Various birthday parties??? Is that a code name for hooking up with four different New York hotties in one wild weekend???? Obviously someone was blowing more than candles at this birthday bash.

Your HIV-acquisition risk is very low. I agree with your doctor: Your symptoms are not at all likely to be HIV related. Your negative HIV tests out to six weeks are extremely encouraging, but not yet completely definitive. I also agree with your doctor's recommendation not to get an HIV-1 RNA PCR test. These tests are not recommended for routine HIV screening, due to the rate of false-positives, other technical concerns and cost. You can read much more about this issue in the archives, as it comes up quite frequently. (It's nearly reached QTND questions that never die status!) Finally, I also agree with you! You are indeed a huge hypochondriac! Your fears are unwarranted and bordering on the irrational. I'm quite confident your conclusive three-month HIV test will indeed remain negative.

Good luck Dave.

Dr. Bob



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