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Sep 22, 2008

Hi Bob-

I was the person who lost his job and had unprotected vaginal intercourse with an escort. I've been so paranoid for quite some time and I realize that what I did was completly stupid and I will never do that again. I did have some friends to help comfort me in my problem dealing with this though. I had a friend that did speak to a physican to see if I could get any advice to help calm my nerves. That person did mention most (not all) newly infected HIV patients would experience primary infection stage of swollen lymph nodes, fever, rash, thrush, and so on and so on within 48 hrs to a week and then disappear. So far it's been a little over 2 weeks and I have not experienced anything of that nature. And I know symptoms are not validated because some people with the phobia (like me) do experience symptoms because their mind is playing tricks on them or their experiencing something else of another nature. And then their are some people who don't experience symptoms and may go on for yrs without knowing it. Is that true?

Also I tried talking to this girl that I dated and I asked her if she would come get tested just to verify (I even offered her money for it just for piece of mind). However, she keeps getting angry with me, telling me she's not a crack whore and she doesn't have any diseases and she's a mother with kids. She told me she does get tested on a regular basis. She hung up on me and then she blacklisted me. I tried calling her back and she said she doesn't trust me anymore and not to call her back. I don't intend on engaging in this type of behavior anymore and especially with people like her. Although I'm still worried. Since she blacklisted me and doesn't return my calls, I still want her to get tested. Is their anyone or any organization I can talk too to call this woman and to convince her to listen to what im talking about? I told her once she get's tested that I would leave her alone.

Also, I'm uninsured and live in Northern Virginia. In the event that something does happen to me (Hopefully not) do you know of any programs in my area that will help? Also I am a veteran (US Marine Corps) Do you know if the Dept. of Veterans Affairs has any programs for vets (especially one who served in iraq like me?) in the event i do contract something? (Hopefully it won't happen)

Response from Dr. Frascino


Acute retroviral syndrome symptoms generally occur two-three weeks after primary HIV infection. You are correct: the symptoms can vary significantly from person to person. Some folks have such mild symptoms they don't even notice them. Others wind up in the hospital. Symptoms in general are notoriously unreliable in determining who is and is not HIV infected.

Regarding your "escort," I'd suggest you leave here alone before she has a restraining order taken out against you! This is your problem, not hers. If she doesn't want to get retested, you can not force her to do so. You had mutually consensual sex!

Regarding your health care, because you are a vet, you are covered by the Veterans Health Administration.

Finally, since you are obviously an anxious, nervous wreck over this situation, I'd suggest you see your doctor and discuss getting some counseling for your anxiety or some anti-anxiety medication to help you endure the window period.

Good luck.

Dr. Bob

unproteced sex with a sex worker Sep 14, 2008

Dr Bob-

Here's my situation. I lost my job a few weeks ago and was feeling really upset and depressed. So I did something incredibly stupid. I went out and had unprotected vaginal intercourse with this girl who happens to be a prositute. I also happen to know this girl because ive dated her before and i never took a risk like this. She told me that she swears she doesn't do this with anyone else, get's tested on a regular basis, and uses protection on everyone. she told me because she took up my offer because dated me before, trusts me, and felt sorry for me. Now I realize the loss of a job is not worth risking your life over something as dangerous like what i did. I called her again because I was really worried and she got angry at me swearing that she doesn't have anything and that she has a daughter to take care of. I plan on getting tested within 3 months but I wanted to know. What would be my risk assesment of acquiring something? i am circumsized, don't do drugs, she doesn't do any illegal substance that i know of, and i didn't see any visible bleeding, washed myself immediately, and it was just that one time (and i didn't ejaculate into her)

Response from Dr. Frascino


The estimated per-act statistical risk for acquiring HIV from unprotected insertive penile-vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. Your estimated statistical risk would be even less, as we do not know the HIV status of your "girl who happens to be a prostitute." Since you are still in touch with her, perhaps she would be willing to get a rapid HIV test now. You would then know her current HIV status within 20 minutes. If indeed she tests negative, you can breathe a sigh of relief, as the only remaining risk would be the very remote chance that she was in her window period (period prior to HIV seroconversion). You should still get your own HIV-antibody test at the three-month mark for complete assurance of your negative status.

Good luck.

Dr. Bob

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