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Very Upset

Oct 6, 2008

Hi im a gay male of 24 who was in a long term relationship, i just found out that my partner had been seeing other men behind my back. HIV status of the men is unknown but my partner was HIV- at the begining of our relationship. I also had a drunken encounter with a male prostitute, he briefly attempted to insert my penis into his anus but i pulled out due to it being unprotected, the incident lasted seconds.

im concerned as iv been thinking about hiv since and 3 days after the encounter with the guy i came down with a sore throat, fever and chills. im going to get tested in 2 weeks once the 3 months is up but im worried about the chances of HIV i know its difficult to say but what are the odds of contracting HIV from the prostitute and from receptive anal sex unprotected with my partner? pleas help as its overtaking my life and iv even started to get signs of ilnesses like headacehes, nech pains, tiredness, diareah.... i do think i may just be over reacting and making myself believe i have these symptoms subconcoiusly but im just so upset. plaese help. Thank you

Response from Dr. Frascino

Hello Very Upset,

I hope the person you are most upset with is yourself, as you are the only one who can assure your HIV-negative status remains intact! Both you and your partner have now had risky unsafe sexual experiences outside your long-term relationship. It is yet another reason I continue to remind everyone that we must all assume our sexual partners could be HIV infected and therefore must take all the necessary precautions to protect our health and prevent STDs, including HIV.

Regarding risk, unprotected anal receptive sex carries a significantly higher degree of risk than unprotected insertive anal sex. You can read about the estimated statistical risks for these various sexual activities in the archives. (A quick search will produce hundreds of hits, all with the identical statistics.)

Regarding symptoms, acute retroviral syndrome (ARS) symptoms generally manifest themselves two to four weeks after HIV primary infection. The symptoms you experienced only three days after your "drunken encounter" are most likely not HIV related. Many of the other symptoms you describe (headache, neck pains, tiredness, diarrhea, etc.) may well be due to stress.

As for testing, both you and your partner need HIV-antibody testing three months after your last potential exposure. Since you are obviously concerned about your partner's infidelity resulting in an HIV risk to you, why not ask him to get HIV tested immediately? If he's negative, you can relax somewhat. He could still be in his window period and you could still have been infected from your own brief lapse in judgment, but the statistical odds you have become HIV-infected would certainly be significantly less.

Finally, I should point out you are indeed "very upset." So upset you apparently forgot how to use the spell check function on your computer! (. . . pleas, ilnesses, headacehes, nech pains, diareah . . . subconciously, plaese . . . etc.)!!!

Good luck on your upcoming HIV test. I'm confident you'll never place yourself at risk again (and hopeful you'll remember to use spell check as well!).

Dr. Bob

Family Med Resident
Please Please Help!!

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