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Really Worried
Oct 14, 2008

Dear Doc Bob,

First of all, I would like to commend you for a very noble effort by providing advise and helping those who need quick, professional answer with regards to their health concerns/issues. May I ask if cheque donations are accepted in your foundation? Please advise the pay-to name and address where I can send my contribution. If not kindly advise how I can remit my contribution since I'm based in Asia (see you have a worldwide following!).

I hope you could take time, provide insights and your views with regards to my worries on a possible HIV infection risk. Almost two months back, I had encountered a condom breakage incident during insertive vaginal intercourse. From top of mind, it would be safe to say that I might have been exposed over a minute and realized that the condom broke after I ejaculated inside a massage parlor attendant. I immediately proceed to shower and wash my genitals. My first concern was her getting pregnant but I was told that she had finished her period a week back. She also gave me an unprotected blowjob and we did some kissing too.

A few days later, but not exceeding a week after the potential exposure, I started experiencing manageable headaches and a bit of chest pain. I would also feel tingling sensations in my arms and legs which lead to my arm hairs rising, like goosebumps. These would go away after taking the ever reliable paracetamol medication.

Coincidentally, around 15-19 days after the exposure, I was scheduled to have my annual physical check-up. Results were generaly OK except that I had UTI and had a low level of good cholesterol count. My doc gave me some antibiotics for the UTI and told me the rest of my metrics were fine, which included CBC blood test, treadmill stress test, chest x-ray, etc.

What bother's me is the persistent bouts with headaches and dizziness. This prompted me to surf the net and research about HIV symptoms. I might say that, now, I'm very well informed because I've preoccupied myself checking out the net for all HIV information, testimonials, pictures, totally the works!

At some point, I would check my mouth for what I suspect as thrush due to a more pronounced tastebud structures inside my toungue. At times, it is more whitish than I would normally observe. Although I've learned that for most people, flu like symptoms are experienced during acute HIV infection, I luckily haven't had yet any bout of fever nor rashes (God forbid).

About a month after the possible exposure, I suddenly felt pain on my inner thighs after an afternoon of leisure walking. Upon checking at home, I found vein-like reddish lines on my upper inner thighs, near the loin/groin area. A few days, the redness subsided and is now a bit dark colored. Could these be stretchmarks? I've had a few bouts of what I think could be night sweats, though they were not as profuse nor as drenched as those described in the Internet.

I recently felt some discomfort in my armpits and neck area. I again suspect swollen lymph nodes but readily, I can't conclude if they were really swollen since these parts of my body appear to be normal (no visible lumps or enlargement).

It has almost been two months from the potential exposure and I'm very anxious about my status. The recurrent manifestestions of what could be infection symptoms is driving me nuts and I think I'm sinking into depression! I also get this tingling feeling in arms and feet.

Given my sharings, hope you could advise this worried fellow. Could the symptoms I'm experiencing be a product of my being hypochondiac? All in the mind? What is the possibility of me being a worried well?

I'm eagerly awaiting your frank and straightforward insights doc.

Thanks and more power! Worry Wart

Response from Dr. Frascino

Hello Worry Wart,

A broken-condom incident does place you at some degree of risk for STDs, including HIV.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected. Your particular symptom complex is not suggestive of or worrisome for HIV acute retroviral syndrome (ARS). In fact, your symptoms are very consistent with anxiety, which would go along with your "preoccupation" with symptom-surfing the Internet and persistent "self checking" for symptoms.

You also report ". . . I think I'm sinking into depression." I agree!

My advice:

1. Stop symptom-surfing the Net and and self-analyzing. Rather, spend your Internet time on this (or other reputable HIV Web sites). The scientific information found here and in the archives should be both enlightening and reassuring for you.

2. Get an HIV test at the three-month mark.

3. Review proper condom use. They seldom break when used properly.

Regarding donations to the Robert James Frascino AIDS Foundation, yes, the foundation gratefully accepts all forms of donations, including personal checks, cashier's checks, PayPal, credit cards, direct wire-to-wire bank transfers, etc. Checks should be made out to The Robert James Frascino AIDS Foundation. The foundation's address is:

The Robert James Frascino AIDS Foundation 1000 Fremont Ave., Suite 145 Los Altos, CA 94024

Additional donation information can be found on the foundation's Web site at www.concertedeffort.org. Thank you for your donation. In return, I'm sending you my good-luck/good-health karma that your definitive three-month HIV test is negative. The statistical odds are very much in your favor that you did not contract HIV from this episode.

If the anxiety and depression persist, seek help from a therapist. These conditions are very amenable to treatment.

Good luck.

Dr. Bob



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