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HIV ARS Fears
Nov 18, 2008

Hello Dr. Frascino, Let me start off by congratulating you for not only being an amazing professional, but a truly wonderful person. Its amazing what one can learn from reading your written responses. I have actually read through most of the posts/responses on this forum and debated a few days whether to waste your time with a questions I suspect youve heard a million times. Still, none of the situations I have read here match my circumstances enough to be comforted by your responses to them. So please Dr., I would most greatly appreciate your response here. I am studying to be a lawyer and know your time is infinitely valuable so Ill try and paint just the facts if you feel you need more information please contact me. Situation: I did something I never do and dont know why I let myself do and that is take a girl I met at a bar home (home is large suburb of NYC in CT). We had sex the following morning (not that night since we were drunk). We had sex with a condom except for a couple minutes where she was using the tip of my penis to stimulate here outer vagina and 20 seconds where I slipped in by mistake.

Facts: I am a strong healthy 26 y/o guy with no previous STD exposure except HSV-1. The girl Caucasian, found out after from her cousin that she is mentally unstable (she is in an alcohol rehab hospital now) and has many one night stands; she had what she says was a herpes sore above her top mouth lip; when asked, she denied several times having any STD including AIDS and she knew this b/c she was tested when she was processed for a 6month jail sentence for DUI one year before. I found out that the girl was bleeding at least before and after sex since I found two blood spots on my boxers (which she wore that night) and she mentioned in passing to her cousin the next day that oh, Im spotting. Symptoms: Night following morning of possible exposure feeling like I was coming down with something but didnt. 3rd day (small sore on my corner lip that went away after a few days) 1st 5th week had sticky/smelly bowel movements on and off. (7th day one night of chills) 2nd week had three days of liberal bleeding from my hemorrhoids (which have only bled on 2 separate occasions in 3 yrs.) promptly stopped after using Prep H; I have had nose bleeds often in my life, but on the 13th day, I had a nose bleed that lasted a very long time where I lost so much blood felt I might collapse; had a few days of blood shot eyes that made my eyes feel EXTREMELY dry, painful, sensitive toward light. Between 3rd and 5th weeks have had several days where my neck is stiff on one side and I can feel little lumps I can move around in my neck just above my collar bone and below my Adams apple as well as bumps on the side of the neck. Not sure if these are lymph nodes or not but they are palpable if you search for them (not visible). 7th day present intermittent (they happen once of twice a day, sometimes not at all) low grade fevers (never surpassing 99.7 usually around 99.1) and hot flashes; white tongue (not sure if whiter than usual for me since I never checked before, but certainly whiter than people around me (Ive checked). On the 22nd 26th day my tongue felt as though I burned the tip, kind of a bitter taste. During the 5th week I had a couple days of diarrhea, nausea, and headaches. Last couple of days my eyes are bothering me again where they are sensitive toward light, almost causing a headache together with a pain/pressure below my eye and next to my nose; also, I have had a couple of days where most of the morning I feel like I am hangover and want to go back to bed. None of these symptom are normal for me.

Medical: On Day 8 with extreme fear, I went to a planned parenthood, was handled by a wonderful Dr. who reassured me the probability was HIGHLY unlikely tested neg. on a rapid HIV test. Day 16 tested neg. for all major STDs (no HIV test) Day 26 Saw my GP who said he thinks its extremely unlikely I contracted HIV, he did a general vitals check, and had viral syndrome blood tests done on me that all came back normal. Going for another HIV test Tuesday (which would be the 37th day past possible exposure.

I would really like to know what you think of all of this. I will admit I have been under enormous stress for all of this to the point of performing badly at the office. Ive had bad thoughts that I immediately turn to the Lord to strike from me, but I really am scared as so many people depend on me and my future. I just dont want to lose my life before I ever get a chance to start it. I want you to know that I have been letting my imagination run wild with horrible thoughts especially after beginning to research ARS symptoms after week 1 of possible exposure. Everyone tells me that its all stress, that I am doing it to myself and that I should not fear is this true? Am I just another worried weller? God I hope so. Please advise. And God bless you!

Love, A scared and foolish boy

Response from Dr. Frascino

Hello Scared and Foolish Boy,

". . . if you feel you need more information please contact me." No, I certainly don't need more information. Are they teaching you to charge by the word in law school? If so, you're sure to be a top earner once you join a firm.

Your HIV-acquisition risk is quite low, due to the very brief potential exposure to your mentally unstable, bleeding, former inmate sex-partner. My advice is to get a single HIV-antibody test at the three-month mark. The odds are very much in your favor that you did not contract HIV from this horizontal mattress mambo.

Symptoms are unreliable in predicting who is and is not HIV infected. Your symptoms are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS). By the way, aren't all bowel movements "sticky/smelly"???

Finally, your enormous stress and "bad thoughts" are worrisome. Turning to the "Lord" to strike them from (you)" is OK, but I think a psychiatrist would be more effective. I don't think you are a "worried weller," because while I agree you are very "worried," I don't believe you are emotionally/psychiatrically well! I suggest you consult a psychiatrist to help you cope with your anxiety and destructive thoughts.

Good luck.

Dr. Bob



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