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scared...please answer...
Jan 10, 2009

Dr Bob, Since my possible exposure this website has been my only peace of mind...finding that I am not alone in this time where I really feel that I have no one that I can talk to...I know that you get many questions and cannot possibly answer all, but I have respected your answers to the questions I have read in the forum and I would really like your input. Whatever the end result of my situation I will be adding your foundation to my annual donations.... I really feel that this is a very "needed" website as I have scoured over the CDC website and was only able to find information I needed through the body.

I know there has been a lot of controversy over 3 or 6 month testing and I have read your responses...so I guess I won't really go down that road...My possible exposure was unprotected vaginal sex back in July...Immediately the following day I started having weird symptoms that have progressed over the past almost 6 months, in order: abdominal pain for 1 week, diarriah for 1 day, small pimple-like sores about 5 on my buttocks (only lasted a day), sore throat, 2 nights of sweats for a week with a mild cold, burning sensation on my tongue with a bit of a whiter color which has never gone away, aching in my shoulders, and most recently a blood blister in my inner cheek of my mouth.

I am sure that you have heard all these symptoms, but I guess what my biggest concern is that my exposure was one night between a break up with my girl friend...So as you can probably guess, I am terrified that I have given her something. A week after the possible exposure "one night stand". I had sex with my girlfriend, and the next day she had diarriah and a small pimple like sore inside her mouth. Then about two weeks later she had a dry cough with a rash on her neck that itched like crazy. Then a sinus infection a few months later with a genital ulcer which was painless.

I have had multiple screenings for all STDs (everything) which have come back negative all the way out to almost 5 months. I was given a copy of a test result from the "one night stand" that said non-reactive <.01 or something after 5 months of our incident. They said that the last time that they had unprotected sex was back in 2003. So I am guessing that this test would be conclusive? I did notice that the test said HIV1 on it which I asked the question and they didn't know there were two different strains. I asked them to contact the testing center and make sure that they were tested for both.

My question is, do I have reason to be concerned and continue testing? I am currently out of the country and will return at about 7 months post exposure. I am going to have another STD screening. Do you think I should I consider myself hiv - in this situation? I did have a vaccination for tetnus during the fist few weeks of this...testing in between. About a month ago I had 4 more vaccines: Hep B, Flu, Anthrax, and Typhoid. Will these have an effect of the accuracy of the test when I return? Does the ELISA which I have been tested with screen for HIV2? I am considering a viral load test when I get back...I know how you feel about those, but I just have to know if hiv is my problem. Lastly, my girlfriend and I both have hsv2 which has never been a problem for either of us, since my possible exposure I have had consistent symptoms of hsv2 and am now on an antiviral to control it, possibly stress? Could all of these symptoms be caused by hsv2? What other viruses could cause these symptoms if it isn't hiv?

I know that you are busy and cannot answer all the questions, but it would mean the world to my peace of mind until I return to the states if you could answer this one.please

Scared Overseas

Response from Dr. Frascino

Hello Scared Overseas,

Your "question" really is not one question, but rather a whole litany of concerns. I'll try to hit the high points rather than dive into detail over each concern, because your basic problem is not HIV but rather guilt and fear of HIV infection.

Your HIV-acquisition risk is unprotected insertive penile-vaginal sex. Unprotected sex does place you at some degree of risk for STD's including HIV. However, you report having multiple STD screens out to five months, all of which were negative. (I assume these included HIV-antibody testing.) You also report your "one night stand" tested negative ("non-reactive") at five months. Consequently HIV (as well as other STDs) is not your problem. No way. No how. No additional HIV testing is warranted.

Regarding symptoms, neither yours nor your girlfriend's are worrisome for (or consistent) with HIV acute retroviral syndrome (ARS). Both of you had onset of symptoms the day after having sex. The symptoms of ARS manifest themselves two to three weeks after HIV primary infection, not the following day.

Regarding testing, your vaccinations will not affect your HIV-antibody test results when you return to the States. However, as noted above, you don't really need any additional testing anyway.

My advice is that you level with your girlfriend. It's not only the best way to deal with your guilt; it's also the right thing to do.

Good luck.

Dr. Bob



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