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Complex circumstances. Can't find answers Going bonkers HELP
Mar 8, 2009

Hello doc. First of all let me congratulate you for the work you're doing on this website and for the support you provide us with.

For the last few weeks I've been scouring the Internet for an answer to my problem. I've read hundreds of threads, articles, essays on studies etc trying to collage bits of info together and clear up my complex case. It hasnt been much of a success, thus I decided to ask a question directly.

27 days ago I had unprotected oral sex with a 30-year-old gay man, whom I (20 years young, insecure, pessimistic, hypochondriac, nave but at the same time skeptical even cynical type of guy who hardly trusts anyone) was told is a decent and quite right-minded person (I know that doesnt really mean anything). He assured me he was perfectly healthy, not even recovering from an illness.

He prolongedly perform fellatio on me - I doubt he had any cuts or sores in his mouth and I know he brushed his teeth at least 4 hours prior. I then performed oral sex on him very briefly. Now, I was extremely drunk so I dont know exactly for how long, but anywhere between 15 seconds to 1-minute tops. I am 1000% sure he didnt ejaculate in my mouth, though there could have been some precum, but again, I cant confirm this.

So far it must sound laughable, because I dont know if the guy was positive (he said he wasnt but could not know it) and Im not even sure there was precum involved.

What makes this complicated is what followed this event.

I am a heavy smoker, so I get a sore throat frequently. The day after I had oral intercourse, I could feel that when I smoked, inhaling smoke wasnt easy as usual, it kind of tingled. The next day my neck swelled. The following day I was diagnosed with pharyngitis and acute tonsillitis. I started taking antibiotics. No improvement after 7 days. I continued till day 10 and integrated with 1mg of cortisone because the lymph nodes under my jaw were the size of a bulls testicles, and so were my tonsils. Then a sense of fatigue and aversion to light and blurry vision came, along with constant tachycardia and shortness of breath, getting up from a chair would be like running the marathon (it lasted for over a week, even though I interrupted cortisone at day 4 instead of 10). Now at day 27 my throat is still irritated a little, the thumping pulse is gone and nodes have considerably reduced their size (although they re-swelled at week 2 - now I can feel them if I squeeze my neck and when I do this they seem to tighten and swell a little bit). Fatigue and blurry vision may occur and last for some 10 minutes and then disappear for days. The funny thing is that in the period of time I described my throat NEVER hurt. I could feel no difficulty in swallowing even when it had acquired a dark purple shade. Never felt swollen lymph nodes other than on my neck. And I only had fever for a couple days (were talking about 99,5ish degrees not Potomac horse fever) so I find it hard to believe that I had even a mild form of mono (thats what people around me are telling me)

Now my questions:

(1) May I have been at risk when I was the insertive partner? I am not circumcised, does it make any difference?

(2) I dont play sports, I am sluggish and lethargic, I have smoked cigarettes for 7 years now + drink socially and dont do drugs, I have had cytomegalovirus, I seldom get sick, and never eat or drink from other peoples glass/fork and I avoid kissing altogether (I am terrified of peoples saliva, even my mothers and above all I am terrified by diseases). Can these facts (my vulnerability) possibly put me at risk?

(3) Could I have been infected if my partner really had HIV and wasnt aware of it? Even if there was little to no precum involved whatsoever? He looks clean, mature and respectable to peoples eyes, but I know for a fact that he gets to travel a lot because of his work and that hes into the gay scene. Dont know about his previous relationships. I asked him again lately about his status, and he guaranteed me he is completely healthy. Should I dig deeper and ask him about his latest tests? Thatd be ridiculous and inappropriate given what he already told me.

(4) VERY IMPORTANT: My throat wasnt sore when it happened, maybe it was irritated or maybe it was starting to develop an infection. Is that considered one of those infamous cuts, sores, abrasions, infections all sites talk about when assessing the risk of HIV transmission???

(5) Could all this be a product of terror and anxiety I have been feeling?

(6) What am I to do?

No wonder why Im freaking out. I have had the strangest, longest lasting symptoms I have ever had; I have been devoured with guilt, fear and anxiety. Ive been feeding myself with the most frightening, spine chilling information, I have seen that something like half the people with HIV dont even know they have it, I have read about terrible cases. And in each of those I find something I can relate to. Whenever I read about a symptom it manifests itself immediately. When I take a breath I am afraid I twill be the last one. I havent told this to anybody, I dont know if I ever will and I will not handle it if I find out Im sick. I have always feared HIV more than anything and I could have sworn I would never have put myself at risk. And I will never ever accept it if I was contaminated by a drop of precum. I know I probably need psychiatric (and shamanic) help. But I need yours first. Sorry for my prolixity, I just wanted to explain everything in order not to ask any further useless questions. Thank you.

Response from Dr. Frascino

Hello Young, Insecure, Pessimistic, Hypochondriacal, Nave, Skeptical, Cynical Guy,

First a few general comments and then I'll address your specific questions.

1. Why are you so worried about HIV when you are a heavy smoker? Smoking will kill you in a very painful and undignified fashion. So why worry about oral sex, which only has a minimal risk for HIV transmission/acquisition?

2. Acute tonsillitis with "bulls testicles" tonsils and fatigue, which doesn't respond to antibiotics, is suggestive of mononucleosis. A simple blood test could make the diagnosis, one way or the other.

And now on to your questions:

1. Insertive oral sex, cut or uncut, carries only a very minimal risk for HIV acquisition.

2. You are not at increased risk for HIV because you smoke, don't play sports and are sluggish/lethargic. However, you are at greatly increased risk for all sorts of illnesses because you smoke (cancer, emphysema, heart disease, stroke, pneumonia, etc., etc., etc.).

3. Stop pestering your partner. Your HIV risk is negligible. But if you remain worried, get an HIV-antibody test at the three-month mark.

4. No.

5. Yes.

6. See #3 above. Plus get some help for your "guilt, fear and anxiety," which you freely admit you are being "devoured" by. Stop "feeding (yourself) with the most frightening, spine chilling information" and instead spend some time perusing the wealth of information on this Web site. You should find the information in the archives of this forum enlightening and reassuring. Certainly a psychiatrist or psychologist should be able to help you confront and conquer your irrational fears surrounding HIV. Finally, and most importantly, stop smoking.

Dr. Bob



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