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Please Help - Need to Ovecome Fear of Testing
Jul 18, 2009

Hi Dr. Bob. I'm utterly stressed and it's a bit overwhelming that I ever put myself in a postion to think I should write. I'm a married middle-aged straight female with two girls, who a little over five years ago was under enormous stress and ultimately broke my vows by having unprotected sex with a man. I still feel guilty and scared that I've potentially broke my family. This man, even though married, I found out is gay or bi-sexual (does it matter).. I had plenty to drink and remember we tried initially with a condom and 'it didn't work -- or rather he didn't work'. He said it was because he was married, I think it was because of the condom. After that I was fine with doing nothing! At some point later, we did have intercourse (nothing anal)and he did not ejaculate. I did not ever get sick after that, except for the flu 6 months later, which now people say that could be ARS. I don't have confirmation that he is even infected, except now I'm just obsessed about this and keep thinking that he is pos. and that he was probably newly infected which caused his viral level to be very high... and because we used a condom first, I must have irritated my vagina, all making it a perfect situation for transmission. And when I asked him it has been tested recently, he said yes... but if he was married, why would he need to be? And I asked if was on any type of medication and he said no. But he never really indicated whether he had put me at risk, because he at some point had put himself at risk. He was vague. So now after five years, I seem to be having some ezcema or inflammation of my hands and feet, and I believe I have a small lymph node under my arm and maybe something on my neck. I don't really know. Will be going to doctor soon. What I do know is that I've been a nervous wreck for about 2 months now and my anxiety is great and I know I should get tested, but I am so unbelievably afraid. If I'm positive, my marriage is over and my family is broken and the guilt of how I could have done this to them is great. So I guess after all this explanation my questions are:

1)Does ARS occur six months after infection?

2)If I've had regular CBC's done in the last five years, most recently a couple of months ago, would something not show up 'off'in my blood work somewhere?

3)Does the fact we originally used a condom and then didn't put me a higher risk because condom's can be irritating to skin?

4)Although he didn't ejaculate (which I still know is a risk), if he were newly infected (he didn't seem sick, but mentioned he had had food poisoning about three weeks prior), would that number of 10 in 10,000 change to about 50% of that or less?

And, please tell me to suck it up and face my fear. I need to get tested.... I don't think I've ever been more afraid of something. What makes us so fearful? I think for me it is the effect upon other people in my life. It will be like I've let them down. Sorry for the chapter in a book. I needed to write all of this down, maybe for my own self. Thank you for your advice and support. Crying in Atlanta....

Response from Dr. Frascino

Hello Crying in Atlanta,

Proceeding directly to your questions:

1. No. The symptoms associated with ARS occur several weeks after HIV primary infection.

2. No. Your complete blood count could be completely normal. The only way to determine your HIV status is to get a specific HIV test.

3. No. Condoms are generally not irritating to skin.

4. There is no way to accurately adjust the statistical estimates of HIV-acquisition risk to reflect your multiple hypothetical situations (no ejaculation, newly infected, etc.).

You ask that I tell you to suck it up and face your fear because you need to get tested. OK. Here you go: "SUCK IT UP. FACE YOUR FEAR. GET TESTED!"

You ask what makes you so fearful. There are several factors. First HIV/AIDS is a scary disease. However added to that is your intense guilt surrounding your infidelity. Your fears have become obsessive and are out of proportion to any degree of true risk.

My advice:

1. Level with your husband about your indiscretion. It's not only the best way to confront your guilt; it's also the right thing to do.

2. Get psychotherapy (counseling) for your fears, anxiety and guilt.

3. Suck it up and get tested! You'll be glad you did!

Good luck.

Dr. Bob



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