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Please help me I feel I'm loosing my mind.
Aug 18, 2009

Hi Dr.Bob, Before I get started I want to thank you for your humanitarian work and for this website. I don't think I could have hung on this long without you. I've donated in the past and will continue to donate, I am very grateful for your work and think your are a God send. I'm writing today because I am ovewhelmed with anxiety over my HIV exposure. Below I've pasted my last question to you so that you may refresh your memory. --------------------------------------------- (Dr. Bob, please help I'm terrified over unprotected oral sex. Jul 10, 2009

Dr. Bob, I think youre a saint for doing the work that you do.I want you to know that I plan to make a donation to your wonderful AIDS foundation. My problem began two weeks ago when I decided that I would break out of my shell and, thinking it was very low risk, had unprotected oral sex with two guys, on different days- both of which came in my mouth. Although I quickly spit out the semen I have been so anxiety ridden since this occurred that I can't sleep, I can barely eat and when I do manage to eat something I start cramping up and feel like I'm going to have to go to the toilet and expel it. I also feel faint, sometimes start to sweat when I get really anxious and also get a tingling feeling on my salivary glands. Every time I feel any of these symptoms I get more nervous and all I can think about is that Im +HIV and that I've got another 10 weeks before I can get tested and that Ill go crazy before then. Ive read in this forum that oral sex is low risk but Ive also read that is some cases the risk can be elevated. I have no cuts or openings in my mouth that I know of, sometimes I'll chew a little on the sides of my cheeks, but I dont know if any of the two guys I was with were +HIV, and if so what their viral load was. I beg you to please let me know three things: 1, if you think my symptoms are just a product of my anxiety, 2, how risky you think my actions really were and 3, what test I can take prior to the 12 weeks so that I dont loose my mind- which I fear I will.

Thank you so very much,

Terrified in Miami ) ----------------------------------------------- After you answered my questions I felt much better. But since that time my gastrointestinal problems have steadily gotten worse. At the begining I just got cramps after eating, then somtimes just stomach pains. Now I get intestinal rumblings all the time and unless I take a capsule of Librax and/or eat a small meal I end up in the toilet disposing of whatever I ate. I've gone to a psychiatrist who prescribed .5mg of Klonopin twice daily and two capsules of Librax a day. That helps somewhat but not entirely- especially when it comes to my gastrointestinal issues- I've already lost 15 pounds. Its been 7 weeks since my last sexual encounter and since about two days after my last sexual encounter (when I started to get anxious about it) I have always experienced some degree of gastrointestinal problem. Since that time I have had no: fever, rash, sore throat or flu like symptoms- so I'm thinking it may not be ARS. Although I did experience some tenderness/tingling of the glands underneath my jaw as well as about 9 days of mild/moderate testicle pain. Please forgive me, I know I'm rambling on I guess my question is: 1. Do you feel my gastrointestinal problems (that have persisted to different degrees over 7 weeks ) are due to anxiety or HIV, 2. Do you still feel my overall risk is very low.

As always, thanks so much for your help, I'm trying to keep my sanity for another 5 weeks but it really is very hard.

Sincerely, Terrified again in Miami

Response from Dr. Frascino

Hi Terrified in Miami,

Thanks for your kind comments.

Responding to your five specific questions:

1. Yes. Your symptoms are quite classic for anxiety.

2. Very low risk.

3. I would recommend you get treatment for your anxiety (anti-anxiety medications and/or psychotherapy). The three-month HIV-antibody test is still the best HIV-screening test.

4. Yes, your gastrointestinal problems are most likely anxiety related. Your general medical doctor can screen you for other problems. HIV is not the cause!

5. Absofrickinlutely! Why would I change my mind?

Dr. Bob



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