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no medical advise from doctors
Dec 11, 2009

Hello Doc, I tried before but will try again with more info. I performed ROI on an HIV+ trans without cum, possible pre-cum and then stopped all activity. Because of the HIV+ aspect I was very concerned, but after checking into it found info that made it sound relatively low risk. Unfortunately, exactly 3 weeks later I came down with a sudden illness with the the following symptoms: ill feeling extreme fatigue stiff neck, back, headache, dreamlike state, unexplained depression, memory loss low grade fever, night sweats, strange muscle aches joint pain nausea diahrea loss of apetite, 5 pound plus weight loss rash on upper chest and neck

A couple of days later, my girlfriend comes down with the exact same illness with pretty much identical symptoms. I explained what happened to my PCP and he ran viral load twice over 2 weeks and tested antibody several times negative at 9.5 weeks. About to take 12 week test.

The problem is, I have done a lot of research and even though the symptoms are nonspecific, the totality seems pretty concerning to say the least. However, every specialist I have seen seems to ignore this or not know about acute infection including infectious disease specialist. Some symptoms still persist, including occasional night sweats, muscle pain, stiff neck, and joint pain. The fatigue has gone. I'm not sure how to proceed in this situation. Living in this state has proved to be very difficult for me and my girlfirend. I'm not sure where to turn. Any words of wisdom would be appreciated. Thanks.

sincerely, Dumb and Stressed

Response from Dr. Frascino

Hi Dumb and Stressed,

I usually think of ROI as Return On Investment! Did you invest in a transexual? Perhaps ROI is reciprocal oral intercourse? I tend to doubt you've been given "no medical advice from doctors"! You've had two undetectable HIV PCR viral load tests and "several" negative HIV-antibody tests out to 9.5 weeks (with another HIV-antibody test scheduled for the 12-week mark).

The critical pieces of information you need are these:

1. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected.

2. If you've placed yourself at risk for HIV, you need an HIV-antibody test at three months (or longer) from the date of possible exposure.

3. A negative HIV-antibody test outside the window period (defined as the first three months from the date of possible exposure) trumps "symptoms" each and every time (barring extenuating circumstances).

4. PCR tests are generally not recommended for routine HIV diagnostic screening due to the rate of false positives, other technical problems and cost.

So the advice (and words of wisdom?) you need is quite straightforward:

1. Get an HIV-antibody test at the three-month mark. If it's negative (highly likely), you are HIV negative and should stop perseverating on HIV as a cause for whatever symptoms you are experiencing.

2. Assuming you are HIV negative (I'm very confident you are), you should follow up with your PCP (or a good general internal medicine physician) to further evaluate and manage any persisting symptoms. If no physical cause can be determined for your problems, you should be evaluated for psychosomatic illness. Guilt may be playing a roll in your "ROI trans" sexperience.

Good luck.

Dr. Bob



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