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Internet diagnosed me. I hope you won't!
Dec 11, 2009

Dear Dr. Frascino:

Thank you for your time. As a married man with children I am living in fear each and every minute of the day regarding two stupid episodes while in business travels 3 years ago.

In a period of 15 days I engaged in two very brief unprotected oral sex with other men. In one episode I received oral sex, and in the other I gave one or two minutes of oral sex to an unkwon HIV status man, without ejaculation, then I received protected anal sex, and the condom was properly used and did not break.

The symptoms that are worrying me are two skin rashes: one is a "come and go" skin rash, in my left thigh and under my right armpit, non itchy, flat, with red to pink circles, this rash dissappear after applying a corticosteroid medicine my dermatologist gave me, but keeps coming every 10 or 15 days (this is happening since the unprotected oral sex episodes).

The other rash appeared 6 months after the unprotected oral (2 and a half years ago), and it looks like small, dry white blisters in my hands, leading to small skin peeling or desquamation (not itchy, not painful).

Yesterday I found a picture in internet showing an HIV positive man with the exactly hand rash I have, saying that was triggered by secondary syphilis (condition I do not have because I took a blood test looking for venereal diseases, and it was negative)

Of course I am totally paralyzed and terrified, and I know I have to test. I am overwhelmed with guilt and I can not even look at my family, thinking night and day that I am infected.

I hope you can bring me some light about these 3 years with rashes, and in hell.

Sorry for my English as I am from south america.

Have yourself and familiy a Merry Christmas!

Roberto.

Response from Dr. Frascino

Hello Roberto,

Unprotected oral sex carries only a very minimal risk for HIV acquisition. Protected sex would indeed be protected, assuming the latex or polyurethane condom was used properly and did not fail (break).

Your symptoms are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS) or HIV disease. I cannot diagnose the cause of your rash over the Internet; however, I can advise that the rashes are not consistent with HIV.

Your problem is not HIV, but rather "fear" of HIV! This is made much worse by your feelings of guilt and by the fact that your walks on the wild side involved man-on-man sexual activities. This in turn brings up sexual orientation issues, despite being married with children. My advice is:

1. You level with your wife. It's not only the best way to confront your guilt; it's also the right thing to do.

2. Get an HIV test to put your unwarranted worries permanently to rest. I'm confident the result will be negative.

3. Consider getting counseling (psychotherapy) to explore sexual orientation issues.

Good luck. Be well. Happy Holidays.

Dr. Bob



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