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If not hiv, then what?
Mar 23, 2010

Hello Dr. Bob. I would first like to wish you the best in health and success. I also enjoy your humor. This is my 2nd question to you. My first went unanswered. I will ask again if need be. I had unprotected anal(top) sex with an hiv positive person 3 or 4 times within a week. I acquired ngu from these encounters and apparently herpes. I have tested negative 5 times out to 8 months. Im a bit concerned because this person told me it took him a year to test positive. With my continuing symptoms, I fear the same. These are the symptoms: Stiff neck, rash on forehead, stomach noises when not hungry, sensations in groin, although no swollen nodes as confirmed by doctor, sore throat and twitching everywhere in body(arms, legs, face, etc.) I know this person does not take medication and I have evidence that their Cd4 count was 400 in 2006. Im thinking this person would have had Aids by the time of our encounters in June of 2009. At any rate, what could I have acquired if not hiv? Could I have caught an opportunistic infection? Im to the point that I wish I would just convert so I can go into the asymptomatic phase. I know this is a sad statement. Dr. Bob please help me to reclaim my former glory. I promise to make a donation when able as Im currently unemployed and without insurance. I never forget a kindness. Thank you for any suggestions.

Response from Dr. Frascino

Hello,

There is no doubt your choice to go bareback (unsafe sex) placed you at risk for STDs, including HIV. You probably understand that all too well now that you acquired NGU and herpes. That your bed buddy is confirmed to be positively charge and not on antiretrovirals dramatically increases your HIV-acquisition risk, but does not guarantee you will acquire HIV. Remember, most HIV exposures do not result in HIV transmission, thankfully! Your five negative HIV tests out to eight months are definitive, conclusive, excessive and WOO-HOO-able. HIV is not your problem. No way. No how. No additional HIV tests are warranted.

Your current "symptoms" are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS). Rather, they are highly consistent with anxiety.

As for what you acquired, I cannot diagnose medical conditions over the Internet; however, as I indicated above, it's certainly possible you are suffering from anxiety and psychosomatic illness related to your prior terrifying experience.

Could you have acquired an opportunistic infection? No. Opportunistic infections occur only in the context of immune systems that are severely compromised (deficient). Yours is not.

I would agree it's very sad indeed that you are wishing you would seroconvert under any circumstance! This reveals significant psychopathology. The best way to "reclaim your former glory," not to mention your physical and mental well-being, is to seek the help of a psychiatrist. You need to confront your irrational and totally unwarranted fears of being HIV infected. Plus, you need help accepting the truly wonderful reality that despite your reckless behavior you dodged the HIV bullet. The evidence is now overwhelming and irrefutable that HIV is not your problem. But you do have a problem that needs attention and medical management.

Good luck.

Dr. Bob



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