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Worried sick, Please help!
Apr 21, 2010

Hello Dr.

Hoping you can shed some light for me. Exactly 4 weeks ago while on a business trip in the US I had intercourse with a 23 year old girl I met at a club who I now believe was at high risk of having hiv. I used a condom as I ALWAYS do, but my condom broke and I didn't realize until about 30 seconds later! I immediately ran to the sink, washed my penis and applied aqua velva aftershave all over it! I then put on a new condom and finished having intercourse with her, which only lasted about 1 or 2 minutes. 2 days later at night I developed a sore throat that cleared up about 95% the next day but remained a little irritated for about 1.5 weeks. The same day I developed the sore throat I had a long flight from the US to the orient. Approx 1.5 weeks after the possible exposure I began feeling very tired/malaise as well as developing a mild cold. I went to see a doctor who gave antibiotics (Azythromicyn), several hours after taking the first 2 pills I began to feel very light headed and weak, the next day my tongue turned white (it's still white today after almost 3 weeks!) Exactly 2 weeks ago (2 weeks after possible exposure) I began to have night sweats, nausia (I barely ate for 1.5 weeks and lost almost 10 pounds), had only 1 incident of diarreah, and this past week (3 weeks after) I am noticing small red dots appear on my body, 6 on the inside of my elbow which went away in a few hours and 1 hive looking legion on my back about 3/4 cm in length. Also for about the last 2 weeks I have some yellow/discoloration around the edge of my eyeballs (you can only see it if I pull the lower eye lid down or turn my eyes all the way to one direction. This past week my apetite has slowly returnd, I gained about 2 pounds back! I did 2 hiv tests so far, the first Elisa 2 weeks after the possible exposure (negative) and then at 3 weeks plus 1 day I did a rapid test at a clinic (also negative). Can my symptoms be hiv infection?

Thank you very much for your time.

Response from Dr. Frascino

Hello,

You applied Aqua Velva to your tallywhacker??? I'm shocked! No, not because you decided to spritz your Mr. Happy, but rather because they still make Aqua Velva! I haven't seen the stuff since Jimmy Carter was president and Sally Fields was the Flying Nun on T.V. But I digress . . . Back to your problem.

"Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. That said, your symptoms are not particularly worrisome for HIV acute retroviral syndrome (ARS). The only reason for concern about HIV is HIV risk. Your risk is broken condom sex with a brief (30 seconds) unprotected penile-vaginal exposure with a gal-pal of unknown HIV status. The CDC's estimated statistical per-act risk for acquiring HIV from unprotected (or broken-condom) penile-vaginal sex with a partner confirmed to be HIV infected is 5 per 10,000 exposures. Your estimated statistical risk would be even less, as we don't know the HIV status of your club-gal.

Your reactive two- and three-week HIV tests are encouraging, but not definitive. My advice is to get an HIV-antibody test at the three-month mark. The odds are astronomically in your favor that you did not contract HIV from this Aqua Velva-scented affair.

Dr. Bob



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