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In a foreign country and need advice...
Dec 1, 2010

Hello

Thank you for your advice you are a legend and although i have seen many posts like mine there is a little twist in my situation.

20 Days ago i had unprotected sex with an African female sex worker in a prominent Middle eastern country. I have known her for over 3 years and asked her of her status and she said she was not HIV. (not important to the situation but nevertheless)

Today i developed these symptoms - mild swelling of glands in throat area only Mild sore throat Mild body aches Hot and cold flushes (no fever though)

Here is the important bit. In the country i am in and living in at the moment if you have a hiv test and it comes back positive you get deported straight away! (very irresponsible view on HIV i think from a very modern country) So thats the way it is here with loss of job and life really as you lose everything. So obviously i am concerned to go and get tested. They do have pcr tests here and i believe i am at a good stage to test. I am happy to man up and go for one. My questions are -

Do you think taking a pcr is worth while or am i over reacting and am i better of waiting till Feb and just continuing my job?

My contract ends here in Feb.

How accurate are these pcr tests at 20 days? If i was positive how would not being on medication till march effect me?

Please help me as i am in what i feel a unique situation and believe and answer would help others in my position.

Thanks for you answers that have led me to this point. Your answers are always insightful and well delivered.

Kindest regards

Middleeastworry

Response from Dr. Frascino

Hi Middleeastworry,

Unprotected sex does place you at some degree of risk for STDs, including HIV. Your symptoms are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS).

Regarding HIV testing, PCR testing is not recommended for routine HIV screening, due to the rate of false positives, other technical problems and cost. The gold standard for HIV diagnostic testing continues to be an HIV-antibody test outside the window period (defined as the first three months after exposure). Your potential exposure was 20 days ago and your work contract ends in February. This appears to be fortuitous timing! I'd recommend you wait until February (three months) to get a definitive and conclusive test result. Statistically the odds are in your favor that you did not contract the virus .

Finally, before you depart that "enlightened" country, you should do everything you can to point out the sheer lunacy of their HIV policy! All it does is fan the flames of the epidemic by acting as a disincentive for people to get tested and know their status. How shocking and unfortunate that nearly 30 years into the HIV/AIDS pandemic countries are behaving in such a morally unconscionable fashion!

Dr. Bob



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