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96 hours after protected sex, and experiencing symptoms
Dec 26, 2010

I was foolish enough to pay for sex with a thai sex worker in Singapore (who's brothel claimed that they practice hygiene right down to the line)

During my 'session', I noticed that my condom was on at all times (even after ejaculation). However, I've been experiencing the following symptoms and I truly feared the worst.

3 hours After event (22nd Dec 2010) a) chills b) waste excrete was in liquid form (thrice) c) felt liquid moist on my anus

2nd day (23rd Dec 2010) a) early symptoms of fatigue felt like a form of virus is gelling with my inner system

3rd day (24th Dec 2010) a) slight chills b) fatigue began to persist (even after taking 2 x 2 panadol extra pills till the end of the day) c) difficulty in concentrating Instant HIV test kit @ Clinic A pointed out as negative

4th day (25th Dec 2010) a) musle pain on upper right quadricep b) fatigue still persist (tried to shake it off by exercising) - Wore specs the whole day and fatigue went away c) suspect white patches on my tongue (oral thrush) - doctor @ nearby hospital did not notice any sign of candidiatis d) i don't feel as energetic as before e) loss satiety level (pretty much have to programmed myself to eat) - suspect loss of appetite manage to eat properly in the afternoon and evening Difficulty in concentrating (in the morning)

5th day a) muscle cramp on left bicep, left upper chest, and lower obliques (right side) b) excrete small and solid chunks of stool c) early morning fatigue

Conclusion,

Early HIV symptoms Tuberculosis Chronic Fatigue Syndrome Candidiatis (doctor at nearby hospital disagreed with this)

It's already 96 hours past 'the event' as I am typing this in right now.

Still, the brutal question is, "Am I beginning to experience the early symptoms of HIV?

If so, I am thinking of heading to the nearest STI clinic to purchase PEP pills. Will that help me?

Appreciate your expert opinion on this

Response from Dr. Frascino

Hello,

Your HIV-acquisition risk is essentially nonexistent, assuming the latex condom was used properly and did not fail (break). Your symptoms are not consistent with HIV acute retroviral syndrome (ARS). Please note HIV ARS symptoms generally manifest two to three weeks (not days) after HIV primary infection. I disagree with your "conclusions" regarding possible diagnoses. The most likely cause of your symptoms is anxiety and guilt. Post-exposure prophylaxis (PEP) is certainly not warranted. (I should also point out that even if PEP were warranted, it would have to be started within 72 hours).

I would suggest you follow up with your general medical doctor regarding any persistent or bothersome symptoms. She should also address your irrational fears of HIV. Psychotherapy (counseling) and/or anti-anxiety and antidepressant medications may be very beneficial. If you remain worried about HIV, get a single HIV-antibody test at the three-month mark. The result will undoubtedly be negative.

Good luck. Happy Holidays.

Dr. Bob



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