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dark days,worried,please help me by answering.

Feb 1, 2011

DEAR DR.BOB im really confused and dont know what to do please guide me. hi sir.i'm 21 yo male,from a third world country(101st in HIV ranking by CIA),i'm in college and night took a prostitute(which turned out to be TS) with a friend of mine to have sex with her.prostitution or having sex b4 marriage is illegal here so prostitutes dont get tested routinely. i had unprotected orall sex(i was insertive) with her also licked her nipples roughly it hurted her but didnt bite her and there was no scar or blood althought there was a bitter taste due to her perfume.she had given bj to my friend 10mins b4.after that i found that she is TS with surgery and she was willing to have anal sex but i didnt and asked her to leave.) symptoms day11 one day diarreha and temperture of 99.14(orally) day14 itchy hives on legs disappearing after 30 mins for 3 days.since after i get one hive a week especially when im nervous. day 25:nonsevere sore throat which lead to dry coughing wich is continueing up to now(71 days post exposure) coughing is getting worse but sore troat is very non severe.(have not taken any drugs for that to see if it is going by it self or not) day 35 one little painfull pimple on my chest never had b4 in that area.get cured after 2 or 3 days. test at day 41 took a test which name was combi(ecl)it had a note:p24antigen for hiv1 and antibodies to hiv 1 & 2 is it a good or modern test?me and my friend both tested negative my friend didnt have any exposure except that orall since 4.5 months b4 test. day 42 one day after the test getting what looks like folliculitis or pimples some very litte ones which have a hair out of them(but not all of them) bigger ones are very swollen and painful to touch and skin around them is very red and red spots wich most of them disappears after some days or become raised and form a new acne,most of these do not have white heads .i squeezed one of them and a clear liquid came out and it became smaller.most of them gets dried and cured after a while and leave scars(especially big ones) but new ones keep they are about 8 or 9 on my chest,1 on my stomach,and 2 on my right shoulder.this situation now is going for more than 4weeks.i never had acne there but had acne on my face wich was cured by taking med. my question: do my rash and other symtoms sound like ARS? shuold i get tested again?by which method?when? thanks for helping me.

Response from Dr. Frascino


Sorry to hear your first sexual experience has turned out to be so anxiety provoking. Repressive attitudes (and laws) concerning sex tend to lead to unfortunate situations such as these. Your HIV-acquisition risk (unprotected insertive oral sex) is exceedingly low to negligible.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected. That said, your symptoms, including your rash, are not worrisome for or even suggestive of HIV acute retroviral syndrome (ARS).

Your negative fourth generation HIV antibody/antigen test is very encouraging; however, it's not yet conclusive. For a definitive and conclusive result, you'll need to repeat your HIV-antibody test at the three-month mark. As for which type of test, it really doesn't matter (ELISA, EIA, rapid test, combi-ECL, etc.). They are all accurate. The odds are astronomically in your favor that you did not acquire HIV from this sexperience.

Good luck. Be well.

Dr. Bob

conflicting or misunderstanding?
HIV or something else...

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