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Extremely worried - please help

Mar 19, 2011

Dr. Bob,

I am a married man who did something awful. About 9 days ago I got very drunk and had protected, receptive anal sex with a male of unknown status in an urban area. There was no oral of any kind or other contact, but there was fingering of my anus (fingers unprotected). As far as I know, the condom did not fail. I stopped the anal after only a few minutes and there was no ejaculation. I have never done anything like this ever before and am freaking the hell out.

About 4-5 days after possible exposure I started feeling swollen lymph nodes first in armpit and now in all areas. They are not hard or painful, more just general discomfort across neck, armpits, groin, stomach. This is consistent with everything I have read about lymphadenopathy which leads me to believe this can be nothing else besides HIV (I mean, really? mono? couldn't be). Too coincidental. I also have been unable to sleep for more than a couple hours at a time and have noticed some sweating at night. Not sure if this is related or due to anxiety. No fever or rash noted (yet). I have already noticed some tingling in my extremities and sweaty feet and palms.

Please, please, please help. I am desperate and don't know where to turn. I am eager to get a test today (both DNA and Antibody), but afraid it is way too early and PCR might have false positive which would freak me out further. I can't continue to not sleep and worry about this. I am unable to focus on work and am running through scenarios of my wife, family, and friends disowning me and dying alone. I feel like a terrible person and no longer enjoy the things I used to. I feel like everything I was and am before this was ruined by this one poor decision. I don't identify as gay or bi and don't have any attraction to men. Not that I have anything against it. Honestly, it was more of a long running fantasy about dominance and submission that happened to manifest itself one night when I was really drunk and some guy hit on me in a bar. But I feel like having to share this news with people will lead to misunderstanding and further alienation. My family is very religious to boot so I am going to be a major disappointment to them and myself. Especially if I can't now have children as I want to do. I feel like I will become a burden if I am on drugs and dealing with this disease. I also feel like it will be harder for me to ever change careers or realize goals because I will have trouble getting insurance or hired.

I know this is excessive, but there is so much divergent information online about the risk of protected anal and my symptoms are starting to feel irrefutable. I am considering what I might do if I get a positive diagnosis.

Please help.

Response from Dr. Frascino


". . . There is so much divergent information online about the risk of protected anal"??? WHAT??? There really shouldn't be. Protected sex is indeed protected, assuming the latex condom was used properly and didn't fail (break). That's why it's called "protected"! Clever, eh?

As for your "symptoms being irrefutable," actually symptoms are anything but! In fact symptoms are notoriously unreliable in predicting who is and is not HIV infected. If you doubt this, take a read through the archives of this forum for a gazillion examples!

Your fears of HIV are obsessive and may be due to related issues of guilt, your religious family and sexual orientation. I realize you don't identify as gay or bi, but having a "long running fantasy" and actually acting on that fantasy by having anal receptive sex suggest sexual orientation issues.

I would suggest:

1. Leveling with your wife. It's not only the best way to confront your guilt; it's also the right thing to do.

2. Consider counseling/psychotherapy to help with your anxiety, HIV fears and sexual orientation issues.

3. Get a single HIV-antibody test at the three-month mark, primarily for peace of mind. (I'm quite sure it will be negative.) HIV-antibody tests taken prior to the three-month mark are not considered conclusive.

4. Review the information in the archives. You should find it both enlightening and reassuring. I'll repost below an example of what can be found in the archives.

Good luck.

Dr. Bob

Please help me Doctor Bob, my paranoia is ruining my life. Mar 19, 2011

Recently, I had a brief risky encounter. I decided to try and have sex with another male. He wanted to have anal intercourse with me. We know eachother, but not particulary well. I agreed to try anal intercourse. He used a condom and stuck the tip in. The condom broke and he pulled out and took the condom off and threw it on the floor without telling me. He tried to stick it in again (this time with no condom) and only got the head in (maybe only half the head) before I thought it hurt too much and made him stop. I was very angry he didnt tell me the condom popped, and left.

Exactly a week later, my throat became itchy and uncomfortable. It was worst in the morning, and got better as I drank fluids and the day went on. I would not even consider it sore, it is not painful, just irritating and dry and itchy. I also noticed a swollen lymph node in my neck under my jaw on the right side. I looked up my symptoms and paniced. I read about HIV all over the place. I asked my partner if he was clean and he said he was tested 2 months ago and is HIV negative but I do not believe him. I began constantly comparing the lymph on the right side to the one on the left (touching both of them constantly) and it was def swollen. I went and got a rapid HIV test which came up negative. Then I read that might not be accurate, and I should get tested again in 6 months. A week later or so, the lymph node on left side became swollen as well, but not as much. I've been in a state of panic. I'm going on week 4 here, and they are still swollen, and I've been in a constant state of fear and depression every single day. I have read that if it was HIV, it would be more than just my neck lymph nodes that would be swollen, but I can't trust things I read on the internet because I always tend to believe the worst things I find. I can't live like this and wait 6 months to get tested again, and I can't afford a more extensive test to be done. I've been thinking "what if my partner had precum on the tip of his penis that infected me?" worst obsessive thoughts have been about my family and what it would be like to tell them if I was HIV+, which has sent me spiraling downward into a very dark depression, unlike and feeling of sadness I have ever had. I'm so depressed all I want to do is sleep, because when Im dreaming is the only time I'm not having these obsessive thoughts about HIV.

Please help, so that i can wake up and live again. I feel like I'm going insane.

Response from Dr. Frascino


Your HIV-acquisition risk is low.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected.

Since you know your top-gun guy, you could ask him to get a rapid HIV test. If he tests negative, you'll be able to relax significantly, because your risk would then be limited to the remote possibility that your buddy has not recently been infected and is still within his window period (infected, but not yet producing detectable levels of anti-HIV antibodies). You'll still need an HIV-antibody test, but the statistical odds are very much in your favor that you did not contract HIV from this brief encounter.

Your real problem now is anxiety and depression: "I've been in a constant state of fear and depression every single day . . . I always tend to believe the worst things I find . . . I can't live like this . . . Spiraling downward into a very dark depression unlike any feeling of sadness I have ever had . . . I'm so depressed . . . etc." I would suggest you seek the help of a mental health professional for counseling (psychotherapy) to help you confront and cope with your fears. Folks often obsess about HIV, because it's easier than dealing with more difficult issues, such as guilt or sexuality/sexual orientation issues, etc.

Dr. Bob

Please help me Doctor Bob, my paranoia is ruining my life.
I know you won't answer but.......

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