Dear Dr.

I'm Canadian living in Saudi Arabia. I am afraid to go to a hospital here because if I have hiv I could get in big trouble. I had sex on two occasions here with Pakistani workers whose status I do not know. I guess I bought cheap condoms because the first time, it broke. I thought that I had to go to the bathroom, so I was holding in what I thought was diarrhea. When I got home, I saw that it was sperm that I had been holding inside of me for about an hour! The second time, I was with another guy and when he came out, I took the condom off him and it had been completely busted through. So, two times, about a week apart, I received ejaculation. This was about two months ago. I have had a sore throat and coughing (there was also a dust storm) for almost a month now. I went to a doctor a month ago and he gave me antibiotics (omnicef) and said I had a cold infection (he said, "do you have your air conditioner on all the time?) Those antibiotics did nothing to help me. My sore throat is worse at night- it changes sides in my throat- my cough (that hacking kind from deep in my chest) seems to be improving but I still have it. I'm a mess right now with worry and just wonder what you think. I have not had a fever.

Hi,

Broken-condom anal receptive sex carries the same risk as unprotected anal receptive sex. Symptoms are unfortunately notoriously unreliable in predicting who is and is not HIV infected. Despite concerns about getting into trouble if you test HIV positive, you need HIV testing outside the window period. There really is no other alternative means to determine if you have acquired the virus. Leave the country if you must, but do get HIV tested and screened for other STDs as well.

Dr. Bob