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Just made donation- please help assess HIV risk
May 17, 2011

On June 30 of last year I had protected sex with a CSW. She put the condom on me with her mouth and it stayed on the whole time during intercourse. I have two possible risk factors and subsequent possible symptoms.

1. I had a sliver in my index finger that I dug out about an hour or so before the CSW came over. There was no blood from pulling it out but the skin was definitely broken in order for me to rip it out. I think that during intercourse when we switched positions and I made sure the condom remained rolled down the vaginal fluid may have penetrated this cut/sore.

2. After sex I lay in bed and smoked a cigarette for about 5 minutes with the condom still on. After I finished the cigarette I went to the bathroom, pulled the condom off with a shirt and then proceeded to wash my penis with cold water with watered down hand soap. The water from the washcloth rolled down my penis and touched my urethra.

3. Some time within two months after I developed a flat red rash in my groin between my leg and scrotum. I applied burn ointment and it went away, but the day after it was almost gone it showed up on both sides- I read that the HIV rash is symmetrical and this worries me. I also read that it is maculopapular, but in this case it was not. It was completely flat and red. It lasted 1-2 days the first time and 2 days the time it showed up on both sides.

On the 63rd day after CSW incident I swallowed a piece of Chex mix wrong and then had a scratchy lump on the left side of my throat. This lasted several days and then I sat across from a guy that was sick and lo and behold, I got the sinus infection that he had. The lump in my throat went away after the sinus infection cleared.

Also, I dropped about 8 lbs. in a couple of months, but I stopped working out and starting smoking regularly (pack a day vs. just a couple a day). I was under a lot of stress not only because of incident, but other things in life.

In October, maybe the first or second week I noticed right above my kneecap I had a tender node and also one in my chest. This lasted one day. This occurred as I was moving to a new apartment, highly doubt this is the case but at first I just figured it was irritated by a box corner or something along those lines.

One month later, in November, I had two tender nodes in my chest and one in my armpit. This again lasted one day.

4. The incident with the CSW has controlled my thoughts day in and day out. I have not been able to get over the incident and the possible infection. A doctor from med help told me that he recommends against being tested because I had no risk. Do you concur or is there a reason I should be worried?

After the incident I started using minocycline and another acne medication which I dont know the name. It was used for changing the yeast on my back because I have bacne. I was taking Cialis, but not until late October, but I did develop some angioma on my back, 1 on my chest, and a couple on my forearms but I stopped taking the Cialis and it seems to have controlled any further signs of angioma/petechiae (whatever it may be).

Please help assess risk and if I should truly be worried. Thanks.

Response from Dr. Frascino

Hello,

HIV is not your problem. So I'll be brief.

1. Even with the recently removed sliver your HIV-acquisition risk is negligible. (This assumes the latex condom was used properly and didn't fail.)

2. Water from the washcloth dripping onto your urethra would not be a risk for HIV acquisition.

3. Your rash is not consistent with or even suggestive of HIV acute retroviral syndrome rash.

4. I agree with your doctor: HIV testing is not necessary. The primary reason to even consider it would be to gain psychological peace of mind. (This reason alone, however, may be worth the time, energy, blood and money.)

5. Even though HIV is not your problem, you do have a significant and worrisome medical issue: cigarette smoking. I urge you to quit immediately. If you don't, ultimately cigarettes will kill you in a very painful and undignified fashion. Cigarettes are definitely more of a health risk to you than HIV.

Thanks for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck/good-health karma that you are now and will forever be HIV free!

Dr. Bob



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