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Things not to do in Beijing.
Jun 4, 2011

Hi Doc, I have read through many of the articles on this forum but still have some questions. Here is my story in brief: I am a 25 year old who was lucky enough to land a job in China from which I recently returned. In my last month in China I had two encounters with sex workers and on both occasions I was drunk enough to put myself at risk. The first encounter was 8 weeks ago, I received unprotected oral sex an had protected intercourse. I understand that the risk associated with oral sex is minimal but what has me worried is that when we brushed our teeth I can remember her spitting blood into the sink while rinsing her mouth. I thought nothing of it at the time as this is normal for people who don't brush their teeth very often. I should also mention that this girl did not seem healthy, she had a cough and probably a bit of a fever. About 2 days after this encounter I started to feel under the weather, fever, night sweats, soar throat. I didn't think much of it at the time and two weeks later just before returning home I had the second encounter. This consisted of a break during sex while I was doing something else and the girl was fingering herself. We had protected intercourse and at some point she stuck her finger up my ass. I must have liked it because I didn't stop her but it's worth mentioning that it took weeks after that for my ass to feel right again so no doubt there was some damage done. I don't have any idea if there was anything on her finger or if she had HIV but I'm assuming that both of these girls did.

After returning home I had an onset of symptoms including: fever, night sweats, fatigue, white hairy tongue with a few red raised bumps on it, a very aggressive but short lived hives rash on arms, legs, butt, back, swollen lymph nodes in groin and neck (sometimes painful), itchy palms and soles of feet. a small amount of fungus in the groin. I've also had myalgia in my pecks, neck and arms. Most of these symptoms are now gone after 6 weeks except swollen nodes and tongue thing. Needless to say these symptoms so close to these exposures have been causing me great distress and an impending sense of doom.

Testing: I had a p24 and antibody test done when I got home which would be 3 weeks after the first exposure. both -. I had another rapid test 6 weeks after first exposure also -. I just went in for another test for which I don't have results but it was also a p24 test and antibody 8 weeks after first exposure and 6 weeks after second.

Questions: 1)What risk is associated with my two exposures? 2)Is it possible that the symptoms that I have could be due to a virus that I picked up off the first girl that is not HIV. 3)How much faith can I have in the latest test that I have taken if it comes back negative at 8 and 6 weeks?

Thanks for all you are doing here on this site. It is the only resource that I have found that seems to be helpful without scaring the crap out of me.

Whatever the outcome I will surely be donating to your foundation... And not putting myself at risk anymore! Hoping for the best but expecting the worst. Jamie.

Response from Dr. Frascino

Hello Jamie,

1. Regarding your HIV risk for Hooker #1, I agree unprotected insertive oral sex carries an extremely low risk for acquiring HIV, even if you noted your gal-pal had some bleeding when brushing her teeth. "Protected intercourse" would be "protected," assuming the latex condom was used properly and did not fail (break).

For Hooker #2, once again you had "protected intercourse," which carries essentially no risk if the latex condom was used properly and didn't break. Fingering is not considered a risk for HIV transmission, assuming the skin on the fingering finger is intact (even if she also fingered herself and if you felt some discomfort after the probing).

2. That you choose to have sex with Hooker #1 who "did not seem healthy. . . had a cough, and fever" and you're assuming both gals were positively charged, you may have exposed yourself to other STDs or other types of infections (respiratory tract infections, etc.). These non-HIV infections may account for your symptoms. Your symptoms two days after shagging Hooker #1 would most likely not be related to HIV, as the symptoms of HIV acute retroviral syndrome generally don't manifest until two to three weeks after acquiring the virus. I'm unable to determine the timeline of potential exposure and onset of the symptoms following your fling with Hooker #2 based on the information provided. However, the general answer to your question would be yes, you could have been experiencing symptoms related to a non-HIV infectious process.

3. The vast majority of HIV-infected folks will have detectable levels of specific anti-HIV antibodies four to six weeks after contracting the virus. Consequently your negative test at eight and six weeks is extremely encouraging.

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!

Good luck, Jamie.

Dr. Bob



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