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Symptoms and Detectable Antibodies ... Will Donate
Jun 13, 2011

Dr. Bob,

I am a bisexual male in his early thirties. Since I am a sexually active guy, I have always been careful in practicing safer sex in my various 'adventures'.

Two and a half months back, I have a sexual encounter with a male escort. Everything was going fine until I withdrew my 'little brother' from his ass and discovered the condom had broke. There was no blood though.

Anyhow, i started to develop neck pain two days after the encounter (which is quite unusual for HIV since the usual cases show symptoms of ARS if any two weeks after exposure). Anyhow, the symptoms started to progress one week later to muscle pains in my shoulders and forearms and later in my thighs. I felt painful lumps in the side of my beck and in my arms and thighs as well. So, I went to the nearest doctor and got tested for STDs and HIV. The test came back negative for everything and I was like Woo Hoo! The doctor did not tell me about the Window period and ignorant fool that I was thought that all was due to my anxiety and stress.

And the first thing I do to celebrate, went to have sex with a callgirl. This time the condom did not break. I also perform oral sex on her unprotected but at the time I thought there was no possibility of contracting HIV from oral sex. She also spit in my mouth when we were kissing but again it was stated that HIV cannot spread through saliva (but then one post in this forum call attention to an albeit 'rare' case which states otherwise!).

Several days after this latest escapade, I started feeling tinglings in my legs and arms followed by mild pain. Soon, I began to develop rashes on my thighs and arms and it has since spread to my chest as well. These rashes always begin with a needlelike stab of pain followed by raised bump like hives. They will then shrink down hours late into red itchy pustule which will end up with little white colour puslike thing in the pustule days later. Sort of like folliculitis which are very common in HIV infection. I also experience a sharp pain in the left side of my neck which evolves into a mild persistent sore throat which has lasted until now (almost more than two weeks). I went to another doctor and he gave me antibiotics and antiinflammation medication but no avail. I went back to him a second time and he gave me a much stronger antibiotics and two types of antiinflammation. I ask him if this may be a viral infection but he assured me that with a lack of fever and the fact that i was not in very 'serious' pain, he could safely rule out viral infection. I of course did not tell him about my sexual escapades. Still the medication did not cure the sore throat.

With these latest persistent symptoms, I began googling around the internet again and came to this site which introduces me to the concept of Window period. Imagine how I feel. I may have inadvertently infected the callgirl in my second encounter and she is just doing her job. Damn the first doctor. Why did he not tell me about the window period or ask me to come back and do the test 3 months later to confirm?!

Anyway, I have called up the girl and asked her to go for an HIV test 3 and 6 months after our encounter and I am doing the same myself later this month 3 months after my first possible exposure with the male escort.

My questions here for you, dear Dr. Bob are:

1) Is it possible to have detectable antibodies in your blood that can show up on the ELISA test once symptoms of ARS shows up on your body even if we are still in the window period or do we have to wait for the symptoms to subside to be able to get detectable antibodies in the bloodstream? Of course I am hoping the negative result from the first test is true since I already have the symptoms then three weeks post exposure for the sake of myself but also to appease the guilt due to the fact that I may have affected someone with this deadly disease.

2) Is it possible that I may have gotten infected from my second encounter due to the unprotected oral sex I performed on the callgirl and the saliva she spit in my mouth? This may be trying to shift the blame and guilt I know, but I simply gotta know.

3) In your vast experience of treating HIV patients, does the rash I describe to you bears a resemblance in anyway to rashes in HIV positive patients?

4)Could my enduring sore throat resembles HIV related sore throat since it started with a sharp at the side of the neck which may be my lymph node? I have heaviness in my ears too like I am on an airplane and occasional runny nose and coughing up phlegm but the cough and runny nose are not a constant. I also have a headache few days back but that may be due to stress migraine and has since subsided the next day. I have occasional pain on both my cheekbones, and numbness along the back of my head as well. Are these consistent with ARS?

Thanks Doc for answering my question. I will be donating to your foundation. Keep up the good work!

Bi Guy

Response from Dr. Frascino

Hello, Bi-Guy.

1. Symptoms associated with HIV acute retroviral syndrome vary considerably from person to person in severity and type. Generally speaking the symptoms correspond with the production of specific antibodies in the blood. However, the CDC continues to recommend testing at the three-month mark for a definitive result.

2. Cunnilingus carries only a very slight risk for HIV transmission/acquisition. See link below for additional information on this topic from the archives. Saliva that does not contain visible blood is not considered to be a risk for HIV transmission/acquisition.

3. Nope. I agree with you. It sounds more like folliculitis from your description.

4. "Are these consistent with ARS?" Nope!

Thanks for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. I suggest you follow up with your general medical doctor for any persistent or bothersome symptoms. These are not HIV related. The odds are all in your favor that you did not contract (or transmit) HIV to/from the call guy or call girl. So if you are now going to go out and celebrate with tranny to complete your sexual spectrum, just remember to play safe to stay safe, OK?

I'm sending you my good-luck karma that your definitive three-month HIV test remains negative.

Good luck.

Dr. Bob

Cunnilingus and a bleeding lip.. (CUNNILINGUS, 2011) Jan 27, 2011



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