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Anxiety, HIV and Lymph nodes
Jul 22, 2011

Dear Dr. Bob,

I hope you are doing well.

I am anxious and worried beyond imagination and looking forward to a reply and most importantly your good Karma...

I will donate 50 USD.

9 days ago I was in Bangkok and had sex with two different sex workers.

Both encounters involved protected vaginal sex, unprotected oral sex (active and receptive) along with deep kissing.

Being a married man with two kids and no history of similar experiences within my 6 years of marriage it is being very difficult for me to cope of with the burden of guilt and the anxiety attacks in fear that I might have contracted HIV.

I understand that the encounters are considered low risk exposures especially that there was no slippage or breakage of condom. The only thing that may be a bit worrying is that one of the girls brushed her teeth direcly before sex and I don't know if that has possibly caused any bleeding in her gum. The oral sex I received in both cases was very mild and didn't last more than 30 seconds before I got the preservative on.

I have fingered one the girls slightly, my finger had no wounds yet the skin around the nail was a bit dry and broken.

What adds to my worries is that I started developing some symptoms that I never experienced before.

S1. Discomfort in the throat especially when swallowing saliva. This is accompanied by slight pressure on the ears.

S2. Contraction in the stomach that I can clearly relate to anxiety as it withers away when the monsters of my imagination are asleep

S3. Pain under the chin and a possibly swollen lymph node

S4. Pain at bottom of the neck, right at the top of the chest bone. I can feel a swollen ball like body that is tender and gives a feeling of pain when pressed

S5. Pain at the top of the stomach, right at the bottom of the chest bone, I can feel a cartridge like body that causes pain in my stomach when it is pressed on. The pain sometimes radiates to the back.

Q1. How would this relate to HIV keeping in mind that these symptoms started 8-9 days after the exposure.

Q2. Is HIV Test and STD screening warranted in my case

Q3. Would excessive anxiety lead to pain in lymph nodes

Q4. How would I protect my wife during the window period before the 3 month mark test.

I have learned two valuable lessons during this trip:

L1. Don't drink in a strip bar, or you will end up in bed with some company.

L2. Wherever you travel, take your wife along.

I have been living on this site for the last week, and wasn't willing to make a post haven't I started feeling these pains especially the ones under my chin and the bottom of my neck.

Your advise will surely help me go throught the window period hell in a much better way.

Thanks a million,

....

Response from Dr. Frascino

Hello.

Q1: Your symptoms are not consistent with or worrisome for HIV acute retroviral syndrome (ARS).

Q2: The primary reason to consider HIV testing would be to gain peace of mind.

Q3: Anxiety can cause an extraordinary array of symptoms. Peruse the archives of this forum for gazillions of examples.

Q4: I would recommend you level with your wife. It's not only the best way to confront your "guilt and anxiety attacks"; it's also the right thing to do. Together you can decide what precautions to take during the window period. You and/or your wife may decide latex condoms should be used until your HIV-negative status is confirmed with a three-month HIV-antibody test. Your overall HIV-acquisition risk is very low, assuming the latex condoms were used properly and did not fail (break).

Thank you 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.

I'm very confident your three-month definitive HIV test will be negative.

Good luck!

Dr. Bob



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