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PLEASE ANSWER, SCARED!
Aug 11, 2011

Hi Dr., if you could help me out with an answer I would really appreciate it. I am a 23 year old male and since I was about 14 I have had a very strong, obsessive fear of contracting HIV. Some times are better than others, and there are periods when the fear comes and goes but, generally, I remain pretty fearful, I suffer from panic disorder and am mildly obsessive compulsive. In March, 2009 I had a complete STD screening that came back completely negative on all fronts. At that time I was in a completely committed relationship with no possibility of contracting HIV. That relationship ended in December 2010 and in March or April of this year I began a relationship with a girl I have known since I was in elementary school. Long story short, I was a bit concerned about her past and I asked that she take an STD test before we began sleeping together, which she did and it came back all negative in June. Even before we began sleeping together, I was worried that I could have contracted HIV from her because I had fingered her a few times, just to give some insight into the severity of my obsessive fear. When we first started sleeping together we used condoms, but since we agreed to remain committed we discontinued usage of condoms in the end of June or beginning of July. Shortly thereafter we broke up. Since that time I have noticed two swollen nodes in my neck, one has been flaring up since February which was clearly before I was ever at risk and it came back again in May which, again was before I was at risk. The other is on the opposite side of my neck. I went to my doctor and he said that it is probably from needing to get my wisdom teeth out, which are impacted. I was prescribed cleocin, 300 MG 4x a day for 7 days, which I am on my last day of now, the nodes have gotten somewhat smaller but still there. Besides that I have no other signs of HIV infection, I had diarehha one time but I figured it was bad food or from the meds. As for the girl I was dating, we went on vacation in the middle of July, I came home early because things were clearly not right between the two of us, she remained for another 3 or 4 days. When she came back she had a sore throat which went away in a few days, I assumed it was because the friend we were staying with had strep. I guess my question is there any risk of infection or is this all just mental? As for the swollen nodes, I am unsure if they ALONE are a symptom of primary HIV infection or if it is only when the nodes come with some other kind of sickness like sore throat, rash, fever, etc. Also, since one of the nodes that is inflamed has been coming and going for months is that encouraging that it isnt HIV? My fear is surrounding some kind of scenario where my girlfriend could have cheated on me and contracted the virus and then gave it to me in a very short period of time. Obviously, I understand that one should ALWAYS get tested if there is any doubt but I feel as though the doubt is only created in my mind and has not been backed up by any kind of facts. If you could get back to me ASAP I would truly appreciate it very much and would be more than willing to make a donation for the hard work and services you provide!

Response from Dr. Frascino

Hello.

Two isolated swollen lymph nodes in your neck are not worrisome for HIV acute retroviral syndrome (ARS). "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. Unprotected sex does place you at some degree of risk for STDs, including HIV. If you remain concerned, get a single HIV-antibody test at the three-month mark. Considering your medical history ("very strong obsessive fear of contracting HIV since age 14; panic disorder, obsessive compulsive disorder"), your current problems are most likely psychological rather than virological. I would suggest you consult a licensed mental health professional for ongoing management of your irrational HIV fears, panic attacks and OCD. I would also suggest you use latex condoms for all penetrative sex to help prevent these fears from resurfacing in the future.

Good luck.

Dr. Bob



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