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I desperately need your advice Dr Bob...
Sep 7, 2011

Hi Dr Bob

I feel completely lost, and really need your advice.

My story began back in mid 2008 when I had a brief relationship with a Nigerian girl (who lived and worked in UK). I had no particular concerns with hiv at the time, other than that no protection was used (and she was of unknown status). I was HIV/STD tested around four months after the relationship finished and was negative. I did however have a concerning illness around five weeks after the relationship ended - chills, fever that lasted three days then disappeared.

Fast forward to January 2011 and I was diagnosed with genital warts (which only appeared anally, and were treated, but returned four weeks ago). I also had swollen groin lymph nodes, pain under arms, peeling skin on fingertips/hands, general skin problems, conjunctivitis, mouth ulcers and a wheezing dry cough which persists to this day. I was HIV tested again (4th gen test) and it came back negative. These symptoms persisted, and new symptoms developed - swollen nodes in jaw line, neck and just below my ear (which I have now had for around 7 weeks), along with some brown mole like skin tags developing on my arms and stomach area. So I returned to the clinic to get some advice. Unfortunately they seemed annoyed that I had returned and stated they would do one more test and that was it (I went there for advice!). I was told I was definitively not HIV positive, regardless of symptoms or risk, and there were no other tests available. This test was again negative but the symptoms keep persisting. My GP is helpful and sympathetic, stating that the symptoms in his opinion are not anxiety based (though the anxiety doesn't help), and are just a series of coincidental symptoms that are possibly caused by a post viral condition. He admits to only having a basic knowledge of HIV but says I should trust the tests, and that no test can be 100%. He said to come back if more symptoms develop (do this mean I should come back if I develop pneumonia!?).

I don't what to do Dr Bob. I desperately want to get on with my life but the last 8 months have been utterly traumatising, and I really feel there's something wrong. Due to the Nigerian link, should I be looking at additional testing for rarer strains? Do you consider the symptoms worrisome? I want to put this behind me, but don't feel I can access psychological help until my medical concerns have been answered. The sexual health clinic simply refuse to look into it any further - I have no idea where to access further help for reassurance.

Please help me, the work you do is fantastic and I would really value your opinion. I will certainly be donating to your foundation.

Response from Dr. Frascino

Hello.

I would agree with the assessment of the sexual health clinic and that of your doctor: HIV is not your problem. No way. No how. No additional HIV tests are warranted. Your repeatedly negative HIV-antibody tests out to three years are definitive, conclusive and WOO-HOO-able. No additional tests as a consequence of the "Nigerian connection" are warranted. Your symptoms are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS) or HIV disease.

If you remain concerned about your symptoms and your primary care doctor cannot identify a physical cause, consider getting a second opinion from an internal medicine physician. If again no physical cause can be determined, you should seek consultation with a licensed mental health professional for evaluation of psychosomatic disease and irrational fear of being HIV infected.

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

Good luck.

Dr. Bob



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