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I need of immediate help.
May 14, 2001

I am 28 year old male in India and there is no help at all.

I have posted questions to different doctors on this site and never got a response.

The whole family is dependent on me (financially and sentimentally) and they want to see myself getting married immediately and the marriage is scheduled for 12th June.

Your suggestions will be of great help as I am planing to stop the marriage even if there is a minor symptom of HIV.

There was an encounter (My first time) on March 30th where I had intercourse with a call girl during which the condom broke off twice and were replaced immediately (I have not washed before replacing the condom on both occasions.

I am uncircumcised and was not having a good erection during the intercourse.

I have shaved my crotch and even the base of the penis, about 2 hours before the intercourse (the sexual activity was not planed).

I met a doctor on the next day who told me that the possibilities of contracting HIV during one time intercourse is one in thousands and told me to wait for 3 months and get tested.

The other doctor whom I met after 8 days told me that it will take 6 months to get a confirmed result and recommended me taking Duovir (lamivudine and zudovudine) & Nevimmune (nevirapine) for 28 days.

After taking these for 9 days I have developed rashes and fever 101 deg. The doctors felt it could be drug reaction and instructed me stopping nevimmune and continue Duovir alone.

I have completed the medicine (60 tablets on 19.05.01). Now I am not taking any medicine.

Now the doctor had gone abroad and there is nobody to help me here and I need your opinion on the symptoms that I am having during this period.

30.03.01: Exposure 08.04.01: started medicine 12.04.01: General uncomfort, tiredness and Gastrological problems 13.04.01: ELISA test - negative 16.04.01: Fever, rash started and stopped medicine. 18.09.01: fever and rashes stopped. 20.04.01: Started taking Duovir again. 21.04.01: Another ELISA shows negative. Till 31.04.01: No problems other that feeling hot. 01.05.01: got sever muscle pain (more on the right hand side) in the arms and neck. Till 10.05.01: Fever in the evenings, Sore and painful throat, swollen glands, swelling on the back of the neck (right side alone), sharp momentary pains all over the body and more in the testicles, inner thighs etc. Completed the recommended course of Duovir. 11.05.01 to 14.05.01: Fever in the evenings, muscle pain (in the neck), pain in one particular spot just below my right jaw, white deposits on the tongue.

Also I am noticing two small hard balls below my jaws.

Please let me know whether these are symptoms of HIV.

Also recommend on what all STDs I have to get tested before my marriage on 12th June.

Response from Mr. Kull

I am curious about your doctor's decision to begin treating you with antiviral medication 8 days after exposure. Post-exposure prophylaxis is probably only effective within 24-36 hours of exposure (see my response to "PEP after oral sex" http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Treatment/Q16861.qna). It is quite possible that the symptoms you were experiencing were related to the medication. Many people have severe enough side-effects to warrant discontinuation of treatment. While there should be no negative long-term effects for you taking the medication, it was probably not necessary and may have caused you additional anxiety.

The first doctor's response sounded quite accurate and reliable. Your risk for infection in the incident you describe is low; condom breakage during one encounter rarely results in HIV infection. According to recent research, the risk for infection during one episode of sexual intercourse with an infected person is .17%. While it is possible that you could have been infected--which means that having intercourse with condoms with your partner is advisable--the odds are low. It is also possible that you could have been exposed to some sexually transmitted infections (see my response to "How does std transmit?" http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Hepatitis/Q16409.qna).

Get tested at least three months following your exposure for an accurate result. Different sources will suggest waiting anywhere from 3-6 months to get tested. See my response to "Definite Exposure" for more information on this (http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Testing/Q11060.qna).

It sounds like you are quite anxious about this experience. I frequently encourage people in this forum to seek out the help of a mental health professional to discuss, and possible relieve the symptoms of, anxiety. You are probably going to need some emotional support as you work through this difficult period.

RMK



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