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Cry for help from Africa - which is the least toxic cocktail?
Oct 23, 2002

Hi Doctor

First let me point out that i am writing from africa and therefore i can not spare too much money for tests at this stage AND there is very limited expertise on HIV treatment and thus what i get here will most likely be more authoritative than what i am likely to get from the most expensive hospital in my country.

about 2 weeks ago, i got drunk due to problems at work and slept with a woman without a condom. Having a history of no alcohol and safe sex, i did not expect the lady i went with would remove my condom. but she did. i didn't know this lady and she does not seem to take hiv seriously.

anyway, naturally i am very worried. i had read about acute viral infection on this site and was watching out for it. now two weeks later, i have now had a painful lymph node in my left armpit for 3 days, though the pain seems to be reducing now, i have also had a mild sore throat which i don't feel unless i am swallowing but otherwise do not feel (been on for 2 days). no fever, no rash, no fatigue, no night sweats, yet. i realised the lady had removed my condom after about a 1 minute. i am not sure if i inserted the bare penis but i know i did not ejaculate. i will eventually go for a test, but i want to know the following before i go:-

1. What are the chances that i could be infected? are the symptoms indicative of high risk or what? what is likely happening in my body? 2. If it is likely that i am sero converting, is it true that if i took drugs now, it could improve my ability to fight the disease for a long time, more than if i took later? 3. If i should take drugs, which are the least toxic even though still effective cocktails? 4. I have read on this forum about fusion & integrase inhibitors. are these drugs better than the earlier combinations? are they available on the market? if not, how can one join the clinical trials? if yes, how much do they cost?

Response from Dr. Henry

The chances of getting infected from a single sexual encounter (such as vaginal intercourse) are generally low (< 1%) so you most likely did not get infected from that single encounter. If you have never had an HIV test then that test will represent your HIV status for all of your lifetime sexual encounters up to the last 4 weeks or so. Getting treatment early if recently HIV infected may help your immune system for the long term though data on that is still limited. The most affordable and non-toxic regimens vary from region to region but AZT or D4T + 3TC + nevirapine is one of the most affordable options out there. The new classes of HIV drugs will be expensive and limited in availability at least for the next several years.



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