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Anxiety/Head and Neck
Jun 12, 2005

Hi. I'm from the Philippines and my country has a very low prevalence rate of HIV/AIDS infection (<0.01% - <0.1% of all adults) with 3,000 recorded by the government and 10,000 estimated by UNAIDS out of a general population of 85 million despite our being a developing country in the third world. But these statistics didn't give me reasons to be complacent and calm. I had protected vaginal sex with a prostitute 4 weeks ago. I also performed oral sex on her just for 1-3 minutes (and even less) prior to vaginal sex. I believe there were no traces of vaginal fluids or any orgasmic fluids on her since it occurred only during the start of the whole "session". Also, her vagina didn't smell bad or anything that might give a sign that she had STD's or other infections. I brushed my teeth immediately after and I'm scared of being infected because of oral sex and brushing my teeth afterwards. Also for the past weeks, I've been very anxious and very stressed out because of that sexual encounter which results to tension headaches. I've never experienced any of the typical indications of HIV seroconversion illnesses in the past weeks BUT now I have reflux gastro-laryngitis and mild otitis media/ear drum infection in the left ear. My ENT doctor diagnosed this. I was alarmed when my doctor told me that the cause of inflammation of my larynx was viral though I don't have sore throat, but I do have an itchy throat. So I started thinking and assuming that the virus might be HIV. My otitis media was bacterial but I fear it's because of HIV too. I was afraid to ask my doctor if it's HIV or something because my mom was present during the check up. I was wondering if reflux laryngitis or mild otitis media are one of the "rarer" symptoms of HIV seroconversion/infection? And, what are my chances or odds of getting HIV from the said sexual act performed? Please help, I'm starting to develop general anxiety disorder and hypochondriasis because of this... I also have the constant fear that I may have the disease... And one last question, do you recommend that I test for HIV in 6 weeks or should I wait for 2 - 3 months? Thank you very much.

Response from Dr. Conway

The symptoms you describe (reflux, otitis) would not be HIV seroncnversion symptoms, even in its rarest form. Sore throat or pharyngitis is one of the more common symptoms of seroconversion, but it is usually accompanied by quite large lymph glands and other symptoms. When your doctor said the condition could be "viral", he was referring to the many viruses other than HIV that are usually causing this condition. Also, the sore throat associated with HIV seroconversion is usually fairly severe and does not resolve in a few days.

You are to be congratulated for using a condom during sex to reduce the risk of HIV and other STDs. However, this does not eliminate such risk, unfortunately. Oral sex is a much less efficient way of transmitting HIV and almost always occurs if the infected person has visible open sores on the genitals and the other person (i.e. you) has open sores in their mouth. All of this being said, your risk is not exactly zero, but approaches this, I would still get tested at 6 weeks and at 12 weeks to be absolutely sure. Over 95% of people who have acquired HIV infection have seroconverted by 6 weeks, so this test will provide you with reassurance, although the 12 week test will be necessary to definitively rule out HIV infection.



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