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Worried Well or ARS?
      #112143 - 10/02/04 01:47 AM


I've spent a good deal of time reading posting here and across the web, and I'm having trouble parsing information that seems ambiguous to me. If this retreads territory that's been covered or makes me sounds like a hypochondriac, i apologize. This is what's on my mind:

Over the last six months or so, I've repeatedly had unprotected anal sex as a top (roughly 15-20 times); I don't know the HIV status of my partners, but, given that they wanted bare sex I can only conclude that they consistently have bare sex and are therefore more likely to be HIV+. The last time I had bare sex was approximately four days ago. Prior to the last six months, I had consistently practiced safer sex. For the last three weeks or so, I've become paranoid that I've been exposed to HIV and that I was suffering from acute retroviral syndrome. Here's me rationale:

-- I experienced a minor but consistent sore throat for about 1-2 weeks in late Aug/early September
-- For about two to three weeks in early September, I consistently had diarrhea. This started shortly after the sore throat. I had some cirpo my doctor has prescribed from a trip abroad and took it, thinking it might resolve the diarrhea; it didn't, but the diarrhea resolved itself about 2-3 weeks after it started and 3-4 days after i completed the cipro course. At the same time, I've experienced various other GI symptoms like gas and nausea and a bloated feeling.
-- I had intermittent muscle soreness, particularly in my neck and calves; this started about one week after the diarrhea and resolved itself after a week or so.
-- I've had a minor on and off headache for the last two or three weeks.
-- I've lost about 4 pounds over the last 3 weeks (that said, I'm also trying to loose weight be reducing my caloric intake).
-- I saw my doctor several days ago (more on this below) and my temperature was about 100.2 degrees. The nurse attributed this to the fact that I was drinking coffee right before she took my temperature.

I've currently taking Paxil CR for depression and anxiety. I had been on 25mg, went down to 12.5mg, but started feeling significantly depressed about three weeks ago (around the time the ARS-like symptoms started but six weeks after my dosage had been lowered to 12.5mg). As a result I saw my doctor this past Monday, who increased my dosage back to 25mg. I don't feel particularly comfortable with him and I felt guilty about my unsafe sexual behavior, so I didn't talk to him about my fears of HIV exposure.

Three days after I saw my physician, I had an anonymous HIV test (the OraQuick rapid test). Much to my surprise, it came back negative. The counselor said that it typically shows sensitivity to antibodies three weeks after exposure. He also said that he felt it was unlikely, statistically, that I was exposed given that i was a top in all the cases where i had bare sex. He didn't seem very concerned about what i felt were ARS symptoms. He suggested I get tested again in 4 weeks and again in three months, and that i talk to a counselors about my anxiety about having been exposed to HIV.

Now my questions:
-- Am I being paranoid: are the symptoms I described truly consistent with ARS or more consistent with anxiety? I'm particularly concerned about the GI symptoms, as i can't come up with another explanation for them.
-- The data I've found online suggests that ARS typically occurs 2 weeks after exposure and lasts 2-4 weeks. That would mean that the rapid test would have been 4 weeks or so after my hypothetical infection; past the 3 weeks sensitivity window the counselor mentioned but also within the three month window period the literature mentions. What are the changes that an OraQuick rapid anitbody test will be positive while or right after ARS-like symptoms manifest?
-- If my belief that I am in fact positive but in the window period where antibodies won't show is true, should I ask my physician for a p24 antigen or PCR RNA viral load test?
-- Finally, any suggestions on how to put my mind at ease while I wait through the next three months?

Sorry about the long-winded questions here.... any advice is appreciated!

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Reged: 09/28/04
Posts: 29
Re: Worried Well or ARS? new
      #112254 - 10/04/04 03:42 AM

Your first test is encouraging. As you know, since you are not practicing safe sex, it may only be a matter of time. So, you can either stop having sex or have safe sex. Also, your activity is defined by Dr. Bob as "High Risk" for a reason. PROTECT YOURSELF!

Now as far as your potential situation now, I would have the doctor that your not too comfortable with do an ELISA blood draw or maybe the County Health Agency where you live. ELISA is a great way to go if you are 6 weeks since your last potential exposure. The PCR test has the potential to give you a false positive. If you are here in the US, go to a pharmacy and buy a Home Access test for about $60.00. You prick your finger and let it bleed onto a piece of special paper and FedEx it to thier lab. Results, three days later via a telephone call and an access number. All very confidential and I personally like it better than going to my doctors office.

Good Luck

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Re: Worried Well or ARS? new
      #117916 - 11/28/04 11:01 AM

I was researching side effects of cipro when I came across your post. You are not paranoid, your fears are well founded. I have to ask you, why are you engaging over and over in unsafe sex, or homosexual sex at all, knowing that it puts your life at risk? If you do not have hiv now, it is almost certain that you will get it if your behavior continues. You seem like a very intelligent person, why aren't you thinking this through? Your answer is celibacy my friend and repentance. You are not only endangering your life here but your eternal life. Please listen. Love JoAnn

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