Dr Bob, I really appreciate all the advice you have given me in the past and the service you provide to so many. So I told myself that I would put all this in the past, but I just can't seem to move on. I have pasted my previous questions below for a reference. A little background, I'm a female and obviously a big mistake (unprotected sex) later with a co-worker is the reason that I am here. Myself, my girlfriend, and co-worker have all been tested, but only hiv 1. My most recent test was this month which is a year and half later which was hiv-1 unigold rapid at planned parenthood which was negative. I have read that hiv-1 tests will pick up hiv-2 70-80% of the time if this was the problem. The one night stand has indicated that the last time he had unprotected sex was with a girl in the Navy which he was in 5 years ago. With all of us testing negative, what are the chances that not one of us would come up positive on the test if we had hiv-2. The only reason I am writing and asking is because the burning sensation on my tongue has never went away and has recently been really white with what looks like longer taste buds all of the top of the tongue. I also keep getting canker sores in the inner mouth cheeks near my gums. I finally found a place that does rapid hiv-1/hiv-2 tests back home and plan on testing again (this will be my 6th test). Does this sound worrysome to you? And do you think that it is highly unlikely that we would all test neg to hiv-1 if we had hiv-2? Your answer would greatly be appreciated as I am overseas again stressing over this incident.
Thank you so much...I plan on sending you another donation right after the holidays.
Your fears remain completely unwarranted. Your chances of being infected with HIV-2 are so remote they are essentially nonexistent. If you can't shake these totally irrational and completely unwarranted fears, why not just get tested for HIV-2? These tests are now readily available. Your results will undoubtedly be negative, but if it puts your anxiety permanently to rest, it may be worth the effort psychologically. If you're concerned about your tongue or mouth, see an ENT physician. Most likely your symptoms are anxiety related.
Thanks for your ongoing support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). I'm sending you my good-luck/good-health karma that you will accept the reality of your HIV-negative status and enjoy happy healthy holidays.
scared...please answer...Jan 10, 2009
Dr Bob, Since my possible exposure this website has been my only peace of mind...finding that I am not alone in this time where I really feel that I have no one that I can talk to...I know that you get many questions and cannot possibly answer all, but I have respected your answers to the questions I have read in the forum and I would really like your input. Whatever the end result of my situation I will be adding your foundation to my annual donations.... I really feel that this is a very "needed" website as I have scoured over the CDC website and was only able to find information I needed through the body.
I know there has been a lot of controversy over 3 or 6 month testing and I have read your responses...so I guess I won't really go down that road...My possible exposure was unprotected vaginal sex back in July...Immediately the following day I started having weird symptoms that have progressed over the past almost 6 months, in order: abdominal pain for 1 week, diarriah for 1 day, small pimple-like sores about 5 on my buttocks (only lasted a day), sore throat, 2 nights of sweats for a week with a mild cold, burning sensation on my tongue with a bit of a whiter color which has never gone away, aching in my shoulders, and most recently a blood blister in my inner cheek of my mouth.
I am sure that you have heard all these symptoms, but I guess what my biggest concern is that my exposure was one night between a break up with my girl friend...So as you can probably guess, I am terrified that I have given her something. A week after the possible exposure "one night stand". I had sex with my girlfriend, and the next day she had diarriah and a small pimple like sore inside her mouth. Then about two weeks later she had a dry cough with a rash on her neck that itched like crazy. Then a sinus infection a few months later with a genital ulcer which was painless.
I have had multiple screenings for all STDs (everything) which have come back negative all the way out to almost 5 months. I was given a copy of a test result from the "one night stand" that said non-reactive <.01 or something after 5 months of our incident. They said that the last time that they had unprotected sex was back in 2003. So I am guessing that this test would be conclusive? I did notice that the test said HIV1 on it which I asked the question and they didn't know there were two different strains. I asked them to contact the testing center and make sure that they were tested for both.
My question is, do I have reason to be concerned and continue testing? I am currently out of the country and will return at about 7 months post exposure. I am going to have another STD screening. Do you think I should I consider myself hiv - in this situation? I did have a vaccination for tetnus during the fist few weeks of this...testing in between. About a month ago I had 4 more vaccines: Hep B, Flu, Anthrax, and Typhoid. Will these have an effect of the accuracy of the test when I return? Does the ELISA which I have been tested with screen for HIV2? I am considering a viral load test when I get back...I know how you feel about those, but I just have to know if hiv is my problem. Lastly, my girlfriend and I both have hsv2 which has never been a problem for either of us, since my possible exposure I have had consistent symptoms of hsv2 and am now on an antiviral to control it, possibly stress? Could all of these symptoms be caused by hsv2? What other viruses could cause these symptoms if it isn't hiv?
I know that you are busy and cannot answer all the questions, but it would mean the world to my peace of mind until I return to the states if you could answer this one.please
Response from Dr. Frascino
Hello Scared Overseas,
Your "question" really is not one question, but rather a whole litany of concerns. I'll try to hit the high points rather than dive into detail over each concern, because your basic problem is not HIV but rather guilt and fear of HIV infection.
Your HIV-acquisition risk is unprotected insertive penile-vaginal sex. Unprotected sex does place you at some degree of risk for STD's including HIV. However, you report having multiple STD screens out to five months, all of which were negative. (I assume these included HIV-antibody testing.) You also report your "one night stand" tested negative ("non-reactive") at five months. Consequently HIV (as well as other STDs) is not your problem. No way. No how. No additional HIV testing is warranted.
Regarding symptoms, neither yours nor your girlfriend's are worrisome for (or consistent) with HIV acute retroviral syndrome (ARS). Both of you had onset of symptoms the day after having sex. The symptoms of ARS manifest themselves two to three weeks after HIV primary infection, not the following day.
Regarding testing, your vaccinations will not affect your HIV-antibody test results when you return to the States. However, as noted above, you don't really need any additional testing anyway.
My advice is that you level with your girlfriend. It's not only the best way to deal with your guilt; it's also the right thing to do.
Confused and Frustrated Jan 16, 2009
Sorry to bother you with this question, but I really need your assistance. I respect the work that you all do on this website, and really need your assistance. I don't want to ask a question that has been answered a million times, so I have found myself scouring the archives with anything remotely to what I am experiencing, and finding a lot of difficulty. Maybe it's me, but most of the questions seem to be coming from men, and I am a female. I know that your time is precious, but I would give almost anything if you would read this and give me some feedback. About six months ago I did something completely out of character, as I am sure a lot of people on this website have done. I was drinking too much and ended up having unprotected sex with a co-worker that did complete inside me. Through my research on the internet, I haven't found anything that sounds like what I have experienced to date. The first day following, I had severe diaririah and a couple of days after the act, I found a white patch on my bottom gum that would not rub off. I found it stange and was able through force to get it off. Although I found it weird, nothing else seemed amiss. About three days later, I had the most excruciating abdominal pain. It was dulled when walking, but worse when I moved around and tender to the touch and this is when I started getting worried. I started scouring the websites scared at what I might have caught. Everything was scary. About three weeks after the incident I came down with a cold. It was a weird cold, as I didn't feel anything leading up to it. It immediately went to my throat which made it hard to swallow. This only lasted a couple of days with medication, but two days later an extremely sore neck and I noticed discomfort when sitting because the skin on my buttocks around my *#$% was really red, hot to the tough, and looked almost like chicken skin. On the fourth week I had 2 nights of sweating. I woke up both nights feeling almost like something was surging through my body. After those couple of days, I woke up one morning with a burning sensation on my tongue. I couldn't see anything weird about the look of it at the time, but it has progressively gotten whiter, kind of funny looking in the back, and I have been noticing very small purple blemishes randomly appearing in my inner mouth cheeks. Also, about this time, my right eye twitched on the bottom for three days and a tingling sensation was on my back in between my shoulder blades. After month one, I went to the doctor with all my complaints extremely worried. At the time they ran me through a STD test including hiv test and all were negative. They told me that I would have to wait another 6 months and test again. Not able to handle the stress, I went to my co-worker and told him of the issues I was having and my concerns. He said that he hadn't had un-protected sex in three years, felt fine, but would take the test to alleviate any of my worries and his test came back negative at two months past the incident and then again at five months. My symptoms continued without any avail, including a lot of shoulder soreness and a feeling of surging heat radiating down my arms in line with my veins. I couldn't wait, so at three, four, and five months I paid for two rapid tests and the last one at the doctors office with the regular STD PAP, again everything negative. The one thing that my gyno did say during the pap was that there was discharge on my cervix, but nothing abnormal came up. I still have the burning on my tongue and it has been six months, a month after my last neg. result. Do you think I should test out longer than the recommended because of these symptoms or possibly these can also be caused from PID? I only have sex on the average once a year, and it was rough. Could that have caused all this? It seems to me they would be able to know if I had PID or something, but I am not sure how difficult that is to diagnose. Can my stress cause these symptoms? Is it possible for a man to be a carrier and never test positive, yet give it to a female? Sorry to bother you with all of my questions, but I just can't seem to get a straight answer from any of my doctors who seem to think that this is all in my head. Is possible that I still have been infected with hiv? I would assume if I am having all these symptoms, there would be antibodies present, right?
Your response is extremely appreciated, I dont know where else to turn.
Response from Dr. Frascino
Hi Troubled Soul,
Although it appears men do tend to screw up (and down and sideways) more often than women based on those who submit questions here, however I can assure you there are at least a gazillion-and-one posts from chicks. Really there are. I just counted them.
Your HIV risk is unprotected sex, which does put you at some degree of risk for STDs, including HIV. However, your repeatedly negative HIV tests out to five months coupled with the fact your horizontal-tango partner tested HIV negative two months past your "completely out of character" experience indicate you are definitively and conclusively HIV negative. HIV is not your problem. No way. No how. No additional tests are warranted!
As for symptoms, please note HIV acute retroviral syndrome (ARS) symptoms become manifest two to three weeks after primary infection. Consequently your "diaririah" the following day or the abdominal pain three days later are certainly not HIV related. (Plus, we now know you definitively do not have HIV!)
To briefly address your other issues:
Yes, stress can cause all sorts of symptoms.
No, it's not possible for a man to be a carrier and never test positive yet transmit HIV to a woman.
Your doctors seem to think this is all in your head. I agree. Your problem is fear of HIV, not HIV itself. This may all be the result of guilt over your lapse in judgment. Counseling may help you confront these fears.
Is it possible you are HIV infected? Nope! Absolutely not.
Regarding possible PID, I have no way of evaluating this over the Internet and recommend you follow up with your gynecologist.
Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).
Very Troubled Overseas Mar 9, 2009
Dr Bob, You might remember me from beforeand I am not sure if you will find time to answer me once again, but if you can it would mean the world to me. And as promised, I donated $100 to the foundation a couple of months ago, and plan to annually. I dont want to run you through everything to my previous posts so I will just add the links
So, after reading both of your responses I felt reasonably better, and I have been able to pull myself out the I definitely have HIV phase for a little bit. I took your advice and told my girlfriend about the momentary lapse in judgment and we are trying to work through it. So the possible exposure was back in mid July, and my girlfriend took at home hiv collection kit this month, which came back neg. thankfully, the one time possible exposure showed me results from a test, but they were 2 post the incidence, neg. Both of the two were tested only for HIV-1.
The problem that I having is that I am overseas for another 2 months, but miserably still having weird symptoms, and I know that I didnt get them from looking on the web. First after I showed up in country I was bit by something, very small didnt even barely feel it, but my whole arm nearly swelled up. One morning I woke up from bed with two pretty bit swollen bags under one eye. The burning I was feeling in my arms, has now changed to burning at the tops of my ankles and radiating a little up the legs, and my tongue is still white and burning, and I am randomly getting sores that appear under tongue and on inside of my cheeks. My left hand was twitching uncontrollably in between my index finger and thumb. Burning white tongue persists and is constant, I have found the burning gets better when I take diflucan for a day or two, so I am assuming it is a yeast problem. The two newest thing that have happened is what appears to be bumps along my hairline and bikini line, they dont itch and I think they are follulitis. (I have never had a problem with acne)
I know bottom line these are all just symptoms, but I was a completely healthy person about 8 months ago and now I feel like Im falling apart. I have two months left over here, and will do a final test (HIV1/2), but I just dont understand whats going on. Because the guy is a 40 something, single and never been married, ex-navy type (traveled a lot), do you suggest testing for HIV-2? Or a PCR because it could be a rare type? I asked him to retest with HIV 1 & 2 and he said he was fine with the results.
Please adviseI know this is a long one, but I am really going crazy overseas.one more $100 donation promised this yr!
Very Troubled Soul
Advertisement Response from Dr. Frascino
Hello Troubled Soul,
Your ongoing HIV fears continue to be unwarranted. "Symptoms" are notoriously unreliable in predicting who is or is not HIV infected. I remain confident you will continue to test negative. Stop trying to evaluate symptoms and instead rely on your test results. By the way, your current batch of symptoms is neither suggestive of nor consistent with HIV acute retroviral syndrome (ARS) or HIV disease. I doubt you have oral candidiasis (thrush). Your swollen arm was most likely an "allergic" reaction to an insect bite.
PCR testing is not warranted. HIV-2 testing is warranted only if you've had exposure to someone from West Africa or other endemic locations.
Your last two months overseas will fly by. Stop worrying and enjoy your overseas experience! And then we'll welcome you back home in May, OK?
Stop worrying. All is well, including you!