Am I ok?

[phone12345]

Dr-
On December 12, 2006, I had slept with a Chinese Prostitute in New York City. We had vaginal sex with a condom. However, I had a cut (not-bleeding) on the base of my penis that the condom DID NOT cover. And vaginal fluid definitely got onto this cut. Also, I had fingered her and the next morning I realized that I had an open cut on my finger as well (not bleeding either). I left immediately & fell into some sort of black hole (metaphorically). The next day I was tired as hell. I was fatigued and felt sick. Day after, it got worse. Then I went on PEP.

After I finished, I felt fine for a day. But the diarrhea came back. My heart rate has been through the roof since the day I slept with the prostitute (sometimes 110+). My neck and head have also been very warm but my body temperature has never been over 99.5. Weeks after finishing PEP (Feb 12), diarrhea is still present and I have constant stomachaches. My bpm is still high and my face and neck warm. I

[H. Hunter Handsfield, M.D.]

Stop it!  You do not have HIV.  One more comment/question along these lines will get you banned from any and all questions and comments on Med Help.

[phone12345]

Thanks. The only thing I'm worried about is why I felt so sick and ridiculously fatigued the next two days and why I have such bad diarrhea when nothing like that has ever happened in my 24 years on this earth.

[richie7124]

Hi Doctor

Like many on this forum I have found myself obcessing over HIV. Anyway i thouught that I would try and take a logical look at the risk of one time exposures to prostitutes in developed countries:

figures for UK:

2004: 1400 cases of HIV in hetero men
lets assume 5 % (realistic?) one time exposures = 70cases
10 cases when condoms used (sometimes fail/lambskin/oiletc) Say 2 were caught from prostitutes

approx. 100000 (read somewhere) prostitues in uk (majority women)= 5 million  cases of vaginal sex (pretty rough guess but may be more)
So we reach the answer that 1/2.5 million people in a developed country such as the UK get HIV when condoms are used in some shape / form (probably even if they fail)

Do you reckon this an overly optimisic guess? or vastly flawed method?

[richie7124]

Hey

Check out the body.com website (HIV/AIDS specific site) for loads of facts on HIV. Anyway since you were not actively bleeding, I do not think your risk was that large.

[phone12345]

Thank you Dr for your quick response. Quick question, is there somewhere on the internet I can find statistics for the "open-cut" percentages? CDC's website is lax in that department and I can't seem to find it here. Do you think PEP can cause permanent/long-term side-effect such as diarrhea?

Any explanation as to what the big-red bumps on the back of my tongue are? (my GP told me they weren't enlarged Taste-Buds and that I should give it a week and come back). I just have a hard time explaining why i felt SO drained and sick the day after possible exposure.

Hope you are right, thank you.

[H. Hunter Handsfield, M.D.]

It is simply impossible to develop HIV symptoms so quickly; and your test result prove unequivocally any current symptoms are not due to HIV.  In the face of that evidence, any continued worry about that possibility is irrational.

[phone12345]

Doc, forgot to post this in my question as I was re-reading this. My lips and the skin around my lips have been extremely chapped/dry more than ever. Chapstick (or anything like that) doesn't seem to work. Any correlation?

Thanks

[H. Hunter Handsfield, M.D.]

You had no significant risk.  I cannot imagine what health care provider you were able to find who was willing to presecribe PEP following condom-protected sex, cut or no cut.  You did not hear from any reliable health information source that having a cut brings a high risk of HIV infection.  Maybe one chance in a few thousand, no more.

Your current symptoms cannot not due to HIV.  Maybe side effects of PEP, but the best bet is emotion/anxiety and nothing more.  Follow up with your provider and/or the doc who prescribed PEP unnecessarily.

HHH, MD