extremely distressed

[joeseph]

Hi,
I was on Holiday in Hong Kong five weeks ago.
I got drunk and had sex with a prostitute in my hotel room.
Afterwards i realised that the condom had split - im not sure at what stage.
Probably as i was putting it on and it slid down the shaft and I didnt notice
Penetration lasted no more than 30 seconds in total as far as I can remember.

two days later i noticed a burning sensation in my testicles so i went to a doctor
and he gave me zithromax, this didnt seem to make so much difference.
I got myself checked out two weeks later (no blood tests)and they Didnt find anything whatsoever,

Its ust over five weeks since the incident and over the last few days
i have developed some strong flu-like symptoms - (very groggy, headache, hazy flu like feeling - aches on my left side, front and back sensitvity to bright light, no high temperature though, .  i am extremely anxious about HIV
You usually quote the figure of 1 in 2000 chances of being infected per one
act of vaginal intercourse. - Are these figures based on research in the U.S and Europe?Are the Asian strains of the virus more virulent? given that aids is much more prevalent among heterosexuals in Asia.
The doctor i spoke to while i was away actually quoted a figure of 1 in 4 chances of infection. - if the prostitute had HIV - which seemed a little bit high to me.
I am home now and so far have been tested for everything except HIV - getting the results tomorrow. (they put me on antibiotics for a urinary tract infection i think ,  doxcycycline.) i finished taking them last week.

I am highly stressed about it - given my flu like symptoms and the timing since the incident it has worried me greatly. I was hoping to get through the next few weeks with a clean bill of health and i would have felt much better about things. Could stress be a factor in my symptoms?
AS it stands I'm preparing myself to come to terms with the possibility that i may well have caught something serious.

Any thoughts?
thanks

[H. Hunter Handsfield, M.D.]

Exactly right.  Almost every symptom human beings suffer, except those obviously due to trauma, can be caused HIV.  Even the reliable, professionally run websites generally provide no context.  For example, they fail to mention all the other, more common causes of the same symptoms; or they don't say that certain combinations of symptoms are more important indicators than individual ones.  On top of all that, many websites are inherently unreliable, run by nonprofessionals or persons with a particular, biased perspective.  Caveat emptor!

[H. Hunter Handsfield, M.D.]

There are no data on different HIV transmission risks in different areas of the globe.  But in general HIV is hard to transmit, and there is nothing to suggest that Asian strains are any more transmissible than those anywhere else.  Your symptoms do not suggest HIV--not even close, and absense of fever is pretty strong evidence against acute HIV infection.  And your symptoms really don't sound particularly "flu-like" either.  (That term generally means fever, headache, muscle aches, and cough--certainly not grogginess, light sensitivity, etc.)

Your "scrotal burning" sounds most like your emotions working extra hard; no STD or HIV can cause such a symptom.  I doubt you had a urinary tract infection, which is rare in young men--if you had any such infection at all, you might have had sexually transmitted urethritis (gonorrhea, chlamydia, NGU); and azithromycin (Zithromax) or doxycycline are the drugs most commonly used for NGU or chlamydia.

Of course I cannot guarantee you didn't catch HIV, and I don't know the proportion of commercial sex workers in Hong Kong who are infected.  But most likely your HIV test result will be negative.

Finally, could stress be a factor in your symptoms?  Absolutely yes; most likely that's your only problem.  Whenever a person suspects his or her own symptoms are due to stress or anxiety, s/he probably is almost always right.  

Of course follow up wiht your provider if your symptoms persist or you remain concerned.

Good luck--  HHH, MD

[H. Hunter Handsfield, M.D.]

This thread is closed.  Feel free to continue the discussion on the HIV support forum.

[Daveansh]

All the best Joseph...do update us..cheers my friend..

[Paranoidman]

i understand what your going through. I dont think you caught anything. Update us with your results tomorrow.

[joeseph]

Ok, its just over 24 hours till my test results.
Ill post them here when i get them.If they turn out to be negative It'll be informative
to other readers I guess

Despite all the re-assurance I am still very worried. I feel much better physically today,
but over the last two weeks i have experienced the following

headache behind the eyes (persistent and ranging from mild to very strong)
malaise,(flu like feeling)
muscle pain(in the chest)
weight loss(over 10 pounds),
loss of appetite(related to the weight loss i guess)
fatigue for the first few days
sore throat (very mild for the last two days)
dry mouth
pain in my left side( I thnk its my spleen)
A touch of diarrhea one day.

I know that the onset of symptoms was quite late(33 days) and that NO fever strongly
indicates against ARS but I really don't feel good about the news I'll hear tomorrow.
I have never experienced an illness like the one I just went through, even if most of what i experienced was quite mild.

[H. Hunter Handsfield, M.D.]

I will have no further comments or advice.

[extremelyconcernedD]

But I take your point monkeyflower - if i were to go "symptom shopping" for anxiety under how im feeling right now.
I'd get a much closer match than i would for HIV.
I need to try and relax I guess.

[extremelyconcernedD]

you have a good point
There's no doubting that I am very very anxious.
I would say my stress levels have been through the roof the last while,

However im not sure what came first, the stress or the symptoms?.
I felt I was doing perfectly fine mentally until I got sick last week.
Thats why im getting tested as soon as possible anyway- to put this to
bed and move on and deal with the consequences(if any).
and believe me I don't want to think its HIV or anything as serious - but when
it looms on the horizon as even a small possibility its hard to ignore, especially for someone (like many on this board) who is not used to this situation...

[monkeyflower]

Your symptoms are absolutely classic for anxiety.  Weight loss, headache, chest pain/tightness, lightheadedness, achiness, everything. I realize no one wants to hear that--for some reason, everyone wants to think it's HIV, or cancer, or some House-worthy obscure disease--but consider that anxiety is just as real, it makes you feel just as bad, but it's not gonna kill you. Talk to your doctor about this possibility, and see if she wants to prescribe any meds. Also consider seeing a therapist, especially if you find that you're anxious about other things as well.

[extremelyconcernedD]

By the way im not a thread hijacker I am the same person as Joe above
just didnt realise i had two usernames.

[extremelyconcernedD]

I've just been to a doctor and she had no real answers.What worried her (and me) is that I have lost 8 or 9 pounds since just before i got sick.
I still have a persistent headache,  pain/tightness in my chest and I feel like
****. I feel like really lightheaded and like I have a bad flu - fever or no....

I really hope this is some other more innocuous virus and not HIV
I'll find out for sure on Friday afternoon.
Regardless of the low risk of the situation i never have felt like this before - so I am  pretty petrified at the moment.
I notice from another thread that you said post 4 weeks for ARS is rare?
Is that correct?
Well my symptoms appeared on day 33(end of the fifth week). So im hoping thats a good sign - along with the fact that i haven't had any significant fever. it once went up to 99.3(for a very short time) .

[joeseph]

I hope it is just stress.
I don't have far to travel to London - so its not a  big deal
The alternative is waiting an extra two weeks for the test results at home.
(three more weeks in this state of mind is not an enticing prospect!!)

I wont hassle you anymore anyway.
Thanks for your time!

[H. Hunter Handsfield, M.D.]

I hope you're not flying from HK to London (or to London from anywhere!) solely for the purpose of having a particular HIV test.  Given the low risk situation you described, that would be an incredible waste of money and time.

Your symptoms don't sound like anything physical; I'll bet it's all anxiety/stress/depression.

From my original reply:  "Of course follow up wiht your provider if your symptoms persist or you remain concerned."  (But that doesn't mean spending money on an airfare, unless you were going to London anyway.)

I won't have any further comments or replies.

[joeseph]

Update on my situation - got all my test results back and i was clear -
They actually tested me for HIV at three weeks and that came back negative.
Slightly re-assuring at least!!

However - I'm still not feeling great.
I still have some discomfot on my left side - slightly below my rib cage -
this I feel most keenly when lying down.(its like something is sticking out, or is too
big in my abdomen
I have a persistent headache, (mild)but its there. And aches running across my chest. I also feel pretty weak (kind of nervous/ my muscles don't feel their normal strength anyway).
I still have not encountered any fever at any stage.
the most persistent thing I've experienced is the discomfort
in the left side of my abdomen. - That has becoming more pronounced over the last three weeks and was there before anything else.

So my question is Doctor -given the other "symptoms" I'm experiencing does the lack of any fever still strongly indicate against any kind
of viral infection? or more particularily ARS?
I'm still trying to avoid looking all this up on Google. Its tough.I guess i should really talk to a doctor about this in person.Which I am doing first thing in the morning.
I'm also flying to London to do the DUO test on Friday.
Anyone in this situation can probably relate to how I feel right now.
I feel like a caged animal, its a horrible, horrible experience.

thanks.

[joeseph]

You know today I realised that by and large consulting the internet for reassurance about possible HIV infection symptoms is an extremely bad idea( this site being one of the few exceptions).

All you end up doing is re-enforcing any fears/ideas you might have about possible
symptoms. I mean  you could probably type in HIV and "sore finger" into Google and you'd find some anecdotal evidence to confirm your worst fears and condemn you to many sleepless nights and missed dinners.
Thats my two cents anyway - to anyone who finds themselves in the same situation..
No more self internet diagnosis for me till i get my results

[joeseph]

Thanks for your re-assuring words.

Ill get tested at six weeks(next week) and hopefully come through that with good news.
I'll let you know how I get on.