How long if ........... ??

I'm a 33 yr old bisexual  (might as well admit it now;  I usually have lived a mostly "straight lifestyle",  and called myself  "straight"  but,  there were instances of  "both" at times).      Anyway,   I'm a male ,   I  was always fairly to very healthy and vital,  a regular gym goer and runner,  etc etc,   up until just this year.   I went w/a friend of mine down to the Carneval in Rio deJaneiro ,  late February of this year,   and while there,  on a Saturday night,  and again on the following night,   had at least four instances   ( I believe there were four)  of insertive and receptive (all unprotected) full anal intercourse to climax with two different transsexuals from the area with whom we had taken up during the time we were down there.   I had been with men and t/s's a few times before,  but always only oral and had never gone "all the way" without safety.    Intoxication ,  "poppers",  the general atmosphere,  etc,  all that was certainly a factor,  and though I vaguely recall risk of illness briefly crossing my mind that first night,  I reasoned that the ppl I was with seemed totally healthy & happy,  not skinny or "sickly",   and furthermore as I said intoxication was a factor  (as was simply thinking with the wrong head,  so to speak).    

  Back home,  approx  a month later,   a fairly bad bout of what I wrote off as simply a nasty flu.   I simply didn't think it could be anything besides.   Other than that,  I have felt pretty much normal ,  if occasionally a bit fatigued.   I'm honestly not sure if my glands have swollen or not;   I'm not a big gland-feeler type of person,  which is probably for the best.     But,  anyway,   approximately two months after the exposures (give or take),   my friend related to me that he too had been similarly ill (even worse than I had in fact) and around the same time,  and he privately suggested to me that we ought to get ourselves tested.    It hit me like a ton of bricks at the mere mention of it as I'd simply never felt I had the need for an HIV test before.   I'd had nothing but gonorrhea,  which was cured,  once before,  a few years back.    In any event we are both HIV-positive,  even with a retest coming back again pos in my case.    They gave me some literature at the public clinic that I went to,  and I am of course no longer sexually active with anyone since the test.   They had me speak once to a counselor from the clinic which was available through them.   I still haven't yet told anyone,  with the exception of a couple very close friends;  not even my family knows yet,   and I haven't yet told my gp.   I never had a very close relationship w/any gp or other doctor due to (generally )  good health and therefore I feel quite awkward about going there and just suddenly laying all of this on him,   telling him the results of the test(s)  and especially  the nature of how I seem to have acquired this.    

    What I come here to ask you is ,   in your expert opinion Dr,   how long,   without treatment,  can a (otherwise healthy) young person go before this turns into AIDS?    Magic Johnson's been positive since 1993 ?   And I read of several cases like this.   Gay author Edmund White;  I read about him on the Net.   Positive for maybe the last 18, 20 years??   And yet there are others who seem to have gotten seriously ill,  even passed away,  somewhat quickly following infection.   For instance the men in the early 1980's who were the first ones to get it (in this country);  all dead in the early (to mid) 1980's -- and they must have only gotten HIV a few years prior to that because I have read that it was really only in this country since the late 1970's.    
What would be the standard procedure a gp would take ,  in your opinion,  and what kind of treatments would they do for a guy like me ?   Frankly I'm quite scared of the pills,  the treatments.   And I am now,  after all summer pondering this,   considering simply using my savings to do things now such as take trips to places I've yet to have been,  etc,   remaining celibate of course,   and enjoying my life a bit.    

    Also I've found a weird sort of peace that I didn't quite have before,  recently.   Prior to this spring/summer when all this has occurred I was usually a neurotic case for instance,  spending my money on psychologists,  quibbling w/myself in my own mind over what I feel now to have been essentially small things,  small phobias ,  "OCD's" , etc.    Now I feel much stronger and ,  strangely,  I don't have those phobias or anything anymore and I find myself enjoying everything,  even the smallest things,  much much more.   In a way I don't want that particular aspect of this (otherwise quite frightening and paralyzing)  experience to end.    How long could I reasonably expect good health  (which,  for the time being,  I seem to be in)  without going in to start all of this with my doctor (and by "start all of this "   I mean ,  confiding the test results to him,   beginning the treatments,  etc etc.)??    Or is that simply an impossible prediction for you to make?   What's going on inside my body?  My "T-cells" (immune system cells)  are slowly being killed ,  aren't they?   And if I do continue to go without treatment for much longer and just , say,   wait for a health crisis of some sort to arise,  is it then too late to do much?  Thank you for your time.   All the best.  

[H. Hunter Handsfield, M.D.]

Sorry, your main questions are beyond the scope of my advice, and I pretty much stopped reading your question after paragraph 2.  See the prominent disclaimer at the top of the forum, including "No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics."  I do not deal with clinical assessment, treatment, or advice for HIV infected persons, only prevention.  I'm definitely not an expert on clinical management of HIV/AIDS.

For excellent online information, visit www.thebody.com.  But whatever else, find a health care provider skilled and experienced in the management of HIV infections and follow that person's advice, not mine or that of any other online source.  Do not delay; long term survival is strongly correlated with prompt initiation of proper HIV care.

Good luck--  HHH, MD

[skerdstraght68]

The doc is not a HIV specialist.  Your questions are best suited at thebody.com.  This site is for transmission assesment/testing.  I'm not sure if you've even been tested.  If you havn't go get tested.  If you have and are positive, be happy it's not 1985 when HIV was a death sentence.

[scared_aussie]

Well, I am going to be a pain. However... is it just me, or "alreadythere73" was just tremendously unlucky?
He said:

"at least four instances ( I believe there were four) of insertive and receptive (all unprotected) full anal intercourse to climax with two different transsexuals from the area with whom we had taken up during the time we were down there"

I read a lot about this, on this forum and thebody.com, and the chances of getting infected after just 4 exposure is supposed to be really, really, really minimal.

I guess "low chance" doesn't mean "no chance". There aren't many unlucky cards, but they are never the less there...

alreadythere73: good luck with everything; for you, and for all the people in the world who discover they are HIV+. I will send you good vibes...

[H. Hunter Handsfield, M.D.]

Your argument is completely illogical.  You can't say to someone struck by lightning that "lightning strikes are rare, so it must have been something else".  Uncommon things happen.

Anyway, I cannot think of higher risk behavior for HIV than anal sex between men, including unknown or new partners, at Carnival in Rio.

HHH, MD

[scared_aussie]

Sorry Doctor HHH, I didn't mean to make you angry.

[scared_aussie]

Sorry Doctor HHH, I didn't mean to make you angry. You are completely right.

[H. Hunter Handsfield, M.D.]

I'm not angry; didn't mean to seem so.

HHH, MD

[alreadythere73]

Thank you for your input, Dr,  and scaredaussie and scaredstraight.   I have found the page referred to here,  the body dot com,   and actually I think I have already had my question(s) answered by just reading through questions already posted there.   Thanks for the site referral.  All the best.

[Ronnie99]

In the specific case noted in the link below the rate was about 25%. Small sample, but telling nonetheless.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5437a3.htm

[Ronnie99]

alreadythere73: You mentioned that about 2 months after your exposure your friend suggested you get tested and then you noted that you got tested and were positive. Did you end up getting tested at approximately 2 months after exposure or was it later than that? I am just curious. Also, had you tested earlier after the exposure or was your first post exposure test positive?

[Kibbles'nbits]

Ronnie99-

I read the article you linked and this quote confused me...

"The index patient described in this report tested negative by HIV PCR twice during the 2 months before engaging in sex acts with the three women who subsequently became infected, including a negative test only 1 week before encounters with two of these women. This negative test likely occurred during the eclipse period when the index patient was able to transmit HIV but before the PCR test could detect the virus."

I thought 6 weeks was conclusive. Why did this man test negative for 2 months?

[Ronnie99]

I think what transpired is that he had the first test and was negative because they test monthly in the adult entertainment industry. Then he went to Brazil and apparently was infected there. He returned and subsequently had another test, but that test was likely only very soon after infection and was therefore non-detected. He then tested positive later. All of the people who were exposed tested within expected time periods and as seen the PCR test and Elisas performed as expected.

[skerdstraght68]

I dont know why the CDC doesnt do a study or SHOW us a study on window periods.  Like case studies such as this.

[alreadythere73]

Yes, I was tested for the HIV approx 2 months after (what I believe to have been) the exposures where I in fact acquired it.  I don't see how else I could have acquired it.  My actions in Rio were the most careless and risky I'd ever been with my sexual activities.   And I took one other test,  several weeks later,   a retest,  and it also came back positive.   However since the time of my one period of illness (the "nasty flu" I mentioned in my post),  I have felt pretty much average,  give or take some fatigue,  body aches,  and minor things like that (but probably everyone has that sort of thing to some degree from time to time, if they only pay attention to it).   So for the time being I guess I'm lucky to be nearly completely "asymptomatic".   According to the body's docs, I probably won't even require meds for some time yet,  but I do need to get in sometime soon (have to bite this bullet it seems)  for baseline checks on viral load,  CD4 level,  and T cell count.   Judging from some of the things I've read about on there,  I don't want to take the "no treatment I'll just wait until something happens"  approach; I'm afraid of side effects of pills, yes,  but I'm also more afraid of some of the horrors described which go along with these "opportunist" infections.   Thanks for your input all.    All the best.

[skerdstraght68]

I meant what I said when I said you should be happy its not 1985.  Check out this VERY promising news in the war on HIV.  This is huge news that everyone shoud read.

http://www.medicalnewstoday.com/medicalnews.php?newsid=50180

[forschung]

There have been studies of seroconversion times - which have been a factor in setting the definitive window period at 3 months - but if you think about it such studies are hard to do. For one thing you need to know the date of exposure, which pretty much rules out anything based on patient report, then you need to repeatadly test the subjects, and you need a sample size large enough to be of statistical use.

As far as I know the studies that have been done have followed infection via ocupational exposure and blood transfusion. Nowadays of course, the availability of PEP which would be given in such cases would make a similar study harder and less useful (since PEP reduces the chance of infection and means that you'd be measuring the window period for people who had PEP).

[Ronnie99]

Note also that while the CDC report link I posted does not say so specifically, I am guessing that the heterosexual sex that the adult industry actors were engaged in was unprotected anal sex.

[obsessed1]

How does someone ask a question in the forum?

[obsessed1]

How does someone ask a question in the forum?

[wackybong]

have you heard of virgin coconut oil as treatment for aids? there are clinical proof that it works! google "virgin coconut oil"