diarrea and initial hiv infection

Dear Doctor,
i was given an unprotected blow job  by a sex worker  in Thailand. It lasted no more than 30 seconds before i came to my senses and put on a condom. Back home,  The doctor gave me an antibiotic (1 straight dose) to  just cover for any possibilities of NGU  and told me not to worry about HIV. Exactly two weeks later i came down with a bout of diarrea (diarrhea) (3 discharges in one afternoon) which went away  the next day (i had just returned from  a trip to central Africa (no sex at all).  Since then i have been suffering  with strange stools. They are not normal  and are quite foul smelling  with some mucus. Sometimes they are not really formed, sometimes they are, and sometimes they are very loose. I would not say that it is diarrea (diarrhea)  and my bowel habits are the usual once per day.  I have also had abdominal pains on the left hand side of my abdomen/gargling noises coming from my stomach  that comes and goes.  It has been going on for over 5 weeks now. Stools sample tests reveal nothing.  Normal blood tests reveal nothing.  Throughout this period i have not had one single headache, bout of fever, or had any other complications  and have continued my normal life including a 5 km run every night.  I have noticed that milk and yogurt tend to bring back very very loose stools .

I was wondering if this form of gastroinstestinal problem is typical of ARS  even without the fever.  There is so much conflicting evidence on the net and some sites indicate diarrea (diarrhea) as a primary symptom even in the absence of fevers.  I intend to get tested shortly  but was hoping for your expert opinion on my situation. I guess that I do not want to be the one that gets HIV from a 30 second encounter,  though logic leads me to conclude that the problems i have are not related to  this incident  and that the HIV test is just a waste of money that could be given to charity instead.

My compliments  on this very informative site  and my apologies for the long winded email.

[H. Hunter Handsfield, M.D.]

Your risk of HIV was too low to worry about, even with a sex worker in Thailand.  As I have said a hundred times, symptoms NEVER are a reliable indicator of early HIV infection, especially after low risk exposures.

In any case, diarrhea or alterered stools (without fever and other symptoms) are not symptoms of early HIV.  However, they are consistent with certain parasitic infections common in Africa, some of which are difficult to diagnose by routine stool samples, such as giardiasis.  If your symptoms persist, follow up with your provider, or ask for referral to a gastroenterologist or infectious diseases specialist for possible more sophisticated tests.

You probably are borderline lactose-intolerant (as are many adults), which is why dairy products trigger your diarrhea.  Lactose intolerance often is more prominent in the presence of intestinal infections or inflammation.

But with respect to HIV, your logic-based conclusions are exactly right.  However, get tested if you need a negative result for reassurance; or follow your provider's advice.

Good luck--  HHH, MD

[crazyitalian]

hello  doctor,
just to inform you and anyone else that is interested  that after two months of this minimal exposure  (and as you predicted),  test was negative.  it is amazing what stress  can do to ones body  and the stomach problems i was experiencing mysteriously went away.

To the other questionner  hoolywood,  if you are worried get tested  but if it was truly protected (and as he said many times  before )  your risk is practically zero.  

thanks