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Three Year Fear

Like so many others here, I have a fear of HIV. A fear which has affected so many aspects of my life over the last 3 years.  

Whilst working abroad, I foolishly had sex with a prostitute in West Africa just over 3 years ago. The condom broke during the encounter but for whatever reason, I was not overly concerned at that time. Approximately 7 weeks after the encounter, I had some symptoms and in a crazy panic, I took PEP (Combivir) for one month. Hindsight is a great thing and I know now that the timing for this was all wrong but such was my state of mind at the time, I demanded it from the Doctor in Africa.

Anyhow, I have had a no. of symptoms over the last 3 years, symptoms which did not occur prior to the encounter. These symptoms have mainly been skin and muscular issues but armpit and groin pain / burning is a recurrent problem. When these symptoms occur, I worry and become extremely anxious. It has got to the stage where I link every health issue to the encounter as that is when the problems began.  It is worth noting that I have also had prolonged periods of excellent health over the last 3 years, during which time my mental health is quite good.
    
It is also worth noting that I have lost count of the no. of tests that I have had. I have tested with PCR, DUO, rapid even Western Blot on many occasions, in different labs, in different countries ... all negative. My last negative test was almost a year ago. I also test for CD4/CD8 to check the status of my immune system. My CD4 counts have consistently been over 1,000 with the last count in July of this year being the highest yet of 1,350. The CD4% has also been between 54 – 60%. I have also had a no. of other blood tests, which have generally been ok.

Despite these test results, I am still concerned about the virus. This is largely borne out of a) symptoms b) human nature of fearing the worst and c) a concern of a rare subtype as my encounter was in Africa.

I have seen psychologists, psychiatrists etc. I have taken anti-anxiety medication. Reading a no. of posts here, I note that people have had this problem for a no. of weeks / months after an encounter but this is 3 years for me. Has anyone else had this problem for this long?

Apologies for the length of the post.
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1699033 tn?1514113133
Oh trust me you are not the only one with this problem.  I have answered other questions on this forum with people saying the same thing.  The thing about reassurance is that it is fleeting as you  have already figured out.  At what point do you think you would ever trust the results if you haven't trusted them for three years?  With untreated OCD, I'm afraid to say that you may never trust them.  Or if you do, the likelihood that something else will start bothering you is pretty high.  

Here is a really good article about OCD

http://www.wsps.info/index.php?catid=0:&id=82:ten-things-you-need-to-know-to-overcome-ocd&option=com_content&view=article
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Avatar universal
Thanks for the informative post JGF25.

Yes, Doctors have tested for other ailments and have ruled them out. However, one of the problems I have is that no Doctor has been able to say what has caused the symptoms that I have had.

It is probably correct to say that increased levels of stress exacerbate symptoms but there have been a no. of occasions when problems arose when not stressed.

Perhaps CBT in combination with medication is the way forward as you allude to. However, at the moment I can’t get away from the fact that I will look to test again. Maybe CBT and medication will change this but at the moment, the reassurances from good test results and physical well-being, generally lead to periods when I am absolutely fine mentally and do not worry about this issue.

Your point of saying WHATEVER or ENOUGH to myself is certainly valid. Part of me knows that this is what needs to be done but another part of me says that I need the reassurance which good test results bring.

I’m sure that most people accept a negative HIV result (if over 3 months) and move on. I’ve been living with a fear of infection for 3 years now. In a strange sort of way, it would be somewhat comforting if I knew that others had this long term fear (following a high risk exposure), despite negative results.  
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1699033 tn?1514113133
I assume that the doctors have ruled out anything else physically wrong with you that would lead to the symptoms you are feeling.  You said you have had a number of prolonged good health periods during these three years.  Do you remember if when these symptoms cropped up if you were under more stress than usual?  I know for me, increased stress leads to a flare up of OCD symptoms.  

As far as CBT, I really think it is the most important thing to learn when you have OCD or even HIV anxiety.  The reality is your brain is tricking you into thinking something is horribly wrong when in fact there is nothing to worry about.  You had a pretty awful trigger with the condom breaking and so you keep coming back to that.  The reality is that nobody turns HIV positive three years post exposure.  So the key here is to retrain your brain and alter the way you think.  This is done with CBT alone sometimes but often in conjunction with medication.

What I have learned is that you cannot give into the thoughts.  So the reality is the more you test, the longer the thought is going to stay with you.  You do recognize that because you say "I accept that this is not an ideal way to deal with this" as far as continued testing.  

Here is a for instance for you.  A bit different than HIV anxiety which I did have at one point but I'm going to use it as an example of giving in.  When I was in college I felt like I had to go to the bathroom all the time.  Even when I walked out I felt I had to go right back in.  The reason for this is because when I was 7 I wet my pants in a very public place.  When stress became high, I did this stupid bathroom thing.  I did it for quite a while and then I said ENOUGH.  I had to realize that there was nothing left in me to come out and embarrass me so when I got the thought and the resulting anxiety, I had to not let myself go back into the bathroom.  I had to do my controlled breathing to bring my heart rate back down so I could think more rationally.  Then after that I started holding it for a while even when I had to go just to prove that I wouldn't wet my pants.  This is a non issue for me now.  

I'm sure any psych doc will tell you that giving in does not work.  So continued testing will never make you better.  You will always doubt.  The trick is to take the symptoms, whatever they are that you know are no real health risk, and say WHATEVER.  If you concentrate on them, you are going to notice things that you wouldn't ordinarily bat an eye at.  Do you see what I mean?  You need to say ENOUGH, breath, self-coach, etc.  These are all CBT techniques.  

As for the medication that you took 4 months and that you said helped to some degree, maybe the Lexapro wasn't the right med for you or perhaps you were on the wrong dosage.  Xanax works to relieve the symptoms of panic and anxiety but it is very short lasting.  In my book it is not a long-term solution.  

I have written a proverbial book here....I'm going to stop and see what you think.  
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Avatar universal
Hi JGF25, thanks for your reply.

I went to a psychologist on and off for about 1 year. I saw a psychiatrist over a period of approximately 3 months. CBT was talked about with both but it is not something that I have undertaken. I was initially on xanax for about 3 months. At the beginning of this year, I was on sertraline for about 4 months.

Whilst all of the above did help to some degree, any strange physical symptoms lead to a fear of infection, regardless of medication or professional therapy. Physical symptoms always trigger my fear and I immediately link any symptoms to the exposure 3 years ago.

Deep down, a part of me thinks that the only way to beat this is to test for the virus and check my CD4 counts for a no. of years to come. If I’m still healthy and the results are goods, this will surely rule out infection?

I accept that this is not an ideal way to deal with this as there is a constant cloud hanging over me. Are there many others who have this kind of fear for such a long period of time, despite negative test results? Is such a prolonged fear of this virus normal? I would like to add that health issues or concerns were absolutely never a problem for me before the exposure referred to.
Helpful - 0
1699033 tn?1514113133
Hi there.  I'm going to jump to your last paragraph and ask some questions.  How long did you see the pdocs and how long did you take medication?  What med and for how long?  Also did you learn CBT when you were seeing the psychologist?  
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