hope you can help

hi,maybe you can give me some help?this is going back several years i had unprotected sex in florida.iam from a small city in canada,i had the std testing done here and came back negative yet many years later something still isnt right it never has,ive been in constant discomfort as far as a aches from my knees and elbows a constant headache,my palms and feet are very sweaty,a soreness in my testicles and shortly after a large growth has appeared on my knee(my doctor has not seen),my doctor in town prescribed some antibotics but did not help and has concluded its my imagination.hopefully you can give me some advise? thanks from a frustrated individual

[H. Hunter Handsfield, M.D.]

There is no chance you have HIV or any other STD.  Your symptoms don't suggest HIV or STD, and almost certainly were not acquired during the sexual encounter you describe--unless they are due entirely to anxiety, depression, guilt, or stress over that event.  From your description and your doctor's diagnosis, that sounds like a good bet.

Good luck--  HHH, MD

[gab5]

Tested at 72 days for HIV - negative.  Should I do the 90 day test or call it a day.  --kms

[timmytim]

I've been having a similar discussion with the Doctor about this issue. Until you get an official response; you may want to browse the thread located at http://www.medhelp.org/forums/STD/messages/764.html which contains some general figures as to the accuracy of HIV tests at different durations after exposure.

Hope this helps. :)

[gab5]

tim,

this is the craziest thing.  I do not know how people deal with the pressure of a promiscuous lifestyle.  the anxiety would kill me.

[timmytim]

People who have that lifestyle are probably not as aware as you or I or anyone on these forums about the hazards their promiscuity causes.  They likely continue such risky behavior because they were never educated/don't believe/don't care about the risks.

I agree, though; I had an episode where I was at risk and I'm sure I lost about 5 years off my life in stress over the nasty things that could have happened.

[monkeyflower]

You'd probably consider me promiscuous, yet I never worry about STDs. I think that's because I've made a real point to educate myself as much as possible about STDs; I'm well aware of what's out there, and well aware of the risks. If you read many of the posts on this board, you'll realize just how very slim your chances are of actually contracting a STD - and how *very* slim they are of contracting HIV, which is the only STD I really concern myself with. So, I take reasonable precautions and get tested regularly, and let it go. After all, everything worthwhile in life entails *some* risk. Jeez, just getting in your car is risky! I just don't allow fear to prevent me from having a fulfilling life.

I think there are many reasons why some people are more frightened and anxious about STDs than others. For one, some people are just more anxious about their health in general. Also, I think sometimes it has to do with your feelings about sex; if you feel deep down that being sexual is wrong, that can easily lead to anxiety about STDs. Some people who have been with other partners, while in a monogamous relationship and without their primary partner's knowledge and consent, are probably already feeling quite a bit of guilt - which again shows up as fear of STDs. Then there's also an enormous stigma about STDs that also triggers a tremendous amount of anxiety. Of course, there are probably as many specific reasons as there are people :-)

[H. Hunter Handsfield, M.D.]

Actually--and don't take this personally, it's just an observation--it is the people who contribute most frequently to this forum who are the somewhat atypical in their perception of the risks.  As of ~1990 the national average was something like 8-10 lifetime sex partners through age 40.  Since that's the average, many people have many more, and many (most?) people go through periods of fairly frequent partner change.  Yet in the best research about overall STD frequency (from a study published back in 1993), it was estimated only ~22 million people had been diagnosed with STDs.  The true STD rate is higher, of course (most infections asymptomatic, others misdiagnosed, etc).  The majority of the population, maybe as much as 90%, gets genital HPV at one time or another.  But otherwise, despite the overall rate of partner change, most people don't get an STD; and most of those are mild and do not lead to long-term, serious consequences.

Don't get me wrong.  STDs are a very big public health problem, and I have spent 30+ years working to address it.  And some segments of the population truly are at high risk for horrible outcomes, such as most gay men (at some time during their sexual lives), minority populations in some settings.  But the fact is that for a big majority of the population, sexual risks are not as giant as many people think.  There is a necessary balance between overt promiscuity and lifelong mongamy, even when the latter is punctuated by occasional lapses.

Regards--  HHH, MD

[timmytim]

As I mentioned in my particular post, I'm 21 and gay, and the big thing that people who are my age and of my orientation are "taught," whether it be through community activism, friends who have been exposed to the lifestyle longer, or just through overly conservative health class teachers is that STDs are easy to catch and very prevalant. As you mentioned in some of your posts, I know that being a part of this minority predisposes me (for lack of a better word) for a higher chance of STD infection given some situations.

I've only just realized through a more "real" viewpoint (such as yourself, who has had extensive professional focused experience in this field for many many years) that while STDs are something to keep in mind, they certainly aren't as prevalant as more conservative sources would have us believe (even in the gay community), and especially when proper protective measures are taken and when we "err" away from the side of overt promiscuity.

Which is why I think it's truly great that a professonal with your experience is fielding these questions -- I'm learning a lot of the reality of things... Having these "real" statistics and diagnostic suggestions is true peace of mind and kind of puts things in perspective for those of us who haven't had the formal education/experience to know any better.

Thanks for the hours of time you volunteer here, Doc! I've referred several friends (with the same misconceptions that you've addressed) to this site, who have agreed with me in just how helpful it is.

[H. Hunter Handsfield, M.D.]

Thank you.  Keep safe.

HHH, MD