HIV question

[S.C.R.E.A.M]

Hello Dr. HHH.

  It has been six  months since my last visit and I had some concerns. The last time I wrote it concerned having unprotected sex quite a few times with a new partner. I am a 23 year old graduate student and I am female. Anyway, I took your advice and got tested 36 days after the event and it was negative. I also took your advice to use condoms the second time around. In November of 2005, I had sex with this person a total of five times between the 18-20th of Nov. Condoms were used, but one slipped after he pulled out. The others were utilized after two or three minutes of unprotection. Not smart. After this encounter I got sick five days later with a fever and sinus congestion. My sickness was gradual and on Dec. 30 I was hit with a really nasty upper respiratory virus. I had a runny nose, scratchy throat, nasty cough and headache. It lasted about two weeks. My lymp nodes were very swollen and tender especially in the groin. They were tender to the touch and sometimes burned. I got scared and contined to poke and prod around my abdomen, upper cest and rib cage. I even continued to poke my groin and thigh muscles. I may have caused unnecessary lymph enlargement. Anyway, In late January I began to experience muscle palpitations in both legs, tightness in the back, and numbess in the left foot. These symptoms come and go. Sometimes its in the one leg, and then it effects anotner area

My questions are:

1) I am coming up for my annual exam, should I get tested again.

2) Does this sound like neuropathy associates with HIV

3) Should I be hitting the panic button and plan my funeral

4) Have you encountered this problem with patients who turned out to be HIV-

5) Considering my use of condoms would that really lower my risk.

6) Am I overreacting and could this be assoaciated with my viral infection?

[H. Hunter Handsfield, M.D.]

So many people have such inflated ideas of HIV risks today, and you seem to be one of them.  I don't mean it crtically; I think it relates to the over-hyping of the risks by people and agencies who have been influenced by the religious right and others of populist, conservative philosophy.  (Although it is partly personality-driven, of course.)  Anyway, you know the women in Sex and the City?  If 1,000 women followed their sexual lifestyles for 10 years, my guess is that well under 10 of them, perhaps only 1 or 2, would catch HIV.  Your story suggests you have a much more conservative lifestyle than those characters.  In other words, your risk or getting HIV is very low.  You simply are not at significant risk.  Getting routine HIV and STD tests (chlamydia, gonorrhea, etc) once a year at the time of your annual pap test is all the testing I recommend.



As far as your symptoms are concerned, they sound more like any of a 100 garden-variety viruses than they do like HIV.  Sinus congestion, scratching throat, and runny nose are not HIV symptoms at all--sounds like you have a cold, nothing more. I can't judge your description of lymph node swelling, but most medical non-professionals are totally incapable of self-diagnosing lymph node enlargement, so if lymphadenopathy wasn't confirmed by a health professional, I am skeptical you have it; and in any case, the enlarged nodes with HIV are not painful.  The muscle twitching and foot numbness could be any number of things, but not HIV; AIDS neuropathy occurs only  in people very sick with advanced AIDS.  Finally, acute HIV almost never occurs without fever, usually high and obvious.



To your specific questions:



1) If you'll sleep better, get tested.  Your risk history and symptoms do not suggest a need for it, however.  2) No.  3) No.  4) No.  5) Yes, condoms really lower the risk, almost to zero (and also protect against other STDs, for which your risk is much higher than for HIV).  6) Definitely yes and yes.



So relax and stop worrying.  See your health care provider if your symptoms persist, but they do not sound alarming.  Best wishes--



HHH, MD

[Willl]

I think it is the Internet that is the source of most of the scaring of people about HIV. There is a lot of conflicting information out there and a couple of other forums are much more conservative in the risk assessment and testing advice than this one. The more people research the Internet to find consistent HIV risk and testing information, the more they get confused, frustrated, and become scared.

[monkeyflower]

Dr. Handsfield just rocks.



I was curious about the real risks of contracting HIV, so I did a little comparison. You are far, FAR more at risk of contracting diabetes, cardiovascular disease, or even dying of the flu. Seriously. In the US, the number of people who die each year from the flu alone is more than DOUBLE the number of people who die from HIV. But how many people avoid contact with others, lose sleep, get depressed, etc. over their fears of contracting the flu? And how many people actually make an effort to lose weight, eat right, exercise - even though they KNOW that being overweight is a clear risk factor for many chronic/fatal illnesses? But a STD - now, that's something to fear. Sheesh.



Yeah, I definitely think all this STD paranoia is fueled by the religious right. Nothing sells like sex or fear, and when you get to combine the two, WOW.

[S.C.R.E.A.M]

To everyone that answered my forum. I appreciate your comments and I did not mean to offend anyone. But, we do live in a time of fear. All the information that is out there about STDs is geared more toward sacring people ratherthan informing them. I also understand that a low risk does not mean no risk. There are so many people out there who never assumed they were at risk and they wind up with an incurable disease. Also all the statistics that exists make it seem like HIV is going to get everybody.

   I realize I need to be more realistic, but in this day and age, sex is downright scary and its often difficult to find a person worth trusting. But I do appreciate all of your comments and thank you for your advice.

[johnsingleton]

Question! I feel really stupid, I have done some really stupid things. I had unpretected vaginal intercourse with 5 different women!!!(all within the last two years, the 1st 2 years ago, the last 6 months ago) What I really did is.....I use a condom, and I always took the condom off before I had an orgasm. Don't know how I got into this habbit, and I didnt realize how stupid I was being! I'm so scarred of having HIV, no symptoms really....just thought of what I did, scarred the **** out of me. I am waiting on my test results now, but I was wondering, what are my chances of having HIV. I don't know that any of these women were infected. But I am so scarred, cant sleep, I dont know if I can handle if the test results come back positive. Please Help! Thankyou!