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Sore throat, swollen, glands, fever etc after HIV scare - cause for concern??

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Question - (5 June 2010) 3 Answers - (Newest, 5 June 2010)
A male Australia age 41-50, anonymous writes:

Unexpectedly and very regretfully I briefly had unprotected anal sex with another guy (I'm gay). I went straight to the doctor who thought the risk was exceptionally low on account of the person, the time, just the once and because HIV and other STIs are low in Western Australia. He said he thinks 99% I'm fine but gave me a form for a blood test for three months time.

I went away feeling very relieved which was about a month ago. I have been sick this week. Sore throat, swollen glands in my neck, fever, headache, and body ache. I just thought it was a cold/flu/virus but then read that all of these could be symptoms of HIV which occur three to six weeks after infection (and it has been four weeks!).

I won't be able to see a doctor for a few days. I am now really stressed out. I know these symptoms could be so many other things but the timing of them is extremely frightening. The symptoms are mostly all gone now, after probably five days, but I am so very worried.

View related questions: anal sex, hiv , sex with another

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A female reader, Myrrh United Kingdom +, writes (5 June 2010):

Myrrh agony auntHi. Im sure you are ok but never the less, it was extremely irresponsible your doctor to use guess work! Id bypass him and go along to your nearest STD clinic.

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A female reader, DrPsych United Kingdom +, writes (5 June 2010):

DrPsych agony auntI tend to agree with the previous post - a doctor who says that your sexual activity does not put you at risk of HIV and other STD's is one in need to retraining. There is a difference between low probability of risk at population level and low actual risk based on the exact circumstances of the patient. I am surprised they didn't offer you PEP treatment but you should go back and take a blood test.

You may be under the weather with stress, glandular fever or just about anything under the sun but it would be wise to have an STD screen (not just for HIV). I would also say that next time you get into a sexual situation you should think about how stressed you are now - it will empower you to insist on condoms.

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A female reader, anonymous, writes (5 June 2010):

I'm so sorry that you're going through this stressful situation. I'm not sure exactly what to tell you. Of course, you recognise that there is a HUGE chance that your symptoms were just due to a common virus (it is winter after all!), but I know that right now you're focusing on the other tiny side of the probability scale. The easiest way to ease your mind would be to contact this guy, if possible, and talk to him about his infection status. If he's a halfway decent person, he wouldn't have had unprotected sex with someone if he knew he was at risk himself.

Anyway. I'm a medical student, and the main reason I wanted to reply to your question was to recommend that you have another discussion with your doctor about his management of you. I suppose it really depends on where you live (urban vs. rural), but I'm from Sydney and here it would be considered extremely irresponsible for a doctor to not offer post-exposure prophylaxis to someone in your situation. If you ever catch yourself in a risky situation like this again (of course I hope that you don't!), I strongly recommend you go straight to an emergency department and request PEP (the drugs are most effective when taken a few hours after exposure, but from memory you have about a 72-hour window). If you have a significant risk in your history (which in this case you do), and if the hospital has easy access to the drugs, they won't refuse you. Even if the probability of you becoming infected was low in the first place as your doctor said, it will be worth it for your own peace of mind.

Lots of love

xx

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