Expert: Terry B - 1/20/2008

Question
QUESTION: i had a sex with a Prostitute when i was at a trip in china, through this condom was broken, she felt it was broken, and immediately i washed my penis and she washed her vagina. after 48 days i felt tired and in the following day there was a pain in my muscles and joints. this pain
continue through the following seven days. after that this muscle and joints pain start decreasing. and i had a light Throat Inflammation . but no fever or lymph or any other Aids initial symptoms.. i am right now
in very bad mental situation... i cant run HIV test because i live in middle east-Jordan... if i tried to run this test... i will face many
problems even if i was negative.. please advise about my current status(if you can through this brief description about my health status)"


ANSWER: Dear Ziyad:

Peace.  If you read through this column you will find several warnings against looking for symptoms of HIV as an indicator of infection.  The only sure way you can tell if HIV infected is by testing for the antibody.  

However... since you experienced physical symptoms, I recommend highly that you see a physician to assess, diagnose, and treat those symptoms.  While it seems (to me) unlikely that this would be HIV because of the apparent low frequency (once) and short duration of your possible exposure, there may be something else that is going on and of importance in your health.

One downside of being sexually active and fear of HIV/AIDS stigma is that people sometimes avoid diagnosis and treatment of other conditions for fear of HIV testing.  Delaying diagnosis and treatment of some can lead to long-term and serious damage to your health.

Please see your doctor and explain the sore throat and your muscle and joint pain.  Your doctor will likely examine you and order some tests to assess your health, and from there provide both of you with hard data which can put you back in charge of your health and care.

The best to you and yours,

Terry

---------- FOLLOW-UP ----------

QUESTION: Dear Mr Terry,

thank you for your reply.i want again to go through these symptoms.as i mentioned, these symptoms were sequenced and they didn't take place in the same time. i read before that they will have a jointly effects on infected person.. as i told you before, there was non of the other AIDS symptoms. and as i mentioned before, the exposure was only for a little time.. am really freaked out.. i cant concentrate in my job, ppl start Criticize me  and my life become miserable..specially that my Weddings will be after 3 months. i had read a scientific article about transition. this article say that the ppl who was Circumcised , they will not be infected easily. is that right?

thank you for your help i really will appreciate your help.

regards

Answer
Dear Ziyad:

Peace.  Perhaps I was unclear.  You cannot diagnose HIV through symptoms.  A blood test is needed.  AIDS can take years from initial HIV infection to development of AIDS defining conditions.  I already stated that your risk seems low, but your symptoms do suggest that you have problems that require medical attention from a professional.  See one soon.

Regarding circumcision, there is a lower rate of infection between some people who are circumcised versus those who are not.  This can possibly be explained by a greater area of skin that is exposed to the fluids of another - and it is a statistical difference, not a means of preventing disease transmission.  People who are circumcised are at risk for HIV transmission, but that risk seems, in population studies, to be less than for those not circumcised.

Again, especially if you are so distressed, see your doctor about your joint pain and related complaints.  A good work-up will include blood tests that will measure your immune system status - if, after examination and routine blood testing, there is a problem, then you can address the question about HIV if it should arise.

While you are in a place where persons with HIV (or persons known to be at risk) may face stigma, we can talk about options for testing AFTER you have seen your doctor about your symptoms.

Best to you and yours,

Terry