Expert: Terry B - 2/1/2008

Question
Hi Terry,
I have a cousin whose husband has slept with prostitutes in Thailand. u know that hiv infection is so epidemic there.He travels to there alot. Some day I went to my cousin's house, she was scratching her leg to take some hair root out of her skin. I asked her not to do that but she suddenly became playful and said: I'm going to do that to you also.and then rushed at me trying to take my pant legs upward, while she was doing that, her nail scratched my skin and made a little wound.her nail remained on the wound about 15 to 20 seconds.about 1 week later I felt a very bad pain in my breast that didn't last long, and it is mentionable that I was on my period that time.2 or 3 days after that(about 10 days after what my cousin did), I felt sick and tired I had a very bad headache and sore throut especially going upstairs and standing up after bending usually caused the pain to become more strong and I was feeling strong and quick pulse beating in my neck when I was going upstairs or standing up after bending.I touched my lymph nodes to check but I didn't recognize if they were bigger than normal or not,but they were not visibly swollen.(as an hiv symptom should their unormal bigness significantly be visible or it can be recognized by only touching also?), anyways I could feel some pain in them. after that I started to sneeze but it was rare but my nose wasn't running at all.I became more worried when I saw a rash on my chest and another one on my face,(I hadn't have any for several months before these 2 come up). This period lasted about 2 weeks.I'm so scared, there was a possibility my cousin's nails were bloody. she is just married and I can remember she caught a bad flu about 2 weeks after her marriage. I'm so scared. can these be acute hiv symptoms? should I go for a test?
Thank you very much and I appreciate your effort to help people.

Answer
Dear Ellie:

Peace to you and thank you.  Theoretically, if your friend's blood was in contact with your open wound, there seems potential risk.  I would remind you that the symptoms you describe can be many things, and if they are causing you continued distress, please see your doctor.  Regarding HIV testing, I would recommend it for your peace of mind.

Regarding commercial sex workers in Thailand, there have been (in the past) aggressive campaigns to promote testing and condom use; for a look at Thailand's epidemic, see www.who.org for details.  The estimated rate is lll4 per 100,000 people, though it would be higher among selected populations (e.g., commercial sex workers).  This is significant, but low compared to some other ocuntries.

Please let me know how your testing comes out.  In the meantime, I wish the best to you and yours.

Terry