Hello, I apologize for returning again but I was recently newly exposed and need some advice.  I am currently a pre-med student (I know, seems ridiculous given how anxious my questions are and I'll probably never make it with this hypochondria) and I was shadowing a physician at the hospital.  One of the patients he saw (doc is a pulmonologist) was confirmed HIV positive and was visiting the clinic (a scheduled appointment type of visit, not an ER visit) for some chronic cough type issues.  Anyway, the exam room was relatively small and about 15 minutes prior to entering the room, one of my cuticle broke and was very lightly bleeding.  I am pretty sure that it stopped visibly bleeding within a few minutes (and by the time I was in the room with the patient), but my fear is that since the patient coughed one of his cough particles maybe contained blood which could've made its away onto my wound if it was still open and infected me.  This happened last week Tuesday.  It is Monday night now (6 and a half days later) and I am coming down with a flu like illness.  Oral temp of about 100F and I feel achiness throughout my body (flu type achiness) and my throat, while not very sore, is very muscusy and I have to constantly clear it.  Aside from my hospital exposure, I was also at a football game this Saturday with an attendance of around 65,000, so I maybe just caught a garden variety illness there.  So far, no body rash and my lymph nodes don't SEEM swollen (not a doc so not sure but nothing visible).  The HIV+ patient was on HAART according to the doc, but I do not know his viral load (but CD4 was in the mid 500s) and the visit was not related to HIV as far as I know.  Please let me know if I should get tested and whether my symptoms 6.5 days past exposure are worrisome.  Also, Friday morning (3 days after exposure), I threw up several times but felt much better after a nap and this was likely because I was hungover as I went out drinking Thursday night.  Thnx

It is clear you are obsesessed and/or otherwise overly frightented about zero to minimal HIV exposure risks in your chosen profession. You're going to have to overcome it in order to complete your training and practice successfully. I strong urge professional counseling:  hearing the standard scientific evidence that refutes your fears is not going to solve the problem. It's not an issue or knowing (intellectually) what the risks are; it's a mental health/perception issue.

No health care provider ever caught HIV from the sorts of events you describe. The only professional exposures that result in HIV transmission are traumatic injuries with sharp instruments contaminated with fresh blood, usually in the context of an injury while provding care. The patient's viral load in this situation is irrelevant. Your various symptoms are not due to HIV from these events. You have accurately discerned the much more likely causes. I do not recommend testing for HIV.

I hope these comments are helpful. Let me kow if anything isn't clear.

HHH, MD

2.  I am a contact lens wearer and despite not sleeping with them, I suffered a corneal ulcer a few months ago which was successfully treated.  I read that people with HIV are at higher risk for this but I imagine this is insignificant since I tested neg and since HIV is a risk factor for probably just about anything?
3. I also did get a canker sore recently.  I do not sleep much with school work and all (maybe 4-5 hours a night during the week) and am stressed, so are canker sores normal?

4.  My physical in Jan. included a cbc w/plat w/diff and comp. metabolic panel.  Everything was normal except low vitamin D and high triglycerides.  I realize that diagnosing my symptoms is beyond the scope of this forum, but given my normal bloodwork and negative std tests, is it possible that constant stress and worry can cause some of these very nonspecific symptoms I suffer?  My own doc and others I have personally seen don't have an explanation for my symptoms other than I should stop worrying and that, based on my bloodwork, there's nothing really wrong with me.
5.  If I do choose to seek counseling (I realize that this may not be your specialty), do you think on campus therapy/counseling could point me in the right direction for help?  I have never sought counseling before so don't know where to start. My chronic physical symptoms are really just annoying more than anything, but it's the mental stress that's the worst.  Thanks so much and I really do hope that this thread is the last you'll need to hear from me (and I know forum rules prohibit more activity)

4,5) Most people with ARS have entirely normal CBC and blood chemistries. Your symptoms are entirely typical for the physical manifestations of anxiety, stress, etc. I find it hard to believe your doctor[s] didn't consider this possibility, whether or not they said it directly. This would fit with their advice that you should stop worrying and that nothing physical is wrong. As for counseling, I imagine on-campus services available to students would be a good way to start; complaints and problems like yours are very common among university students. Or ask your personal physician for her advice about it.

3.  In the context of this thread and my prior threads (since which I had no sexual encounters meaning that my negative std results for HIV, HEP A/B/C, HSV1/2, syph, chlamydia, and gonorrhea through stdcheck.com done at Quest labs are all done after my last sexual encounter), would it be safe to begin a sexual relationship with a new partner in regard to her sexual health (as in can I rest assured I won't spread anything to her)?

Thank you and this concludes my questions.  I really do appreciate the service and I realize that it is not appropriate to come whenever I have anxiety driven questions.  I really will do my best to seek help and refrain from such behavior.  Happy Thanksgiving!

2. No STD, including HIV, causes a rash like this.

3. You cannot transmit an infection you don't have! And so yes, it would be neitrely safe to start a new sexual relationship.