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I'm Italian if that will help in getting an answer!
Feb 18, 2002

Hi Dr. Bob. Let me start by saying that what you do here is nothing short of amazing. The world can use more people like you.

My question is about testing, and the reason that I don't categorize myself with the masses of worried wells is because I have not abused the testing process. I see questions on here asked by people that have had little or no risk for infection, yet have taken numerous tests as well as an incredible variety of tests (i.e. antibody, antigen, PCR DNA, p24, etc.). I feel that this is a waste of much needed resources, and am shocked that the doctors have actually ordered this many tests. I wish it weren't all about the bottom line when it comes to medicine, at least not at that level.

Enough opinionating, now on to my question: I have had only a handful of risky exposures, one that was pretty high risk. A few years ago while working, me and another person (of unknown status) were moving something together and our hands were pressing against each other, both with significant fresh cuts (the cuts were in firm contact for about 15 seconds). This was obviously the high risk. Other less risky encounters included unprotected insertive oral sex and protected vaginal sex with a sex worker (once); unprotected insertive and receptive oral sex with a female of unknown status (not a sex worker-also once). That is about the extent of my risks.

The risk factors that I mentioned were in order chronologically, and I had an EIA taken through my insurance company (they used LabOne for analysis) when applying for life insurance, which was negative. This was about 7 months after my last potential exposure. That is the only test that I have taken. 1. Is there any reason at all to be concerned that I have only had one test? 2. Is there any margin of error that I should take into consideration that I do not know about with the antibody test (is that why people get so many tests - they are actually sucking me in!)? 3. Would you recommend a confirmatory test? I am sorry about the length of this question, but who knows, maybe somebody will look at this and realize how obsessive the amount of tests some report are; I hope so!

By the way, I really am Italian! My family is from Reggio Calabria. We stay in contact with my family "back home" and see each other often!

Response from Dr. Frascino

Buon Giorno Paesano di Calabrese,

Wow, any further south and you would have wound up in Sicily. My family is from small towns north of Napoli, not too far from your roots! Maybe our great, great grandparents played bocce ball together.

OK, enough dreaming about the old country. Now on to your question. A negative EIA 7 months after a potential exposure is indeed conclusive. You are negative. WOOHOO! (or in Italian, BRAVISSIMO!) No confirmatory or other testing procedures are needed. Thanks for pointing out to our readers that testing over and over and using different types of tests is usually not warranted. There are special circumstances when certain types of tests can be helpful, for instance when trying to tell if a newborn infant from a confirmed HIV-positive mom is actually infected or not.

So, Paesano di Calabrese, start planning that next trip back to sunny Italia. Perhaps we'll meet there over a cappuccino and some biscotti. (This is where I start humming the theme from THE GODFATHER.)

Ciao!

Dr. Bob


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