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RAW SEX WITH ESCORT IS PCR TESTING RELIABLE?
Sep 5, 2003

Dear Dr. Bob:

I recently engaged in a barebacking encounter with a male escort who swears he is negative. I understand that the conventional wisdom is not to believe such a representation. I was the insertive partner and this is the only possible exposure to HIV transmission that I have had in the last 11 months. I am obviously very concerned about the possibility of contacting HIV through this encounter. It was a stupid mistake and one I do not intend to make again. I called AIM Healthcare and was told they offer PCR testing for HIV. I was informed I should wait 14 days after exposure and that the test is very reliable in determining my HIV status. Is this an accurate representation?

Response from Dr. Frascino

Hello,

Yeah, I agree. I don't think I'd believe a barebacking male escort even if he had a lie detector strapped to his Mr. Happy!

So your risk is one episode of insertive anal sex with a guy of unknown HIV status. This does place you at some degree of risk for STD's, including HIV. The formal recommendation at this time is for ELISA (antibody) testing at 3 months. PCR testing is a very sensitive assay, but not usually recommended for routine screening, because it has a significant false positive rate. That means your test may indicate you're HIV-positive, when, in reality, you are not. Certainly a negative PCR at 2 weeks could be considered encouraging, but I'd still recommend an antibody test at 3 months. And if you do decide to get a PCR, don't be overly alarmed if your result is positive, as this may be a "false" positive.

Hope that helps clarify things for you.

Dr. Bob


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