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May 4, 2005

Dear Dr. Bob, How are you feeling? I feel like shit. I wrote to you previously and thankfully you responded. My situation dealt with oral sex on a man three years ago without a condom, but the sperm went on my hand. My doctor looked at my hand two years later and noticed that I had eczema and a few red dots and blatantly asked me if im gay. It has been 30 months since the risky exposure. I have taken 3 ora quicks, 2 elisas, and 1 viral load-all came back negative. I feel very stupid to be writing to you again, but you are the most sincere doctor on the site. Every day is a constant struggle with my emotions, i'm breaking down and crying three times almost every day. I don't feel like getting tested again, but when i was seeing the infectious disease specialist, i was so nervous that i couldn't even ask any of the questions are are still daunting me today. Is it possible for me to even be positive with all those negative tests? I have heard of some things as antibody-negative, asymptomatic people--if those people took a viral load test, would the virus show up? Was it ever recorded that after having antibody tests and viral load test come back negative that person still had hiv? My 2 and half year relationship with my boyfriend, which I plan to spend the rest of my life with, seems like its a disaster. It has gotten to the point where I have to go see a psychic to feel better(appointment today at 6), I really want to get a cd4 count done. I know that i have asked so much of you, but I hope you understand that I may be slightly mental after my doctor's visit. Please help me Dr. Bob, lately thinking of suicide is the only way I can control my emotions.

Thanks again,

Your admirer

Response from Dr. Frascino

Hi Admirer,

1. Is it possible for you to be positive after three negative OraQuicks, two negative ELISAs and one negative viral load? Nope!

2. Would a viral load test be positive in "antibody-negative asymptomatic" HIV-positive folks? Yep!

3. Could you be HIV positive despite negative antibody tests and viral load tests? Nope! (Weren't you paying attention to my response to your first question???)

I believe you correctly identified your problem when you wrote "every day is a constant struggle with my emotions . . . ." Stress and anxiety are your problems. Not HIV!

As for what to do next, I'd recommend a psychiatrist rather than a "psychic," particularly if you are considering harming yourself to "control" your emotions.

You do not need CD4 counts or any other HIV-related tests. You need psychiatric help.

Good luck. Remember HIV is not your problem. And I don't have to be "psychic" to be absolutely certain of that, OK?

Dr. Bob

Procrit and my HIV meds
Hope you are okay

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