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Malaria & HIV in ex
Feb 12, 2007

Dear Dr. Franscino,

Thank you for the wonderful work you do.

I am a positive woman from Europe and I had a boyfriend in Thailand. We never had unprotected sex and I never let him ejaculate in my mouth. Recently he has been diagnosed with malaria and HIV. He insists that before me he was tested negative twice for HIV. The doctors tell him that they can't be sure but they think he is positive for HIV, however the malaria is certain. I am so worried about him because he has recurrent fevers and takes HIV and malaria medication but is still sick. They did not do a western blot (too expensive) but an eliza. My questions are: 1) what is the chance for a false positive HIV since we have never had unprotected sex? 2) although he is being treated it is at a rural hospital and I am so scared. Are the fevers symptomatic of malaria or HIV? Will he get better - I know there is no guarantee on what you say but I would like to know if this is a normal malaria relapse or if in fact he is deteriorating. Many thanks for the wonderful job you do.

Response from Dr. Frascino


If you never had unprotected sex and the latex condom was used properly and did not fail, the risk of HIV transmission would be negligible. HIV cannot pass through intact latex (or polyurethane). No way. No how. Insertive oral sex would carry a very minimal HIV transmission risk.

To specifically answer your questions:

1. If a confirmatory Western Blot test was not performed and there was minimal risk for HIV transmission, there is certainly a chance the positive ELISA was a false positive.

2. Fevers are a common feature of malaria. They can also occur with HIV infection, usually during the acute retroviral syndrome and then again in late-stage disease.

If your boyfriend is uncertain about his diagnosis or current treatment in the rural hospital, he should try to get a more thorough evaluation and treatment plan at a larger medical center with HIV experience. ] Good luck to you both.

Dr. Bob

hep c and anemia
Enlarged Spleen

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