Dr. Bob,

I swear to you, I have been to hell and back. I feel somewhat like Dante; it would've been nice to have a Virgil to guide me along, but I had to do it alone.

Anyway, on to my story and subsequent questions ... In December, I started dating a guy I met though my ex, and we began a sexual relationship. We used protection most of the time (the key word being "most"). A few times, my excitement got the better of me, and we engaged in unsafe sex (6 times to be exact - I was always the insertive partner). I know this places me at risk for STDs, and it was foolish of me. A mistake I hopefully never will repeat. So, I insisted we both go and get tested. I was negative, and he was positive ... and thusly my foray across the river Styx began. All of this occured in December and the beginning of January. My last possible exposure was December 18th, 2005.

I have been a nervous wreck ever since, my emotions waxing and waning like a schizophrenic moon. I, of course, followed up with a 6-week test, and it came back negative. I know Massachusetts says 6-weeks is definitive, but I surely wasn't willing to risk it. I tested again on March 23rd, 2006(about a month ago) with the Oraquick Oral Swab, and the result was again negative. That put me at 95 days, slightly over 13 weeks. I just about W00-HOOed, but I started reading the forum again. I saw that if you have had a significant exposure you should be retested at six months.

Okay, on to the questions.

1) Do I really need to get retested in two more months?

2) If so, how much should I be worrying? You have said to many the three-month mark is definitive and conclusive, except when there are extenuating circumstances. Should I ueber-concerned, or really happy with my three-monther?

3) And, last but not least, why the disparity? I have read that in all the years of HIV testing only rarely do people take six months. Is the six month test just recommended to be absolutely, no-questions-asked sure?

All right. I think I'm done. I just thought I would be whooping for joy at this point, but I only feel anxious and depressed. Can I finally move on, lessons learned? "Purgatorio" here I come?

I want to thank you for all the work you do, Dr. Bob. I would love to sit down and have tea with you sometime if I ever get out to San Fransisco. It would be a great Bush-bashing extravaganza!

PS: I saw a very humorous bumper sticker the other day (you've probably seen it). It reads: "Bush/Satan: 2004". I laughed my ass off (I had to go looking for it). I just pictured Bush standing at the podium with a satyr next to him. Very amusing!

Take care.

Hello,

I'm sure many worried wrecks in the square red states in the center of the country are wondering who Dante and Virgil are and where the River Styx is located, but I'll bet they have an excellent understanding of "purgatorio!"

I'll proceed directly to your questions:

1. There is a recommendation from the CDC that many of us would consider to be outdated, but it's a standing recommendation nonetheless: individuals who have a "significant" HIV exposure who test negative at three months should get one supplemental confirmatory test at six months.

2. Should you be worrying? No, absolutely not. Statistically, you have every reason to be WOO-HOOing.

3. This is a tougher question to answer briefly. Basically it has to do with statistics. The statistical risk of someone acquiring HIV obviously increases if there was significant exposure. The vast majority of folks who get HIV tested have not had a significant exposure and therefore can statistically rely on their three-month result as definitive. For those with a confirmed significant HIV exposure, a six-month follow-up test adds an extra layer of certainty to their negative test results. As HIV diagnostic testing improves and as we better understand the body's immune response to HIV infection, this extra level of certainty may no longer be necessary. (Many folks feel we've reached that point and the extra test is no longer justified.)

I'd say move out of "Purgatorio" immediately. If you want to be uber-certain your WOO-HOOing is current-guideline certified, then park yourself in "limbo" for a few more weeks and then go take the test with great confidence. It, too, will be negative.

As for Bush bumper stickers, here are a few of my favorites:

Bush/Cheney '04: Four More Wars

Bush/Cheney '04: Leave No Billionaire Behind

Bush/Cheney '04: Deja-Voodoo All Over Again!

Bush/Cheney '04: Compassionate Colonialism

Bush/Cheney '04: Because the Truth Just Isn't Good Enough

Bush/Cheney '04: Making the World a Better Place, One Country at a Time

Bush/Cheney '04: Over a Billion Whoppers Served.

Bush/Cheney '04: Putting the "Con" in Conservative

Bush/Cheney '04: Thanks for Not Paying Attention.

Bush/Cheney: Asses of Evil

Bush/Cheney '04: We're Gooder!

Bush/Cheney '04: This Time, Elect Us!

George W. Bush: The Buck Stops Over There

Don't think. Vote Bush!

More Trees, Less Bush

One Person, One Vote (*May Not Apply in Certain States)

Stay well and Good luck (lord knows we need it with bozo and butthead occupying the White House!)

Dr. Bob