Dr. Bob, I had protected oral and vaginal intercourse with a CSW in Las Vegas late on 10/26/08. I do not recall the condom breaking, but I was a mess and do not recall everything perfectly. I know it was not completely broken, but I guess small break is possible. I asked the CSW after sex if she were clean and she assured me I had nothing to worry about as she always used protection. She was an older (and unfortunately, very unattractive and hygiene lacking lady). The sex was brief, a few minutes with her on top and me from behind. Afterwards, I showered off.

I tested with my GP with blood antibody tests for all stds 3 days after exposure and GP gave me doxycyclinjust in caseto kill what he considered the more common CSW diseases. All tests came back negative, though he DID say I had whatever causes canker sores and fever blistershsv-1 maybe? I have had a few canker sores in my life, so was not surprised by this. I repeated testing at 1 monthall tests negative. No symptoms ever presented themselves, except for some tingling/burning in my genitals that subsided with good test results.

My fears subsided until I entered a long relationship and moved in with girlfriend. My fear of hurting her really made me research further and then when the spitzer news broke, my research turned in to an obsession. I was constantly reading how some people could convert after 3 months, etc. My GP led me to believe I had nothing to worry abouteven after the 3 day testso I took on the challenge of educating myself.

I repeated HIV test with GP using antibody test (chemoimmunoassay by Bayer) at 4 months 3 weeks. I also took a rapid test that weekboth negative. The CDC guideline had me scared, so I tested again at 5 months 2 weeks and then again at 5 months 3 weeks with rapid tests. I also tested with blood again for ALL STDS at 5 months 3 weeks (174 days) and all were negative.even my hsv-1 was negative this time.which scares me. Why would I be positive at one point and then negative 6 months later? While at the AHF wellness center (amazing service they provide), I was recommended to a NAAT test because my fear was not being subsided by the antibody tests because they were prior to 6 month (barely). I am awaiting my NAAT results ANY DAYand now read they have a high rate of false positives. I am a MORON. In the meantime, I have been diagnosed with a stomach ulcer and put on nexium. My girlfriend and I both had small rashes on our backs and arms start around month 5 as well (hence the additional testing). I have been negative for everything thus far do you think I am in the clear? I really am struggling to find an expert opinion (obviously my GP does not have a clue with his testing me at 2-3 days post exposure). Does my ulcer or rash warrant further testing? I am otherwise healthy.26 (as of last Sunday!), monogamous for 6 months post exposure, athletic (training for your SF marathon in August)but scared. I started seeing a therapist two weeks ago and after two sessions, I am starting to calm down and realize I am really just disappointed in myself. To hear from an expert that I have reason to woooohoooo would be amazing. Please pray for good NAAT results and know how much I appreciate you. Please let me know where to donate (I already have significantly to AHF).

Thank you truly

Scared and ashamed

Hello Scared and Ashamed,

You're repeatedly negative HIV tests out to 174 days are definitive, conclusive and WOO-HOOable! Dude, this is definitely a case of what happened in Vegas stayed in Vegas!

Sure, I can see feeling a bit scared and ashamed. After all you did give it up for a "very unattractive and hygiene lacking" Vegas hooker. But dude, you did use a condom and that's something to be very proud of! BRAVO!

Your "symptoms" are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS).

No further HIV testing is warranted. I'm delighted you are seeing a therapist and starting to calm down (with only two sessions!).

Continue your therapy sessions and marathon training and I'm confident all will turn out "well" (including you).

Thanks for your willingness to make a tax-deductible contribution to the Robert James Frascino AIDS Foundation. Donation information can be found on the foundation's Web site at www.concertedeffort.org. In return I'll send you my good-luck/good-health karma that your HIV NAT results are undetectable and that your unwarranted HIV fears continue to evaporate. I may also cheer you on (from the sidelines) during your S.F. marathon!

Be well! Run fast.

Dr. Bob