I need your help and advice badly. The last 4 months have been very rough. A friend told me about you and that you will answer questions honestly.

I had unprotected sex about 4 months ago with a guy that is HIV postive. The doctor put me on PEP drugs for 28 days although I did not see him to day 11.

He said we had nothing to lose by putting me on the PEP drugs.

My doctor did has done three regular Aids tests combined with a western blot test and tests for Hep A, B and C. All of the regular Aids test have come back normal but the western blot have come back indeterminate.

The test that came back today were negative on the regular test but still indeterminate on the western blot.

He said the band that showed positive was a "weak positive."

Much weaker then the other times. I think he said it was the 24 band.

Like I said it has been about 16 weeks since the exposure.

He says that he cannot say that I am out of thw woods until 6 months.

He wants me to come back at the 6 month mark.

Do you think I am ok?

Could the weak reactive band be caused by the fact that I wasa on the PEP drugs for 28 days and they are not out of my system.

I asked the doctor hese questions and he had no answer but come back at the 6 month mark.

Is there anything else that can be done to ease my mind.

Thanks for your honesty and for answering my question.

Hello,

Yes, of course I answer questions honestly. Why would I answer them any other way?

Do I think you are OK? Yes! I'm quite confident from an HIV standpoint you are fine and dandy. However there is something definitely wrong with your doctor! His knowledge of HIV diagnostic testing and PEP treatment is severely lacking. This guy is certainly not doing you any favors and I'd suggest you switch to a more competent physician without delay.

First off, prescribing a course of PEP 11 days after a potential exposure makes no sense whatsoever! His comments about there being "nothing to lose by putting you on PEP drugs" reveal a shocking lack of understanding not only of how these drugs work, but also of their potential toxicities.

Next, regarding testing, his lack of understanding of how HIV tests should be ordered and interpreted is also evident. Standard HIV screening consists of an EIA (or ELISA) followed by a confirmatory Western Blot to be run, if and only if the EIA screen is "repeatedly reactive" (positive). If the initial EIA is negative, the Western Blot (WB) should not be performed! WB testing should always be coupled with EIA screening, because it has a 2% rate of false-positives!

That you've had multiple "regular AIDS tests" that are all negative means you are HIV negative. (The WB should never have been run!) An indeterminate WB without an initial positive EIA test is meaningless.

The sum of your tests indicates you are definitively and conclusively HIV negative. No further HIV testing is recommended or warranted. Getting a new physician certainly is!

Dr. Bob