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playing the odds
May 28, 2003

Hi Mr. Kull

It is worrisome to me and many others that you say if the test is negative at 3 months, HIV is not the person's problem. Isn't it just a little irresponsible to allow people to assume they are totally free of HIV when there have been documented cases of delayed seroconversion, and plenty of claims of long periods of sero-latency that aren't necessarily proven, but anecdotal? Isn't that tantamount to saying that just because HIV transmission from woman to man is rare in the United States, that heterosexual drug-free men need not worry about HIV? You seem to make a strong case that despite the odds being in the thousands against an insertive partner getting HIV, that people should still not take the chance. Well what about people taking a chance at infecting loved ones with a virus they caught off a prostitute or affair, just because they test negative out to 3 months, when in rare cases, there have been delayed seroconversions. I don't understand why you seem to lean towards playing the odds when it comes to seroconversion window period, but not when it comes to risk groups. That seems extremely inconsistant to me, and to many others, I'm sure. This is a question that has been raised especially in response to many of your posts on this website (I hear this argument all the time, and it makes sense to me - what about you?)

Response from Mr. Kull

Thank you for your post. No one should take my words as the final answer. People should ultimately make decisions based on what is right for them. If you think that you are at risk for infection, you should get tested and use condoms with your partners. I'm not sure what you are suggesting people should do if they are at risk for infection, but at some point you need to get tested and call it a day.

If you are still concerned about your HIV status after getting tested three months after exposure, you can always get tested at six months following exposure. That's up to you, but according to all of the information I've gathered, it is uneccessary in the vast majority of cases.

If your clinical history is incompatible with your test results (meaning that you had a significant risk exposure and are experiencing symptoms indicative of infection despite negative tests), talk with your doctor about alternative testing methods that can rule out HIV infection. If you've had a recent exposure and are sure that the person was HIV infected or at significant risk for infection (MSM, IDU), speak with your doctor: early detection and treatment may be indicated.

Peace-

RMK



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