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HIGH RISK EXPOSURE IN THAI--PROPHYLACTIC TX OPTIONS

Jun 30, 2003

I AM AN RN WHOSE HUSB HAD HAD WAY TO MUCH TO DRINK AND WAS DRUGGED AND KIDNAPPED IN BANGKOK IN LATE MARCH/APRIL. 2 WEEKS LATER THE SKIN OF HIS PENIS SLOUGHED OFF. NO URETHRAL DRNG--DID NOT TEST FOR SYPHILIS--LONGSTANDING HX HERPES AS A YOUNG 20'S--NOW 49 AND HEALTHY. 2 MO POST EXPOSURE NEG FOR HIV, HEPC, ETC--KNOW THERE IS SEROCONVERSION TIME AND WILL RETEST IN SEPT--QUESTIONS WHETHER HE SHOULD BE ON SOME DRUG TX NOW DURING THIS UNCERTAIN TIME AND IS HAVING HIGH ANXIETY--NO MEMORY OF EVENT. VAGUELY REMEMBERS MAN AND 2 WOMEN. OUR FAMILY MD AND I HAVE READ UP, BUT I FEEL I NEED TO GO DEEPER. CAN YOU HELP US??? SINCERELY, , RN--COLORADO

Response from Dr. Frascino

Hello RN,

So your "49 year old healthy" husband was in Thailand and had a few too many drinks (OK). Then he was drugged (a bit unlikely but if you say so OK). And then he was kidnapped (now its beginning to sound a bit weird). And then he has vague sexual memories of a man and two women (now it sounds like a bad flashback sequence from an even worse porno flick). But thats his story and if you want to believe it its your choice. So.on to your question..

The skin on his penis sloughed off? You mean like a snake shedding its skin? I dont suppose it was just one of those "almost invisible" condoms left behind by the phantom kidnappers was it? No, I suppose not. Testing negative for STDs at two months is encouraging. Yes, I would agree a three month test after the night he may have "banged cock" in Bangkok is warranted.

PEP (post exposure prophylaxis for HIV) is recommended only for significant HIV exposures and must be started within 72 hours to be most effective so it wouldnt apply to your hubbys situation. Besides that whole drunk-drugged-kidnapped and used as a sex toy scenario seems more than a bit far fetched to me. Could it be hes not telling you "the truth, the whole truth, and nothing but the truth?"

Have him see a dermatologist if his "snake" continues to shed (slough). And tell him to come up with a more plausible story time he decides to take a walk on the wild side. Has he ever told you he was abducted by space aliens and anally probed?

Good luck,

Dr. Bob



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