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Some interesting Info and a question for the good doc
Nov 18, 2003

Hi Doctor Bob, I had had a low risk encounter (stripper's groin came in contact with my with my face, concerned for any possible open wounds i may have on/in my nose,followed by cunnilingus for 10 seconds)with someone of unknown status on July 11, 2003. I had an ELISA/Western Blot test 5 days later (Negative) and on October 15 (Negative). I know that you have said many times that this test after 3 months is considered definative for HIV, but my doctor says no. He said that 3 months is only 40 definative, 6 months 70 and 1 year is 99. I had mentioned to him that the CDC told me that 3 months is definative for low risk exposure and 6 months for greater risks, he said I was misinformed. He said that was the "textbooks" information. Please tell me your thoughts on this. Should I wait longer or go on with my life?

Secondly, a friend of mine is in the insurance industry. He has spoken to an underwriter at a large life insurance company. The underwriter said that the ELISA/Western Blot test is so sensetive that it can detect HIV within 24 after hours of exposure. They are so confident in that test that they can write a 1 million dollar policy based upon that test, without having to wait for any time frame window. He also said that in the last 10 years, they have never had to pay a cent based upon the test giving a false negative. He also said that the medical community will never release this information for fear of liability. Please let me know your thoughts. Thank you for your time and good work to us hopefully worried wells.

Response from Dr. Frascino

Hello,

I find it quite amazing that your doctor told you that the CDC (and virtually all HIV/AIDS experts) are "misinformed!" And that apparently he doesn't believe the information in "textbooks." I have to wonder where he gets his information. Perhaps "The Journal of Irreproducible Results." I think your doctor is in dire need of a very basic textbook. Perhaps you could buy it for him. It's called "Medicine for Dummies." My dear friend, it's your doctor who is misinformed. You don't need additional HIV tests. You do need a new, more competent doctor -- preferable one who learned his basic medical knowledge from textbooks.

Your insurance industry friend is also woefully misinformed. The immune system just doesn't work that way. Insurance companies know the sensitivity and specificity of antibody tests and are very cognizant of the "window" period. However, having you take more than 1 HIV test wouldn't make a whole lot of sense, because if you are negative on day 1, and they come back to test you 3 months later on day 90, they still wouldn't pick up an infection from unsafe sex on day 80. Right? All insurance rates are structured to take into account the very small number of folks who might test negative due to being in the window period.

Hope that clarifies things for you.

Dr. Bob



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