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Doc PLEASE RESPOND!
May 14, 2004

Doctor Bob I first wanted to thank you for all of your work and your courage in dealing with this terrible disease. I am a 35 year old male who has had several unprotected vaginal sex episodes with several women (only one instance with each). They both say that they have never had an std but who really knows. I recently came down with a small case of molluscum (about 20 bumps) on my stomach. Both of them said that they have never had any sort of rash like molluscum. I have read that you can contract molluscum from towels, pools, hottubs etc. My questions to you are: 1) Is molluscum as sign of HIV and or ARS? Could it be the ONLY sign of ARS (as I have no other symptoms except extreme stress and anxiety over putting myself at risk)?How common is molluscum in HIV negative adults? Since it is located on my stomach rather than my genitals does that mean that I did not contract it sexually? What are my chances of contracting HIV from 2 instances of vaginal sex as I described (I have no stds to my knowledge)? Doc PLEASE RESPOND to me. I will be tested at 3 months and I will send a donation to your foundation. All the Best!

Response from Dr. Frascino

Hello,

Molluscum contagiosum sounds like a bad horror film from the 60s, but is really a viral infection of the skin and mucous membranes. It is most frequently seen in childhood, but can occur in adults as well. There have been clusters of infections reported in children's institutions, among wrestlers, and among members of the same family. It can be transmitted between genitalia during sex. The incubation period varies between two and eight weeks. Particularly severe and extensive cases have been reported in HIV-positive folks with significant immunodeficiency.

To answer your specific questions:

1. No, Molluscum is not a sign of ARS or specifically diagnostic of HIV disease. As I mentioned above, Molluscum can be extensive and more severe than usual in HIV-positive folks with significant immunodeficiency.

2. How common is Molluscum in HIV-negative adults? I don't have a specific incidence or prevalence statistic for you, but it's certainly not uncommon!

3. Transmission is via direct skin contact. I really don't have a way of determining how or where you picked up your infection.

4. Your risk of STDs, including HIV, is the same as it is for everyone else who has had unprotected vaginal sex. The estimated risk is 0.1% to 0.2% per episode of receptive vaginal sex with an HIV-positive partner. Your risk is less than this, because you were the insertive partner, and we do not know the HIV status of your partner. HIV testing three months or longer after the last potential exposure would give you a definitive result.

Thank you for your donation to my foundation. It will be used to provide crucial services to men, women, and children living with HIV/AIDS.

Don't worry about the Molluscum. A dermatologist can zap them off you very easily. I do not believe your localized eruption is indicative of any underlying immunodeficiency problem.

Dr. Bob



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