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DO I HAVE TO ASK YOU IN A CREATIVE MANNER TO CATCH YOUR ATTENTION DR BOB?I HAD UNPROTECTED SEX WITH A STRANGER!!!
May 4, 2005

Dr. Bob: I hope you are doing ok. I am just wondering, why do you keep answering questions of protected sex and protected oral sex, while others LIKE ME, are here becuase we had UNPROTECTED SEX, which is in fact, considered RISKY. Heres my story and Ill make it brief: First of all, im a girl. I had unprotected vaginal sex with a stranger (a night of too much alcohol). No ejaculation involved. I dont know the status of this person and havent seen him ever since. This happened on March 31st. 27 hours later I was on PEP, which is combivir+crixivan. I have a week left of this nightmare and I am off the meds. I want to know more or less, what my chances are of contracting this virus. Some say it`s between 0,1%-0,5%. When can I take a RELIABLE PCR? (followed by a 13 week elisa) Also, wouldnt it be better to stick up with the meds until the 3 month period until I get my ELISA done? I am scared of getting off the pills and letting the virus replicate more. And finally, the fact that you work with people who are poz and that you see so many cases, what are your expectations on MY case? would i probably get out of this one ok?? Thank you so much doc, and please, can you give me the online address to your foundation? Thanks!

Response from Dr. Frascino

Hello "Just Wondering,"

While you are "just wondering" why I answer the questions I do, I'm sure there are many folks reading this post who might be "just wondering" why someone would be having unprotected sex with strangers. And so it goes. For my part, I'm just here to answer questions, OK?

The estimated per-act risk for acquisition of HIV for receptive penile-vaginal intercourse is 1 per 1000 exposures to an infected source. Your estimated risk would be much lower, because your partner's status is unknown, and because you took PEP.

As for PCRs, I don't recommend them for routine testing. The current guidelines suggest if your exposure was significant enough to warrant PEP (a debatable point in your particular situation), you should be tested for the presence of HIV antibodies at baseline, six weeks, three months and six months after exposure.

Regarding PEP, a complete course is 28 days. There is no scientific (or even theoretical) data that would suggest it is "better" to take PEP for three months.

My expectation of your case? Well, statistically, the odds are very much in your favor.

Finally, donation information for my foundation can be found at www.concertedeffort.org.

Good luck!

Dr. Bob



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