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How Is This Even Possible, Dr.
Nov 13, 2005

Dear Dr. Bob:

Before I ask you any questions, I want to say that you and your brother are in my thoughts. I do believe in the power of prayer. Even though it may seem insignificant to you, I want you to know that I include you and your brother in my prayers.

My question is brief, and as such, Im sure your response will be brief. About 35 days ago, I allowed a pro to perform a fellatio on me for about 10 to 15 seconds. Thats all we did.

In my state of panic, I took a QUALITATIVE DNA by PCR test that was administered by LabCorp (using a Roche kit).

My understanding is that a QUALITATIVE DNA by PCR test should be able to detect the mere presence of HIV after 28 days (due to the fact that recently infect people have large quantities of HIV in their bloodstream). Also, a QUALITATIVE DNA by PCR test only gives you a yes or no answer, and not a measure.

The test case back negative. I dont understand this, Dr. Bob. If the test is so sensitive, then why was it not able to DETECT the presence of the HIV virus in my blood?

I asked my primary care doctor, and her answer to me was that, Even though the PCR test is not the standard way to diagnose HIV, the reason it came back negative is that I was infected via the 10 to 15 seconds of fellatio. And furthermore, a 10 to 15 second fellatio is not worrisome for HIV, and for practical purposes is essentially negligible risk.

The issue I have here is that my PCP is a close family friend. Thus, I feel that her professional judgment might be clouded.

Whats your take on this? Lastly, please note that this was the ONLY sexual contact in my entire life (yes, Im a boring person).

Response from Dr. Frascino

Hello,

I'm not sure whose judgment is clouded here, but there is definitely some confusion. Let me try to sort it out for you.

1. Insertive oral sex carries a very low risk for HIV acquisition. I agree your 10-15 seconds with a pro noshing on your joystick presents an "essentially negligible risk" for contracting HIV.

2. I agree qualitative DNA PCR testing is not recommended for routine HIV screening. The recommended test is an ELISA (HIV antibody) test taken at three months or more following a potential exposure.

3. Even though qualitative DNA PCR testing is not recommended for routine screening, it is true that this test should be able to detect HIV (actually proviral DNA) in individuals who have contracted HIV by day 28. The results are either yes ("positive," HIV is detected) or no ("negative," HIV is not detected). You took the test at day 35 and it was "negative," indicating HIV was not detected. In other words, you are not HIV infected. This is the expected result, since your potential exposure was negligible. This also seems to be the point you or your doctor is confused about. So let me be clear. Your brief blowjob did not result in your becoming HIV positive. Consequently, the qualitative DNA PCR test at 35 days was negative, because you have no HIV in your blood to detect.

4. Your statement, ". . . the reason it came back negative is that I was infected via the 10 to 15 seconds of fellatio," is wrong. You were not infected.

5. As for the fact that this has been your only sexual contact in your entire life and it only lasted 10-15 seconds . . . hmmm . . . no comment.

6. Finally, thanks for your prayers. Actually I do believe in the power of prayer. I just don't believe in wingnuts, like the delusional Pat Robertson, who is sounding more and more like the urine-soaked crack pots on the corner of Skid-Row and Nasty Lane spouting Bible verses, as he warns the city of Orlando that it'll be hit by "terrorist bombs . . . earthquakes . . . tornadoes . . . and possibly a meteor" for supporting Gay Pride Month. Now he's ranting on about Dover, PA because they voted out the Faith-Based Intelligent Designers from the school board. And then there's Pope Benedict who wants to eliminate priests with "deeply rooted homosexual tendencies" from the priesthood. Hmmm . . . there are going to be a lot of "vacancy" signs on rectories and at the Vatican, if that policy ever gets truly executed. However, these guys really have very little to do with the power of prayer and the true higher powers that I'm confident would frown on such petty nonsense when the world is suffering from AIDS, poverty and famine.

Dr. Bob



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