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Dazed and confused....
Feb 20, 2006

Hi SUPERDOC....

::::::PLEASE DR FRANCINO GIVE ME AT LEAST A BREAF ANSWEr, YOUR BOYFRIEND DOESNT ANSWER MY POSTS IN SPANISH and I AM VERY CONFUSED AND SCARED:::::

First i want to thank all of you at THEBODY.COM for your the support yourre sending to all of us scared and confused in these difficult times, but mainly you and Dr Bob because you are the only positive reference we have found of a magnetic couple, your entusiasm and sense of humor are an inspiration that help us keep going...me and my positive partner are from barcelona, Catalunya...

i have been reading you for the last year and i have a question that remains uncertain for me and maybe for some others......

On Feb 16Th somebody send you a post named "multiple HIV+ exposures" he said he had a negative 3 months elisa test, but he was afraid to do the 6th month test... well... i am in a "similar" situation.. i had unprotected sex (always top) for 5 months with my 4-years-monogamous-partner after he "cheated on me" and seroconverting (april 2005) , after finding out i developped every imaginable symptome of ARS. I had and elisa and p24 antigen test on the 1st and the 6th week after last potencial exposure, then on the 11th week the doctor who attended him at the Hospital Clinic de Barcelona made me have a Elisa test along with a p24 antigen (both negative) and also i had a quantitative PCR test to "discart" seroconversion because of my "so called" symptomes.

i read in a spanish medical webpage that if you dont show hiv antibodies and at the same time you have a PCR test negative/indetectable after the 9th week its almost impossible i had true symptomes of seroconvertion, False negatives on a PCR arent easy as false positives are... how is this?

Why you and doctor bob dont recommend having a PCR test at least only for people in our situation (highly possible exposures)as the doctors here in spain do it??? Are there in America different test standars or my 11th week negative PCR test along with the 11th week negative elisa/p24 arent conclusive enough as his doctor said and asured ????

We have been in hell and we are trying to get our lives back on track but the lack of security remains....

my boyfriend is more optimistic than me and he is the positive one i just dont really know what to do and everything seems so complicated....i feel betrayed, alone, supportive, furious, sometimes i hate him sometimes love him with all my heart and some others i just want to help him go thru this and no more, if he had been honest at least i could have "trust in trust", no matter what i decide everything seem so difficult....... i know in your case you didnt have to deal with this cheating situation but if its there any suggestion id appreciate it, i honestly dont know what to do!!!

Thnks for all you have done for us without knowing us... i would really appreciate if you could spare two minutes on me, it would mean a lot... really a lot...

"Stay well" as you say.... Grettings from BCN.

Albert

Response from Dr. Frascino

Hello Albert,

PCR testing, both DNA and RNA, has its role in the diagnosis and monitoring of HIV infection. At this time, I do not recommend PCR for routine HIV screening, because of the rate of false-positive tests and the cost involved. Yes, specific types of PCR testing can be very useful in specific aspects of HIV diagnosis, for instance when the serological tests are disputed or indeterminate, and also in selected cases for diagnosing acute HIV infection. However, for routine screening and for the vast majority of folks who think they have "all the symptoms," it is not warranted.

For your particular situation, you had unprotected insertive anal sex with a partner who is confirmed to be HIV positive. Your repeatedly negative ELISAs and p24 antigen tests out to 11 weeks plus your negative quantitative PCR at 11 weeks are extremely encouraging. Because your exposure was "significant," the CDC would recommend one additional follow-up test antibody at six months to definitively confirm your HIV negative status.

As for getting your lives back on track, I would recommend some couples' counseling to help you both work out your fears and frustrations. Lasting, loving relationships need to be built on a foundation of trust and honesty. We all can make mistakes. In fact, we all do. However, strong, healthy relationships can cope with both adversities and challenges. Admitting our mistakes, accepting the consequences of our actions and learning from our indiscretions are key to reestablishing "trust."

Good luck to you both!

Dr. Bob



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