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Still have doubts
May 16, 2006

Dr. Bob,

I emailed you about 3 months ago regarding an oral encounter I had during an acohol induced "dumb-ass attack". You were very kind to respond and ease my mind somewhat about the low risks involved in oral sex and I thank you for your prompt response and kind words. However I could not wait til the 3 month mark for the routine test you recommend so often so I spent the big bucks on a DNA/PCR test at 32 days after possible infection in which that test came back negative. I know you have said many times you do not recommend this test because of the cost involved and the high percentage of false positives but what about a negative result? I have not read much at all on this site regarding false negatives with this test. The lab I purchased the test from says it has a 95% confidence level for detecting the virus after 28 days from exposure. Well I am now at the 3 month mark and still have a some doubt about infection but don't want to have another needless test if it can be avoided. Can I put this all behind me with the negative DNA/PCR result or would you recommend further testing?

Thank you again for your time and all you do for all of the other concerned readers on this site. I am not sure I could have made it through this most difficult time in my life without the support of you and this site. Donation was made to your foundation as promised per my earlier post.

Frantic(previously)

Response from Dr. Frascino

Hello Previously Frantic,

HIV DNA/PCR tests are not considered sufficiently accurate for routine HIV screening without confirmation by standard serology. The test is not FDA-approved for this use, and therefore I do not have exact sensitivity/specificity data to report to you. Even if the specific DNA-PCR test you took could live up to its "95% confidence level for detecting the virus after 28 days from exposure," would you be comfortable knowing that the test was missing 5 out of every 100 positive tests??? No, I didn't think so. Neither would I.

So let's review. My advice has not changed.

1. Your risk (oral sex) is extremely low at best.

2. A 32-day big-bucks negative DNA-PCR is extremely encouraging.

3. For a definitive result, get an HIV-antibody test at the three-month mark.

4. My good-luck karma is on the way!

Dr. Bob



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