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Scared (Again)
Aug 25, 2006

Hope your vacation went well. I wrote to you while you were away and received no response. I'm trying again in the hopes that you might help me.

Almost three months ago, my boyfriend and I learned that we were both carrying gonorrhea and chlamydia. We got tested for all STD's when I started displaying some strange symptoms. Before we met, I got tested for HIV and tested negative. After we met, I got tested again just for good measure. He didn't get tested at all. After our STD crisis, I insisted that he get tested for HIV as well since we had had months of unprotected sex (him=bottom, me=top). He unfortunately tested positive. I freaked out and got tested for HIV right away. That was two weeks after our last unprotected sex encounter. That test came back negative. After nearly a month and a half of REAL freaking out, I got tested again. Again, it also came back negative. During that time, I displayed every possible symptom of ARS which only added to my anxieties.

Here are my questions. I've read your other answers about the likelihood of testing positive at about eight weeks post-exposure (encouraging but not definitive). All of those posts seemed to be talking about exposures that were fairly low-risk. I see my case as very different. I had repeated high-risk exposures for a long while and then contracted an STD to boot. The counselor who talked to me at the two-month test told me that the STDs I had are great carriers for HIV and that the likelihood for being positive was good, despite my negative test result that day. After continuing to feel like crap for another couple of weeks (fatigue, nausea, mild fever, aches and pains, localized headaches, loose stool, etc.) everything has seemed to clear up rather quickly. I started to feel better physically and emotionally about things, but am now panicked that the sudden clearing up of my symptoms is a signal that I'm really infected and that the "seroconversion" process is now complete. I'm now at the 3 month mark since our last unprotected encounter and am terrified of getting tested again. Based on your other answers, I know that a test at 3 months would be damn-near conclusive, but I'm scared. I'm feeling certain that I know what it's going to be. How could I be that sick and it only be something in my head (stress/anxiety)? So, what are the odds of a top getting gonorrhea/chlamydia and NOT HIV? And, how encouraging is a negative OraQuick test result at 53 days post-exposure? Is it a 50.001% type of encouraging or a >90% type of encouraging?

BTW, a big part of my fear isn't some selfish desire to be negative and free of the whole situation. My fears have made me an awful partner to be with at the worst possible time. I want to know, not just so that I can deal with my own physical and mental health issues, but also so I can decide how supportive I can (or cannot) be to my boyfriend, who really does need my support right now.

Thanks.

Response from Dr. Frascino

Hello Scared Again,

Sorry to hear about your boyfriend's recent diagnosis.

From reading my previous posts, you seem to already know the advice I'm going to give. But here it is again, nonetheless.

1. The estimated per-act risk for acquiring HIV from unprotected insertive anal sex with an HIV-positive partner is 6.5 per 10,000 exposures.

2. Symptoms, no matter what they are, are not equal to HIV disease.

3. Your repeatedly negative HIV tests out to 53 days from your last exposure are encouraging (very encouraging), but not definitive.

4. Gonorrhea and chlamydia are much easier to contract than HIV. An active case of gonorrhea and/or chlamydia can increase the chances for HIV transmission.

5. Being afraid of testing positive is not going to change the reality of whatever your serostatus is.

6. Stop being a ninny. You know you need to be tested, so just go do it. Frevinsakes!

7. As for being able to be supportive if you are unlucky enough to also be HIV positive, well, what can I say? I'm HIV positive and have been since January 1991, and I'm here being supportive of you, aren't I? Being supportive to a loved one (or anyone else for that matter) and being HIV positive oneself are not mutually exclusive conditions.

Get tested and be supportive to your lover. As Jack Bauer would say, "Do it. Do it now!"

Good luck.

Dr. Bob



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