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Please, need more help!!!!!!
Sep 4, 2006

Hi Dr. Bob, I hope you find time to answer my follow up. I am so confused, did the right thing but my doctor is not responding to my questions. Several weeks ago I asked you "Hi, I recently had an sexual encounter where I am concerned that I may have been exposed to HIV. I am a male and in the process of putting on a condem on a someone (who was a casual sexual encounter) I at first out it one the wrong way, I immidiately noticed it and turned it around, kind of rub it with my fingers to wipe away any pre-cum and then we had anal sex ( I was bottom). Would this incident put me at risk? I am considering going to an ER to see if I can get PEP, is this an over reaction?" and you answered back that indeed it was a very low risk.

The same time you answered that question, I called my doctor and asked him the same thing, the only thing he said was that I needed to take medications for 28 days, so now I am in week two of Combivier and Kaletra. After reading your answer I wanted to aske him again if this was warented, but he refused to see me and said come by at 6 weeks after exposure incident for a blood test. Never any explanation of the side effects or any sort of clinical counseling. To my surprise the side effects have been minimal, so now I am wondering, its already been 2 weeks, should I just stick it out for the remaining 2 weeks? I feel like I am doing this solo so any guidance you can give me would be helpful.

Response from Dr. Frascino

Hello,

Your doctor refused to see you and will not answer your questions? Hmmm . . . nice guy. I always wonder why guys like that ever decided to become physicians. My advice to you hasn't changed from my initial post. (see below).

As I have stated in this forum previously, I believe anyone who has had an HIV exposure significant enough to warrant PEP should be evaluated by an HIV specialist. The HIV specialist will accurately assess your degree of risk and advise whether PEP is recommended, prescribe or optimize your PEP regimen if warranted, evaluate and manage PEP-related side effects and toxicities and arrange for and interpret post-PEP HIV tests.

What should you do? I'd recommend:

1. You turn the tables on your rude and unprofessional physician and refuse to see him ever again.

2. Consult an HIV specialist for all the reasons I listed above. If you don't know any HIV specialist in your area, try the American Academy of HIV Medicine's Web site, www.aahivm.org. They have a listing of HIV specialists organized by locale.

Whether you chose to discontinue PEP or complete a full 28-day course, your HIV risk remains minimal to nonexistent.

Stay well.

Dr. Bob

HELP......Large donation on its way!!!!!

Aug 25, 2006

Hi,

I recently had an sexual encounter where I am concerned that I may have been exposed to HIV. I am a male and in the process of putting on a condem on a someone (who was a casual sexual encounter) I at first out it one the wrong way, I immidiately noticed it and turned it around, kind of rub it with my fingers to wipe away any pre-cum and then we had anal sex ( I was bottom). Would this incident put me at risk? I am considering going to an ER to see if I can get PEP, is this an over reaction?

Tanks

Response from Dr. Frascino

Hello,

I would not recommend PEP for such a minimal risk. Yes, you are indeed overreacting.

If you're worried, get an HIV test at the three-month mark. The odds are beyond astronomical that you did not contract HIV from the events you describe in your question.

Thanks for your donation! (www.concertedeffort.org) One gift can touch many lives in desperate need, turning despair into hope.

Be well. Stay well.

Dr. Bob



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