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I need the Icon of societies help!
Oct 16, 2006

Hey Dr. Bob, I've been an avid reader of your forums for the past 3 months and have read almost every posting in the archives and almost every bit of medical literature I could find. First off, I would like to give you a standing applause for all the hard work your doing both on-line and off-line regarding HIV education. I'm sure at times reading all these postings seems like an up hill battle that will never end, however, amazingly in each post you seem to carry the same amount of compassion and humor! That is a true gift.

Secondly, I would like to know if you are taking donations in terms of human capital rather then just financial capital? I can and want to offer both, I just need some advice and idea's on how to do so. Additionally I'm local to your foundation and

Lastly, like many others before me I would like to hear and a little bit of your professional advice. Last July (July 28th) to be exact, I had a lapse in judgment and had unprotected insertive anal sex with another male (use lube, no mutual ejaculation) as well as both receptive/insertive oral sex as well as deep kissing (possible precum). At the time I was told the person was negative, yet sadly I found out and confirmed a week later that the person lied and was positive (personally was told he has had HIV for awhile with a low viral load and doesn't need meds and still lied to me). Oddly the night of exposure I already started to feel sick even before exposure. The next morning is when the throat soreness, etc developed. Four days after exposure I saw my doctor and had a standard HIV test performed as well was a strep throat test for my developing sore throat. The HIV test came back negative and the instant strep test came back positive so I took penicillin for 10days which seemed to clear up the throat condition.

After confirming my HIV exposure I saw my doctor again at 4.5weeks (32days) post exposure and was given another standard HIV test as well as a quantitative PCR test (Mills Valley Medical Center performed the tests) as well as a hepatitis b&c test, urine chlamydia test, gonorrhea test and mononucleosis test. Everything came back negative and I was told by my doctor that the results give a 100% certainty that Im negative. I asked about the 3 month mark and was told that because of the specificity of these tests at 4.5 weeks (32days), Im conclusively negative.

Two weeks later my throat again became sore and I also developed swollen tonsils with ulcer looking patches, a white tongue (painless, just white coated) and strange lump feeling in my throat. I called my doctor again was given an antibiotic (clarithromycin) for 10days. This seemed to clear up the condition, however, a week after being off the antibiotic I have developed that same lump feeling in my throat and still have white coated tongue. Also for the past month Ive been eating yogurt and taking several acidophillous pills, etc to help my tongue yet it seems to do almost nothing.

Anyhow, long story short, I know symptoms are not an indicator for HIV nor is having a strep throat immediately after exposure, however what is your take on my test results, etc I almost went to the DeFrank center in San Jose last Wed night for an instant HIV test, however I backed out since today is only 11weeks post-exposure and I didnt want to take it too soon. What is your feeling on when I should take my test for 100% certainty?

Again thanks for the amazing and time consuming work you do each and every day. Your efforts lie in the hearts of all us here and elsewhere! I just pray that more people step up to the plate and take a more proactive approach in helping others as well as themselves. I know for me, this experience has changed me forever and I know that I will never put myself or those around me at risk again with such a stupid and regrettable act.

Response from Dr. Frascino

Hello,

1. Thanks for your kind comments.

2. Yes, the Foundation is staffed primarily by volunteers! If you want to help, just give the Foundation a call (650-917-1357) and let us know. We keep a list of volunteers, and as various local projects come up, their generous services are put to good use. (www.concertedeffort.org)

3. Your risk was significant unprotected anal insertive sex with a dude who is HIV positive and not on meds. Your 4.5-week negative "standard" HIV test is encouraging, but not definitive. I don't recommend PCR tests for routine HIV screening, but certainly your negative result can also be seen as encouraging. For a conclusive and definitive HIV-antibody test, wait until the three-month mark. I'll send my good-luck karma that your definitive test remains negative, as I strongly suspect it will.

Good luck.

Dr. Bob



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