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So when did it happen?
Dec 5, 2006

Hi Doc:

I am a 39-year-old heterosexual female, married, with three beautiful children. My husband was recently diagnosed with AIDS after a bout of PCP. His T4 < 40 and viral load in the 10,000's. As a consequence I also tested positive at this time with T4 at 650 and viral load at 5000. I'm going nuts trying to figure out when we contracted the virus. Could it have been 6 years ago when we were going thru a wild phase and experiencing new things (no more comments on that phase - boy were we stupid!) Since that era I was tested in 2001 with my last pregnancy which turned out negative and then we both had the oral swab test for life insurance purposes. I'm assuming these were negative also since we never received any more info and were approved for the insurance. How accurate are the swab tests? Thank God my children are all negative. Is it possible to get as sick as my husband did within one year? six months? What's the minimum time frame to get that sick after initial infection? He is a healthcare worker and worked for years in blood banks and drawing blood. And now as far as safe sex goes, I've read about the risks of semen and precum when it comes to vaginal penetration. Does this mean that from now on no penetration whatsoever without a condom? This worries me a little. How do I convince my husband without making him feel rejected? And one more thing, thank you so much for all the information posted in this website. It's great. I wish there was more for heterosexual women though as this disease does not discriminate. I also noticed that you have the site in Spanish. Money's a little tight right now so I'm unable to make a donation; however,I am a translator/ interpreter and would be more than happy to contribute my time in doing any translations you might need. Thanks again for your help. I sincerely hope you can answer me this time although I understand you are extremely busy. Thanks. V.

Response from Dr. Frascino

Hello V,

Oral swab tests for HIV are very accurate. It's safe to assume you and your husband were infected sometime after that test.

There is no absolute minimum time for developing symptoms or an opportunistic infection following primary HIV infection due to the many variables involved, such as viral strain, host immune response, coinfections, etc. Generally speaking, it can be up to 10 years from the time of primary infection to the development of an AIDS-defining illness. But this is not a hard and fast rule. From your counts and degree of immune deficiency, it's highly likely your husband was infected well before you. His current CD4 count may be depressed due to his concurrent PCP infection. Hopefully it will increase as the bout of PCP resolves. Spending time trying to figure out exactly where and when your initial infections occurred may not be worth the effort at this time. Life only goes in one direction forward. What happened in the past is unchangeable history. You need to focus on the challenges of today and the promise of tomorrow.

Regarding safer sexual practices and the chance of superinfection for poz couples, you can refer to the extensive information in the archives, as I've addressed these topics at length on multiple occasions. In brief, yes, latex condoms are indeed recommended. Your husband should not feel rejected, as the condoms are for his protection (against superinfections) as well.

Regarding information for heterosexual women, I agree HIV does not discriminate and neither do I. I answer a wide array of questions from all types of questioners. If you read through the archives, I believe you'll find the heterosexual women are well represented.

Thanks for your kind offer for translation services. We just may take you up on that offer! You can contact the Foundation at frascinoaidsfound@sbcglobal.net if you would like to be added to our list of trusted volunteers!

Best of luck to both you and your husband.

Dr. Bob



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