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Promise to donate and Hopeful Answer from a Phenomenal MD
Jan 27, 2007

Dear Dr. Bob, On Jan 10th, I received unprotected,receptive anal sex (with no ejaculation) from a man. He penetrated me for nearly 3-4 minutes. To be honest, I know of very little pre-seminal fluids. We had mutual masturbated earlier that evening and I noticed he had little or no pre-cum. He stated that he was tested in Oct. 06 (negative). I was curious to know what is the likelihood of this one time experience being the unfortunate one of contracting HIV. I had never befor received unprotected sex, and NEVER will again. I was wanting to do a PCR test by DNA along with a standard HIV antibody test @ one month. I called a co. (that does testing with Lab Corp.) that stated that after 28 days the PCR DNA was 99.9% accurate. They stated that they do a western blot to rule out false positives on the PCR DNA. PLEASE, tell me what you think. You are a phenomenal person and I applaud your assisstance with helping others. Whatever I can donate I am willing to assist with as well. Begging for an answer. Thank You from my heart. S.

Response from Dr. Frascino

Hello S,

Your estimated per-act risk of acquiring HIV from unprotected receptive anal sex is exactly the same as everyone else's! The per-act risk is 50 per 10,000 exposures to an infected source. We do not know the status of your partner; therefore, this statistical estimate would be somewhat less.

Regarding testing, I do not recommend PCR DNA testing for routine HIV screening, for the following reasons:

1. It is not FDA-approved for this purpose.

2. It has a considerable rate of false-positives.

3. Certain technical considerations.

4. Its cost.

Western Blot tests are not recommended as confirmatory tests for PCR testing, because between 4% and 20% of Western Blots produce an indeterminate result showing at least some positive bands for HIV-1 proteins, which are due to nonspecific cross-reacting antibodies as well as other reasons. Therefore, even a PCR DNA and Western Blot can lead to very confusing and anxiety-provoking results. The company person you spoke to wants to sell you expensive laboratory tests that are clearly not appropriate for your situation. What you need is a three-month HIV antibody test. It's inexpensive, highly accurate and FDA-approved.

Thanks for your interest in making a tax-deductible donation to the Robert James Frascino AIDS Foundation. In return, I'm sending you my good-luck karma that your definitive three-month HIV test is negative.

Good luck. Be safe. Be well.

Dr. Bob



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