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Dial H for HIV

Jun 4, 2007

Dr. BDear ob,

Last November I did something out of character and completely irresponsible, for both my psychic and physical well being. Very drunk, my birthday night, abandoned by friends in a club, I met a guy and went back to his. I was fairly out of control, and this guy ended up fucking me unprotected for little under 10 seconds. I also, fucked him, unprotected for about a minute. As far as I can tell, he didn't cum inside me, and there wasn't any blood, though I know this is impossible to tell. The next morning he was a complete prick and basically in true 'one-nightstand' fashion made things awkward, being now unresponsive and entirely disinterested. I remember putting my phone number into his mobile phone that night, but leaving his that morning, didn't bother asking for his. A few weeks later while Christmas shopping I got a text message from an unknown number, saying that this individual had just been diagnosed with HIV and that this he lived in a certain area, the same area as my birthday buddy. I put two and two together and came up with him. This guy wouldn't talk to me over the phone, and just dumped this news on me. I felt very upset and cried for days; I actually became so depressed that over Christmas I was admitted to a psychiatric unit. I missed my final exams and came to the point of near and total collapse. At 10 weeks after the possible exposure ( I was also released from the unit) I went to a clinic and got tested: my results for HIV came back negative. It is now a little over six months since the incident and I have started to think about a retest. I didn't go back at 12 weeks because the healthcare provider didn't think it was necessitous. Recently my father was killed, and the stress and trauma of this has impacted on me greatly. I've started to sublimate this trauma into a revived fear that I may be HIV positive. Recently I've noticed that my tongue has a white coating, much like pictures of Hairy tongue on HIV sites. I also have bodily pains, what I can only describe as pains in my bones, sometimes groin and arms. What I am asking Dr. Bob is your advice. I know 12 weeks is the stated test time, however, I need you to help me out here, and let me know, in all honesty, what my chances of being HIV positive are, considering the particulars of my situation and these symptoms pseudo or otherwise, which I am experiencing now at six months. I will test again soon, but don't think I could deal with my father's death and this right now, though equally I seek closure on the HIV issue.

I promise to donate to your foundation when I can. I admire your strength and courage greatly, and take peace from it.

Sending all good wishes from Ireland, Dx

Response from Dr. Frascino

Hello Dx,

Sorry to hear you've had such a devastating past six months! I wanted to take a handful of Prozac just reading through it! Regarding your HIV risk and chances of seroconverting, there is no doubt unprotected anal sex puts you at risk for STDs, including HIV. However, your 10-week negative HIV test is extremely encouraging. The vast majority of HIV-infected folks seroconvert (have detectable levels of anti-HIV antibodies) within three-six weeks. Your "symptoms" occurring at six months post-potential exposure are not worrisome for or suggestive of HIV ARS or HIV disease. "Symptoms" in general are notoriously unreliable in predicting who is and is not HIV infected.

I absolutely agree with your insightful suggestion that your father's recent death has contributed to reviving your HIV fears.

I have several suggestions:

1. You had a significant enough psychiatric problem to require hospitalization six months ago. I would suggest you have a follow-up outpatient counseling session with a psychiatrist to help you cope with the recent loss of your father as well as your renewed fears of HIV. These conditions may well be interrelated as you suggested. Certainly it's a lot for the psyche to handle and you may well need help coping with both.

2. Once you've reestablished an ongoing outpatient relationship with a psychiatrist you trust and with whom you can work comfortably, I would suggest you get a definitive six-month HIV rapid test. Results of HIV rapid tests are available in as few as 20 minutes. I very strongly anticipate you will indeed be HIV negative; however, only a test can confirm my very strong suspicion.

Thank you for your willingness to make a donation to The Robert James Frascino AIDS Foundation. In return I'm sending you my very best good-luck/good-health karma that your definitive six-month test is negative.

I'm here if you need me, OK?

Best of luck!

Dr. Bob


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