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You have passed me up TOO MANY TIMES!!!!!!!! YOU GOTTA READ THIS
Jun 10, 2007

Dr. Bob

I've read your comments and questions for almost 6 months. I've also asked a bunch of questions, I really need your help.

December 20, 2006 I had unprotected sex with a woman...it lasted about 1 minute and then I realized what was happening. Since then, I have been terrified and have gotten almost every sympton in the book. I've gotten tested for all STD's at the 1 and 3 month mark. I tested positive for Strep Throat at 2 months.

After the 3 month mark I was at ease for about 8 hours...then again the thoughts came into play. I've gotten about 20-25 rapid test since December 20th.

Now...yesterday I was extremely sick and used the bathroom about 10 times in 1 day, I had a fever and was extremely sore. I didn't eat and was scared that I once again...had HIV. Today, I feel better, but I'm still scared.

I am at the 5 1/2 month mark and I still fear I have HIV. This past week I've taken 2 Oral-Quick Rapid Test. Both were negative. Please help me out and calm my mind. I was told by someone I might be physcosomatic <---check spelling.

I believe him, but I need someone who is skilled in this field to help me out.

1)What are the odds of me being positive?

2)Do my symptoms match with those of HIV?

3)Why haven't you answered my questions!?!?!?!?

4)What the hell can my problem be?

5)Why do you say 3 months is enought time and other sites say 6? I've read plenty on it but it doens't make sense.

Please help me

Thanks, Mr. Broke...thanks to those Rapid HIV Test!

Response from Dr. Frascino

Hello Mr. Broke,

First off, I have read your previous questions and the reason I did not respond is that there are already so many other questions extremely similar to yours that have been posted in the archives. I really don't have anything new or additional to add to what I've already told so many other worried wrecks in the past. And as I have already said many times, I hate to repeat myself! (Get it? As I have already said many times, I hate to repeat myself. That's supposed to be clever.) Anyway, here comes the Department of Redundancy Department once again as I reiterate what has already been posted repeatedly.

1. The odds you are HIV positive are exactly zero! That's zero as in zilch, nada, zip!!! Dude, you've had 25 negative tests since December 20, 2006! Just what part of "NEGATIVE" don't you understand?

2. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. A negative HIV test trumps symptoms each and every time.

3. See explanation above.

4. Anxiety? Guilt? Depression? Stress? Psychosomatic disease? Probably all the above!

5. See below.

I recommend you stop testing and seek the help of a psychologist or psychiatrist to confront your irrational and unwarranted HIV fears. Stop chasing a disease you could not possibly have and get the psychological help you obviously need. HIV is not your problem. No way. No how.

Dr. Bob

Robert James, this is your Mother talking Jul 26, 2004

okay so I am not your mother, but I do need some advice. You have said over and over if you think you were exposed test at 3 months, but you also say if you know you were exposed test to 6 months??? What gives? Don't quote the CDC. I want you to be straight with me, (there is a joke in there) Why are you not consistent? 3 months if I think and 6 months if I know! What is your opinion? I have had the works when it comes to symptoms and was diagnosed for 1 STD, all are gone except for the PN. This after a 1 time insertive exposure with a female who I fear has HIV. I had a neg elisa at 5 months. Do I need another test or not? And why the 3 or 6 months answers? P.S. and don't be straight the world loves you the way you are!

Response from Dr. Frascino

Hello Not My Mother,

I do realize this issue is more than a bit confusing, so let me try once again to explain the rationale behind our advice. The question seems simple enough: three months or six months for a definitive result. The answer, however, is far from "straight" forward. The confusion results from variability in the immune response (time to produce anti-HIV antibodies) which is different from person to person, limitations in the test's sensitivity and specificity (ability of the test to pick up all true positives or eliminate all true negatives), and clinical judgment. In addition, there are special circumstances where our general recommendations for testing might not be applicable. For instance, when folks are simultaneous exposed to hepatitis C and HIV or when folks have previously received experimental HIV vaccines, consultation with an HIV specialist is often required to provide guidance on when to test and how to interpret the test results. Added to his are many very anxious folks who are absolutely certain they have contracted HIV, but in reality, have no identifiable risk. You know the type: "Grandma farted while trying to get out of her Barco-lounger chair. It smelled worse than usual. Now I'm convinced I've got AIDS." Of course, these folks require basic HIV prevention counseling and education, not HIV testing. But that doesn't stop them from getting tested "just to be sure," etc. So what would the answer be to these folks' "three months versus six months" question? In reality, neither, since they didn't need testing in the first place. And what about folks with some degree of potential ongoing exposure? How do we monitor their HIV status? So you can see this is not as straight forward as you might originally think.

OK, back to your questions. The best I can do is take all the information provided to me from an individual questioner, apply the information concerning the limitations of HIV testing, the results of large-scale epidemiological studies, and the scientific facts pertaining to how HIV is transmitted, and then give the questioner my expert opinion and advice. Whether that person chooses to accept my advice or follow my recommendations is, of course, totally up to him or her. The reason I quote the CDC's published guidelines is that they are perhaps the most conservative set of published and well-referenced recommendations I have seen.

So what can I, in good conscience and backed by science, advise? I can say that following a single possible or known exposure, the vast majority of infected persons will develop detectable HIV antibodies within three months of exposure. If the initial negative HIV test was performed within the first three months after exposure, repeat testing should be done at three or more months to rule out the possibility of a false-negative result within the window period. If the ELISA test is negative at three months or more after an exposure, the individual is extremely likely to be HIV negative. This is all based on statistical risk analysis and large-scale epidemiological studies. Now comes the confusing part. If a person was significantly exposed to a known HIV-infected person, the estimated statistical risks change and a second repeat test "might" be considered at six months or more from the exposure depending on the circumstances. And yes, there are very rare reports of seroconversion 6-12 months after a known exposure. The exact details of these very rare historical cases are a bit sketchy, but the reports do indeed exist in the medical literature. Today, however, extended follow-up testing beyond six months after exposure to rule out the extremely rare possibility of delayed seroconversion is not recommended, except under exceedingly rare circumstances that should be based on the clinical judgment of an HIV specialist.

I realize some folks may find this response unsatisfying and perhaps unsettling. However, I'm here to provide you with the best confirmed scientific knowledge that we have, and that's the extent of our knowledge at this time.

I'm also here to provide you with an expert opinion about that science. So let's proceed "straight ahead" (or should that be "gaily forward?") to your question. I would consider a negative ELISA test at five months following a "1 time insertive exposure with a female" of unknown HIV status to be definitive. I would not recommend additional testing. However, as always, the choice to follow my advice or not is totally up to you, whether you are my mother or not.

Good luck.

Dr. Bob



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