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Post Donation Question: The Kung Pao Mistake
Jun 26, 2007

Dear Doc -

Here it is again, the old "Got real drunk and made a mistake with a prostitute". But this one has a twist.

Well, on a trip to Beijing some 8 days ago, I found myself drunk after a long night out at 7AM in a taxi, trying to gesticulate my need for food to the driver. This was, given the circumstances, naturally interpreted as "prostitute" and I found myself in a brothel where for the first time in my life, I slept with a sex-worker. I had protected (insertive) oral and vaginal sex with a woman there. She used a clear lube for the vaginal sex as I recall, and I am confidant that there was no breakage. I got back to my hotel after about an hour where I lightly cleaned myself but then somehow managed to find the desire to masturbate again before passing out for about 11 hours. It was only then that I realized that I had not properly showered.

My friends reassured me that all would be well, given the fact that I was protected, but in the last several days I have detected some problems urinating: a frequent need to do so, and occasional burning.

This has devastated me, thinking that this could be a bacterial infection, and who knows what else. I also know that other STDs amplify risk. I am a wreck, spending most of my time hunting for data and stories on the internet.

I have arrived back in Korea, where I work, and today (day 8 post-possible exposure) I got a full, 30-item blood, urine, swab test done, including an RNA PCR HIV test with a Korean doctor (doctors are good here). My results are due in a week.

My questions: 1. Could I have infected myself in my "second round" with leftover vaginal secretions at the base of my penis after an hour? (I dont recall any, but..) Does HIV live that long outside the body?

2. Can a PCR test after 8 days have any accuracy? The doctor cliams that after 5 days, it is solid. Can I trust the results? What testing regimen to you recommend? Just the 3 month? Can a 4 week negative add some comfort?

3. Is it possible to get a bacterial infection and not HIV, if the person is infected?

Thank you doctor. Your website is amazing, and the work you do as well. I have donated some already, and please expect more soon.

- Slipping away from Sanity in Seoul

Response from Dr. Frascino

Hello Slipping Away,

You gesticulated the need for food so the driver took you to a brothel? Hmmm . . . apparently charades is not your strong suit, eh?

OK, on to your questions:

1. No. Nope.

2. I do not recommend PCR testing for routine HIV screening, due to the rate of false-positives, other technical considerations and cost. I would recommend a single rapid HIV-antibody test at the three-month mark. Antibody tests taken prior to this are not considered to be definitive.

3. Yes. Many STDs are much easier to contract than HIV.

My advice is to stop "hunting for data and stories on the Internet." Stick to reputable HIV-information Web sites, like this one, to get the basic information you need. There is no reason to let your sanity slip! Just follow through with your STD/HIV screen and learn from your mistakes. And you might want to brush up on your nonverbal skills in case you need to pantomime any other desires in the future.

I'm sending you my good-luck karma that your definitive three-month HIV screening test is negative!

Good luck. Be well.

Dr. Bob



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