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6 doctors, 6 HIV tests, 2 NAATs, What's going on?
Aug 9, 2007

Feb 24th I had unprotected vaginal sex with two females. 2-3 weeks later I broke out with a very large blister on my left tricep as well as a sore on my penis head. I had one of the females tested for HIV which turned out negative. I was tested for syphllis, HIV 1+2, ect. All to be negative. However my CD4 count was low, I think high 300s or low 400s. The sore on penis healed completley. I had another rapid HIV test done in the next few weeks which was negative. Then at then end of April 07 I made a mistake and had unprotected vaginal sex again. I had an HIV rapid test and NAAT test the end of May both to be negative. Then the blister on arm came back with redness on penis head as well as purple spots on penis shaft. I also had red spots on feed and hands. A rdr syphllis test showed negative. Early June I had a rapid oral hiv swab as well as NAAT test done all to be negative. Then at the end of June I had another oral swab rapid which showed positive. Immediatley after at the same clinic I had a rapid blood test and NAAT both to be negative. They thought that the ora swab was a false positive. I instantly went the next day to another clinic to have anothe ora swab rapid done which swhowed negative. Then I had another breakotu with the blister on my arm, sore on my penis head and purple spots on my penis shaft. Mid July 07 a biopsy of the skin was taken and showed nothing. Assuming erythema multiforme. July 31st I had another HIV rapid test done to be negative as well as a syphllis RDR and FTA-ABs both to be negative. So to wrap things up, this whole 5-6 month period I had 3 total breakouts on my penis, and only the first one healed completley, then others are still purple and doctors don't know what to say. My main concern is that since my CD4 count was low originally I was wondering if my immune system is supressed causing me to seroconvert much later(past the 3-6 months). I'm considering getting another CD4 count, NAAT and HIV rapid at 6 months from the first incident. I'm just wondering if you think I'm HIV negative or positive or have anything to worry about, or what I can do about the purple spots. Basically it goes like this. I had a NAAT test done at >30 days of exprosure and a rapid blodo HIV test done at 5 months after first exposure and 3 months after second exposure. What should I do? I'm so stressed, Please help...Please..

Response from Dr. Frascino

Hello,

What's going on??? Well, I suppose I could be asking you exactly the same question! "Unprotected sex with two females" followed by "symptoms" and HIV/STD tests and then, two months later, "unprotected vaginal sex again"?????? I ask you, sir, what is going on???? Now you're totally stressed out about your "exprosure" and "blodo HIV tests." I don't believe you have HIV; however, whatever you've got may well prevent you from ever playing Scrabble or doing crossword puzzles again, as your ability to spell seems to have been significantly impaired!

My assessment is that you placed yourself at risk by having unprotected sex. Your syphilis screening tests are negative. Your HIV screening tests out to three months following your last potential exposure are negative (NAAT and rapid HIV tests) with one false-negative rapid oral fluid test. CD4 subset analysis should never have been ordered, as there was no indication to do so.

Regarding your symptoms, I have no way of diagnosing them over the Internet. One thing that I can, with great certainty, advise is that these symptoms have absolutely nothing to do with HIV. No further HIV testing is warranted. If you are having ongoing skin symptoms, see a dermatologist. Stop chasing a disease you could not possibly have. And most importantly, stop placing yourself at risk. Your current situation could have been easily avoided by using a thin piece of latex! If you won't cover your rocket, keep it in your pocket!

Dr. Bob



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