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Doctor-instilled fear of rapid tests

Oct 17, 2007

Dr. Bob:

Foremost, thanks for your dedication to studying HIV - it's incredibly reassuring.

A little over a year ago I had a potential exposure to HIV and let the fear linger until about 2 months ago, when I finally got tested. I went to Planned Parenthood where a rapid test was done (OraQuick, the kind that tests only for HIV-1) - it came back negative. From what I've read, I believe I can consider this result definitive. However, in conjunction with the leftover fear, I've been dealing with an enlarged prostate, for which I've been seeing my general practitioner. The other day, at which time we discussed my testing history, he suggested the rapid tests weren't "all that trustworthy," or rather that the traditional method of testing (having blood drawn and sent to the lab) was more reliable. I had that done today, and the fear is still driving me nuts. I'm seeing a psychologist to deal with the anxiety problem, which I thought would subside after the rapid test, but I've seemed to absorb the doctor's concerns and am now driving myself crazy thinking the rapid test result was wrong.

Was the doctor right, that the rapid tests aren't as reliable? After all, it only took ten minutes to get the results, and it just seems that it would take longer to detect something like that. That the OraQuick test is FDA-approved doesn't really reassure me, since those are the same people that inspect our crappy food supply. And that I've used the word "fear" in this post numerous times goes to show that I definitely have an axiety problem, which I'm dealing with professionally, but the GP seems to have made it worse. When a doctor tells you something it's hard not to take him or her seriously. But then, my GP isn't an HIV specialist, so my thought is that you know better than he about the accuracy of these tests vs. the accuracy of "traditional" testing.

Can you give me some reassurance? Thanks again, Doc.

Response from Dr. Frascino


You are absolutely correct! Your GP is not an HIV specialist and his comments about rapid testing not being "all that trustworthy" clearly underscore this fact. Sorry he made your "axiety" problem worse. There is absolutely no cause for concern. The sensitivity and specificity (i.e. the accuracy) of OraQuick tests are between 99.6% and 99.8% and compare extremely favorably to "traditional" tests. There was no reason for you to have the additional blood test. The result will undoubtedly be negative. Rather than getting additional unwarranted tests, perhaps you should consider getting a more competent and compassionate GP. Doing so may actually decrease your "axiety" levels!

Be well. HIV is not your problem.

Dr. Bob

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