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Re: In Dire Need of Woohoo Karma
Apr 19, 2008

Dr. Frascino,

First of all, I want to thank you for answering my previous question. You did help alleviate some of my fears. I shared your post (and a hug) with my wife. As I stated earlier, she has forgiven me and does not share my fears of HIV infection. She is confident that I am OK. Unfortunately, I, like the many other worried folks, am still concerned. I am counting the days until I can give you a Woo-Hoo!

In the meantime, I do have a couple more questions. I have been fighting prostatitis on and off for three years. I had a recent flare-up (around the time of my low-risk exposure) and was prescribed Bactrim. Unfortunately, I learned that I am allergic to that and am now on another antibiotic. The Bactrim gave me a rash, very sore mouth and joints. My questions are: 1) Does having prostatitis increase my chances of acquiring HIV? 2) Could these symptoms I described be related to ARS?

I really hope you can answer these for me. Although my wife has forgiven my transgression, she is getting tired of my being worried so much. We both look forward to your response.

P.S. I have already made the first of my donations to your foundation. I admire all that you do.

Response from Dr. Frascino

Hi,

1. No, prostatitis does not increase your chances of acquiring HIV. It's a fairly deep-seated gland and not related to the superficial areas where HIV transmission occurs.

2. The symptoms you describe are very consistent with a Bactrim reaction and there is no reason to suspect they are anything but that.

Thank you for your donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). A personal acknowledgement/thank-you will be arriving in your snail mailbox sometime soon.

If indeed you are having ongoing excessive anxiety waiting out the window period, you could consider seeing a therapist or getting some anti-anxiety mediation from your family physician. As I stated in my last response, your definitive HIV test results will undoubtedly be negative. Consequently I would suggest you begin practicing your WOO-HOO! I'll look forward to celebrating it with both of you soon.

Be well! (And that's a doctor's order!)

Dr. Bob

In dire need of Woohoo karma Apr 13, 2008

I, like many of those who have asked the similar question, am scared to death. I have read through the vast majority of your posts, but have a question with a twist. Unfortunately, I had unprotected insertive oral sex with a woman of unknown HIV status last week. It was during a business trip that involved a lot a alcohol and not much common sense. Since that time I have been scared to death. To make matters worse, I am a happily married man with a wonderful wife and two great kids. This recent encounter has filled me with deep regret and fear. In reading your prior posts, I agree that honesty is always the best policy. As such, I admitted the episode to my wife. Luckily, she has chosen to forgive me. However, I cannot shake the fear that I may have put myself and her at risk of HIV. I have been afraid to touch her for the past week. I had a full bank of tests, including HIV and all STDs, this week. I know it is too early for the HIV test to be valid, but it did come back negative. However, my monocyte count (which I had never heard of before), was a little low. It was a 3. In addition, I learned that I do have HSV 1. That was not a huge surprise since I have had sores in my mouth before. I know my risk of HIV is low, but would like to know if the low monocyte count is a foreshadower of doom. The work you do here is incredible. In addition to an answer to my question, I could really use some good karma for a future "WOOHOO!". At this point, I am worried sick. I really appreciate your time. I will gladly send a donation your way. Thank you!

Response from Dr. Frascino

Hello Scared to Death Happily Married Man,

As you undoubtedly know from having read "the vast majority of (my) posts," insertive oral sex carries an extremely low risk for acquiring HIV. The estimated statistical risk for acquiring HIV from insertive oral sex with a partner confirmed to be HIV positive is 0.5 per 10,000 exposures. Your estimated statistical risk would be even lower, as we do not know the HIV status of your alcohol-soaked hoovering honey. I'm delighted you leveled with your wife, as this is the best way to confront one's guilt and accept the consequence of one's actions/indiscretions/mistakes. I'm even more delighted your wife has forgiven you (the vast majority of spouses do!). Please give your wife a hug from me! (Stories like yours help other petrified husbands and dads do the right thing as well!) Now what is all this nonsense about being "afraid to touch her for the past week?" From your extensive reading of my archives you should well know that HIV is not transmitted by causal contact. Your HIV risk is negligible. For an extra degree of safety during your window period, I'd suggest you use latex condoms for penetrative sex. That way both you and your wife won't have to worry. I would also suggest you get a single rapid HIV test at the three-month mark to put your residual (and largely unwarranted) HIV worries permanently to rest. The result will undoubtedly be negative.

Regarding your slightly low monocyte count, no, this is not a "foreshadower of doom." Stop being such a drama queen! Your mildly depressed monocyte count has no clinical relevancy whatsoever and certainly has nothing to do with HIV.

Thank you for your tax-deductible contribution to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's urgently needed and warmly appreciated. Your one gift will touch the lives of many in desperate need, helping to turn hopelessness into hope. On behalf of those lives, please accept my heartfelt thanks. In return I'm sending you (and your wife) my best good-luck/good-health karma that your three-month definitive HIV test is negative. I'm extremely confident it will indeed be negative and that all will be "well" including you.

I'll await your WOO-HOO!

Good luck.

Dr. Bob



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