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Years of Fear

May 7, 2008

Hi Doctor Bob,

Unfortunately, I have landed back at the board due to a recent tailspin. It has now been 7 years that I have been reading this board (even before you started doling out advice. I have greatly benefited from your posts, and have passed on your wisdom to many. Unfortuntely, I just can't think rationally about my own fears (or believe the advice of docs).

After each relatively low sexual risk in the past, I was able to go in, get tested, and sortof move on. This time, however, the fact that I have a bit of seborrhea by my nose crease has made me very worried. I see the connection between Seborrheic Derm. and HIV, and can't seem to move on.

My risk is sex with three women, using latex condoms. I know what you'll say.. if the condom did not break or fail, than my risk is "essentially non-existent". The trouble is, just a few days ago, I got some folliculitis in the groin/thigh area.

I suspect the folliculitis was caused by one lesion I popped, allowing some staph bacteria to get in, however this is armchair conjecture.

Do you still think with the intermittent bout of seb derm, and the instance of folliculitis, that I will test negative for HIV given my risk factors? It has been three years since my last test, and I am concerned that I am showing early symptoms (or am I jumping the gun just a bit?).

I did not have acute infection, and have not experienced any other symptoms. Though I have been reading long enough to know that the presence or absence of symptoms means nothing...

Sorry to drone on. For this, I will get my butt in gear and send in my yearly donation to the Frascino found.

Glad to see you are well Bob.

Your pal D

Response from Dr. Frascino

Hi D,

Are you jumping the gun just a bit? Not just a bit; you've managed to prematurely catapult yourself completely into the "worried-well pit!"

D, you are absolutely correct that I'm going to tell you that if the latex condoms were used appropriately and did not break, your HIV risk is essentially nonexistent! You are also correct that I would reemphasize that symptoms are notoriously unreliable in predicting who is and is not HIV infected. Furthermore, I must add that the vast majority of cases of seborrhea and folliculitis have absolutely nothing whatsoever to do with HIV!

You've been reading this board for seven years! No doubt you could have answered your own question. It's time to put your "years of fears" permanently to rest. And I'm not just recommending a rapid test to calm this most recent flare-up of your HIV fears, but I also recommend psychological counseling to help you confront and ultimately conquer once and for all your completely unwarranted irrational fears of contracting HIV. Sex is supposed to be fun, not anxiety provoking.

Consequently I strongly encourage you to:

1. Get a rapid test at the three-month mark. The result will undoubtedly be negative. Then yell WOO-HOO!

2. Get psychological counseling to address your underlying anxiety and irrational fear of contracting HIV.

3. Continue to sign onto the forum for updates about HIV and of course for its "entertainment value" as you read about other hapless worriers trying to find their way out of their self-inflected worried-well hells!

Thanks for your donations to The Robert James Frascino AIDS Foundation ( They are urgently needed and warmly appreciated. In return I'll send my good-luck/good-health karma that not only your HIV test remains negative, but also that your "years of fears" come quickly and permanently to an end.

Good luck.

Dr. Bob

cocaine and HIV
Physician with probable HIV infection

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