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8 ELISA & 3 PCR tests after PEP (DOUBLE BAGGING) (USING TWO CONDOMS)
May 23, 2008

Dear Dr. Bob, Hw r u? am 28 yrs old south African. i had written u b4...bt didn't get reply...i know u r really busy helping ppl. pls this time reply me...i beg u. On the 30th of Jan 2008 i hada condom failure with a sex worker in Dubai. i used 2 condoms & both ruptured.i asked d girl 2 test bt she refused ...later i heard most of these sex workers(illegal migrants) in Arab countries r positive...and sadly they try to infect their clients deliberately...they call it REVENGE.i heard all this after dat sad night. So pls let others NOTE this INFO...while they go out at night in Dubai.... anyway i immediately returned to Johannesburg after 40 hrs and was put on combivire/kaletra..finished with 101%adherence.

since then i did 8 Elisa tests (at week.3.5.8.10.12.14.15.17)and 3 PCRs(at week 5.10.15)all NEGATIVE.

So doc do u think i still need further testing(am nw on week 17)...and also i had a mild sore throat & swollen glands on my neck for almost 3 months...antibiotic couldnt help me..do u think it is related 2 HIV...?

last bt not least..since i dont have credit card is it possible to send donations to ur organization through bank transfer? u knw in africa it is nt easy to get credit card easily...even though u hav money in ur account...

thank u

Response from Dr. Frascino

Hello,

First off, the claims that sex workers in Dubai are deliberately trying to infect their clients with HIV seems very spurious to me. Don't believe everything you hear! Next, using two latex condoms simultaneously is not recommended. The friction of latex-on-latex can compromise the integrity or the condom, making them more likely to break. This may well have contributed to your condom failure. (See below.)

Finally, the post-PEP HIV-testing guidelines recommend an HIV-antibody test at three and six months post-exposure. You've had way too many tests, based on these guidelines. PCR testing is not recommended for routine HIV screening, due to the rate of false-positives, other technical concerns and cost. So, do I think you are HIV negative? Yes, I do. However, if you want to follow the post-PEP testing guidelines, you should get a single (as in only one!) HIV-antibody test at the six-month mark to confirm your status.

As for your mild sore throat and swollen glands, no, I do not believe these are HIV related.

Thanks for your interest in making a contribution to the Robert James Frascino AIDS Foundation. Yes, direct bank-to-bank transfers are readily available and warmly appreciated.

To make a direct wire transfer, please follow these wiring instructions: Mellon Bank Pittsburgh, P.A. ABA # 043000261 Credit ML Account Number 101-1730 Further Credit to: Robert James Frascino AIDS Foundation Account # 830-04C48 For international transfers add: Swift number MELN US 3P

This and additional donation information can be found on the foundation's Web site at www.concertedeffort.org. In return for your gift, I'm sending my best good-luck karma that your six-month definitive post-PEP HIV test result remains negative. I'm highly confident it will indeed be negative.

Be well. Stay well.

Dr. Bob

goodyear rubber (DOUBLE BAGGING) (USING TWO CONDOMS) Nov 27, 2007

thank you for your much needed service.i will be happy to donate to your cause.iam a married man who "BI ANAL ly has anal sex with a man who visits my area .i am the insertive partner.as a ultra safe precaution i have used,four,yes four condoms on my penis. no i don't get the sensation but the act itself gets me off.i know what your thinking,but it works for me. i have heard double bagging can be counterproductive as it can cause friction between the condoms.do you think using four erases any cause for concern(not my mental well being ) but my obvious fear of contracting hiv?i and he both enjoy these twice a year get togethers.i guess i'm just seeking total piece of mind and yes my wife knows.

Response from Dr. Frascino

Hey Goodyear Rubber Guy,

"Bi-Anal-ly" indeed! Hmm . . . and you use four condoms for your backdoor action to potentially "erase any cause for concern???" And you state, "I know what you're thinking . . . ." Hmm, I tend to doubt that, but what I'm thinking doesn't relate to the point of your question, so I'll save those comments for another time. Regarding your four-condom action plan, well, there is absolutely no evidence that four condoms offer any more protection than one. You are also correct that there is some evidence suggesting double bagging causes friction of latex on latex, which may compromise the integrity of condoms and increase the likelihood of breakage! One could surmise the same increased risk could apply to quadruple bagging.

So Goodyear Rubber Guy (or Michelin Tire Man?), my advice remains that you should use one condom, but use it properly with plenty of water-based lubricant. (See below.)

Dr. Bob

Can two condoms be safe (DOUBLE BAGGING) (USING TWO CONDOMS) Aug 27, 2007

An HIV + male had on two condoms, we had vaginal intercourse (i was on top)...not for very long time......as soon as i got off of him (condoms still on), I saw him ejaculate into the condom. i did not see anything leaking out...everything seemed to be in the first condom. i inspected the condoms the next day and noticed the internal condom was full of semen, mainly at the top and the outer condom seemed to move loosley around the outside, as though it had never come in contact with semen from the first condom. I am very scared and worried and mad with myself for what I did. What are my chances of getting past this without having contracted HIV?

Thanks for your time.

Response from Dr. Frascino

Hi,

Your HIV risk would be nonexistent if the latex condom did not fail. HIV cannot permeate intact latex. No way. No how. That said, I do not recommend "double bagging." See below.

Dr. Bob

Double condoms to prevent HIV Aug 29, 2005

Dear Robert, I travel lot for asian countries like thailand etc.When I have sex with Bar girls there I always use double comdoms(ie one on other) as precaution ,so what is my chance of getting HIV.For information my condoms never brokened nor I had oral sex with them.

Response from Dr. Frascino

Hello,

There are no scientific studies showing "double bagging" is safer than properly using a single latex condom. In fact, there is some information suggesting that double bagging causes friction of latex on latex, which may compromise the integrity of the condoms and increase the likelihood of breakage! Besides, it's hard enough to get one layer of latex on and used properly. By the time you double wrap, your partner could be out of the mood or asleep. Plus, Mr. Happy will probably not feel all that happy. He might not "feel" much at all! And if two layers were safer, then what about three or four or a dozen? Pretty soon it's going to be like sleeping with the Michelin Tire Man.

Dr. Bob



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