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Contacting guy re: risk encounter - penultimate update
Sep 8, 2008

Hi Doctor Bob,

Thanks again for your patience (how do you trudge through all of these emails, offer free advice and still remain jovial!(for want of a better word!) I'll keep this brief and promise if you post it that I will make a donation and only contact you once more (with a woo-hoo, hopefully!). My 1st post (below) outlines the story (possible exposure on June 29th '08). I got my 6 weeks (post-incident) results and they were negative. I've read other people's experiences of swollen nodes and think and hope I MAY be imagining my enlarged armpit nodes (since 8 weeks post incident). Anway before I end up "waffling" you into a state where you reach for the (Irish!) whiskey bottle here are my questions!

1. I was told by my STI clinic that my 6-week post incident neg result is around 80% reliable, regardless of pep. Would you agree?

2. I've read on other hiv related forums that PEP delays the window period by one month (you are often quoted on these forums by others who refute this claim! You should "google" yourself to see just HOW respected your views are:) ) Anyhow - Are you definitively happy with a final 6 month post-incident test?

And Finally - would you agree with my following lay-diagnosis of my own situation?

Very low risk, made even lower by pep and 6 week negative?

Am I approaching a number near zero when it comes to risk?

Thanks and God bless you,

Worried Irish

PS - Off-topic but you ever been to Ireland - if not you should!

Response from Dr. Frascino

Hello Penultimate Update Guy,

Yes, it does take some patience to "trudge through all of these emails;" however, what would a doctor be without his "patients," right?

1. There is no scientific data to either prove or disprove this claim. Consequently, whether I agree or not is a moot point. The bottom line is that you need to follow the post-PEP testing guidelines to assure an accurate test result. Besides, even if it were 80% reliable, that means it 20% unreliable!

2. Google myself? Yikes! There's a scary proposition! Am I definitively happy with the final six-month post-incident test? Yep! Deliriously happy.

3. Yes and yes.

P.S. Nope. But it is on my list of travel destinations!

Finally, thanks for your pledge to the Robert James Frascino AIDS Foundation. It's warmly appreciated and urgently needed.

I'm looking forward to WOO-HOOing with you in the not-too-distant future.

Dr. Bob

Contacting guy re: Risky Encounter - Update Jul 3, 2008

Thanks so much Doctor for your swift response (which I pasted below). I am worried sick, but if the spanish guys does respond to my initial message you're right I'm just going to be upfront with him. I must ask one more question and please be as blunt and honest (as I know you value honesty!) as you can. The Clinic doctor told me the odds are heavily stacked in my favour in terms of HIV transmission but I can't stop worrying, like the majority of visitors to your site. Was she just trying to make me feel better or are the odds pretty good that I'll test negative? I'm hoping PEP will help to reduce the risk even further. I should also support what I think you have stated before - that PEP is no picnic on the body and has certainly taught me a vauluable lesson. I hope you can again answer my question and I commend you and your colleagues on the site.

Response from Dr. Frascino

Hello,

You're correct: All my responses are honest. Why would I answer any other way???

I absolutely agree with what the clinic doctor told you. The odds you did not contract HIV are indeed very much in your favor.

Good luck.

Dr. Bob

C0ontacting guy re: risky encounter Jul 2, 2008

Firstly, can I just compliment you on your excellent site and forums which obviously provide invaluable information/support to people across the globe. Over the weekend (and while on holidays in Spain), I had a risky encounter with a 19 year old spanish guy (unprotected anal where I was the top). Afterwards, riddled with guilt I phoned my boyfriend of 4 years to tell him what I'd done. I'm now back in Ireland and we're taking some time apart. In the meantime I was really worried as I don't know the spanish guy's HIV status. This concern made me go to my STI clinic and I'm now on PEPS (began around 32 or 33 hours after the encounter). However, I have also managed to find the spanish guy through a networking site on the net and have sent him a message just saying I'd like to speak to him. I obviously want to know if his sexual history should give me cause for alarm but I don't know exactly how to approach the subject without him running a mile. I've been lucky enough to find him online - now I just don't want to ruin my chances of verifyung his positive or negative status (for both our sakes). Any advice would be greatly appreciated.

Response from Dr. Frascino

Hi,

As always, I recommend "honesty," pure and simple. Don't beat around the bush. Just tell him exactly what you're worried about and that you've begun PEP (not "PEPS"). Ask if he knows his status or if he's willing to be tested. And let him know you'll advise him of your HIV test results as well. If he "runs a mile," well, you're in Ireland and he's in Spain. What difference will one more mile make anyway? You clearly are doing everything you possibly can to abort an HIV infection. No matter what your hot Latin bottom boy tells you or doesn't tell you, I doubt it will change your course of action and it certainly won't change the ultimate outcome of your HIV serostatus.

Good luck.

Dr. Bob



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