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Tested in your foundation
Sep 22, 2008

Dear Doc,

I am a healthy male in late twenties living in San Diego. I have heard terrible stuff from everyone about their hiv test experience, and am planning to drive up to your foundation to get tested, hoping for a testing experience which won't make me commit suicide. I am tired of living with fear after a few unprotected exposures few years ago, which has given me stress, thrush and painful lymph nodes in the armpit area. I know I will be positive, and just hope to get the news in a way which won't crush me !! Is it possible to get tested in your foundation? And what is the procedure that you have there to give the bad news to people !!! I am scared ! Please help me.

Response from Dr. Frascino

Hi San Diego Guy,

We don't do HIV testing at the Robert James Frascino AIDS Foundation; however, we do offer testing at the Frascino Medical Group. These are two distinct organizations. The foundation is a not-for-profit charitable organization whose sole mission is to provide crucial services for men, women and children living with HIV/AIDS worldwide and to raise awareness of the HIV/AIDS epidemic through advocacy and education. Its Web site is www.concertedeffort.org. The Frascino Medical Group is a medical practice devoted to the comprehensive and compassionate care of those infected and affected by HIV/AIDS. We do offer HIV testing at the medical group. We make every effort to make the testing experience as calm, supportive, educational and non-anxiety provoking as possible. The procedure we have to give news (good or not-so-good) is direct physician-to-client discussion. Nurse, technicians or other staff are not involved. We understand how nerve-wracking this experience can be; consequently, it's conducted entirely by the HIV specialist physician. He interviews you, performs the test and discusses the results. If negative, you WOO-HOO together. If positive, extensive discussion ensues regarding the next steps for further evaluation and management. Negative or positive, hugs are usually given! For an appointment, call 650-917-1357. Don't be frightened. Not knowing is far worse than knowing. See below.

Dr. Bob

GET TESTED Sep 22, 2008

Dr. Frascino, you are wonderful and I look forward to your supportive and uplifting answers and comments. This is not a question, but a plea to anyone who may have any risk for contracting HIV. I am a professional, healthy, gay, 47 year old guy who tested positive in May 2008. I had engaged in some risky behavior a number of times but thought I would never get infected. I had been tested about 5 years ago, but kept putting more recent testing off...maybe I didn't want to know. Finally one day I ordered a Home Access Kit, sent it in and 5 days later found out by phone I was positive. I was of course shocked. I have not been sick and felt fine. Luckily one my best friends counsels people with HIV/AIDS. He was incredible. Within 3 days I was at the Erie County Medical Center in Buffalo receiving tests and being well taken care of. My counts were good. CD4 511/29%, Vl 47,000, but my doc knowing I was motivated and educated started me on Atripla. Its been 4 months now. No side effects, Vl undetectable, CD4 up to 667/31%, and I'm feeling good. The bottom line: What if I didn't get tested? Getting sick was almost certainly inevitable. Eventually I would have found out by contracting an opportunistic infection. I am controlling the virus now. It is not controlling me! My body has not been ravaged yet so I am strong enough to fight with the help from strong meds and great docs. So, don't be scared to get tested, but be very scared not to get tested. GET TESTED!!!!!

Response from Dr. Frascino

Hello,

Thank you for taking the time to write in and share your story and insights! I absolutely agree! HIV is one of those conditions where what you don't know can kill you! I'll repost one recent example from the archives below.

Dr. Bob

my bf died of PCP Sep 22, 2008

My BF knew about his HIV status on Mid Jul 08 (ELISA). His Western Blot Assays Test come 1 month later. However he died 1 weeks later due to PCP. I have a unprotective anal sex (receptive & active) on late May with him. I did 2 test after I knew about his HIV status which was on 80 days and 100 days after exposure. Both result come out negative. I konw I have to do another test on 6 month mark. My friend suggest me to see Physician for help, he think PEP may help. Dr Bob, do you think this is necessary?

Response from Dr. Frascino

Hello,

I'm sorry to hear about your boyfriend's passing. His story of not finding out about his HIV disease until his immune system was already decimated by the virus is shockingly common here in the U.S. Twenty-five percent of the estimated one million folks with HIV infection in this country are completely unaware they have contracted the virus. Many will not learn of their HIV-positive status until they have incurred extensive damaged to their immune systems and become seriously ill usually with a very preventable condition (PCP, MAC, toxo, CMV among other opportunistic infections). That the average CD4 cell count of those initiating care in the U.S. is 187 cells is shocking! (The current guidelines recommend beginning antiretrovirals at CD4 counts of 350.) There are many underlying contributing factors for this tragic phenomenon, including:

1. fear of HIV testing, due to stigmatization and criminalization of HIV;

2. lack of HIV/AIDS awareness; and

3. misinformation or lack of vital HIV prevention education, due to Bush's disastrous abstinence-only sex (mis-)education programs.

Regarding your specific question, PEP (post-exposure prophylaxis) would definitely not be warranted. PEP is only effective if begun within 72 hours of the exposure. I'll reprint below some information from the archives about PEP.

Good luck with your six-month definitive HIV test and please accept my heartfelt condolences regarding your loss.

Dr. Bob



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