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Donation Today. Question Asked Yesterday re: indeterminate w/gum transpant
Sep 24, 2008

Hi Dr. Bob,

I asked the question yesterday about the indeterminate WB test results (equivocal P24, not sure what other band was but it was only two presenting) and the possibility of a gum transplant causing such results. i also included my sexual history (one possible condom-breaking episode two weeks before the test in which my anal-insertive partner of unknown status did not ejaculate within me...and a couple others with intact protection). 9 days after my positive ELISA and indeterminate WB I had a negative Rapid HIV Test (Blood). In addition to the info I gave you yesterday I can tell you that I've had no noticeable ARS symptoms. Naturally I'm freaking out and I'd love to hear from you...if only for your wit and charm!

here is my donation confirmation: Your transaction was approved!

Total Amount: $100.00

Still Worried in LA!

Hi Dr. Bob,

First let me say that I think this site is an invaluable resource and your insights and knowledge are a lifesaver!

Now, to my story...Two weeks ago I had an HIV test as part of a general workup and a week later the doctor called to tell me that the ELISA came back positive and the WB was indeterminate (p24 was equivocal and I'm not sure what the other band was but I'm positive only two bands showed up). 9 days after the first blood test I went to a free clinic and got a Rapid HIV test that came back negative.

Now to my history: In late July I had one encounter with a male sex worker in which receptive and insertive oral was performed with protection and I performed insertive oral sex with protection and the condom's integrity was uncompromised. In early August I received oral with protection and engaged in receptive anal sex with protection in which the condom remained intact and the act was not done until completion. In late August I briefly received uncovered oral sex (about 1 minute) and then briefly performed protected oral sex before protected receptive anal sex. I think, however, the condom broke. My insertive partner did not climax and it only lasted about two minutes. I do not know the HIV status of any of these partners...yes, they were NSA. Also, of note, in Mid-August I had a gum tissue transplant from a human donor to alleviate some recession. In tis procedure gum tissue from another person was surgically grafted into my mouth.

So, my questions are 1) What is your read on my status and my risk? 2) Could the gum transplant be causing the positive ELISA and indeterminate WB? I have read organ transplants can be a cause for false positives... Worried sick in Los Angeles!!!!!!!!!!!

Response from Dr. Frascino

Hello Still Worried in L.A.,

I've combined your two posts.

Regarding your HIV-acquisition risk, protected sex of any variety is indeed protected, assuming the latex (or polyurethane) condom was used properly and did not fail (break). That leaves one episode of brief unprotected insertive oral sex and one episode of brief broken-condom receptive anal sex with partners of unknown HIV status. Oral sex, particularly insertive oral sex, carries a very low risk for HIV transmission/acquisition. The failed-condom episode does place you at some degree of risk for STDs, including HIV, and consequently testing is warranted. That your top gun didn't pop his cork inside will decrease your risk somewhat, but not totally eliminate it, due to the possibility of pre-cum.

The gum tissue transplant would not be a consideration, assuming it was well healed at the time of the unprotected oral sex.

Regarding your HIV tests to date, a positive ELISA and indeterminate Western Blot followed nine days later with a negative rapid test would indicate you are HIV-antibody negative so far. However, please note HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. Consequently, you'll need a repeat HIV-antibody test at three months from your last potential HIV exposure to obtain a conclusive test result.

Finally, the gum transplant would not affect HIV-antibody tests (ELISA, WB, rapid tests).

Thank you for your donation to the Robert James Frascino AIDS Foundation. It's warmly appreciated. In return, I'm sending you my good-luck/good-health karma that your definitive HIV test will continue to be negative. I'm quite confident it will.

Good luck. I'm here if you need me.

Dr. Bob



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