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RE: Scared. HIV - (so far)....
Oct 10, 2008

Hello Dr. Bob, I hope you are doing well. I had written you earlier in August with this subject line. Short summary - extensive oral sex (both ways) with prostitute in China, went on 3 month regimen of Atripla 4 days later, have tested negative (Elisa/WB 1/2) at 6 weeks, 4 months, and - just recently - 6 months. You graciously responded after my last post that the 4 month test was "woo-hoo" able so I guess I should feel even better with the negative 6 month test. I would love to get this behind me but I am finding it very difficult - I continue to have palpable lymph nodes in my armpits,, pectoral muscles, inguinal region and lower abdomen, as well as periodic stiff neck (though haven't felt any nodes there yet). In addition, I have periodic night sweats or chills and minor skin ailments. I just don't understand what could be causing these and am concerned that I am a late seroconverter due to the protracted atripla dosing at the beginning. Are there any studies on impact of Atripla on seroconversion? Also, what would you recommend from a testing standpoint to be even more definitive that I am negative? Is a DNA PCR definitive at this point? I am so tired of not feeling well and worrying. Any advice appreciated. And donation on the way - you are doing amazing work.

- Joe M.

Response from Dr. Frascino

Hello Joe M.

Your title sums up your situation extremely accurately: "Scared. HIV-". You are both HIV negative and scared! Your repeatedly negative HIV tests out to six months are definitive and conclusive. HIV is not your problem. No way. No how. (No McCain. No Sarah "I can see Russia from my house" Palin.) No further HIV testing is warranted or recommended.

I cannot diagnose the exact cause of your symptoms over the Internet. However, what I can do with certainty is advise you that HIV is not the cause! The Atripla you took would not delay your seroconversion. If your physician cannot determine a physical cause for your "not feeling well," you should consider psychosomatic illness. Psychosomatic disease causes real symptoms! I urge you to seek counseling to help you accept the truly wonderful news that you are unquestionably and irrefutably HIV negative. How you choose to live with that reality and whether you choose to WOO-HOO or continue to BOO-HOO is totally up to you.

Remember, HIV is not your problem; fear of HIV is!

Good luck.

Dr. Bob



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