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Basic facts about Hiv
Oct 12, 2008

Hello doctors,

I would like to take issue with the overly cautious and often inaccurate info. you give regarding window periods etc.

I am sure that you are all professional so I know you are aware of some of the points listed below.

Your "cover my ass" mentality leads to a lot of unnessasary worry.

1. Window period: The average seroconversion time is about 3 weeks, with 90% of people producing detectable antibodies by week 4.

6 weeks is about 99% and 8 weeks is definative. ( this is the govt. window period used in Japan and well know by all immunologists.)

The above figures are for people with normally fuctioning immune systems, so if someone has a suppressed immune system due to transplant or other illness it could be the oft. quoted 3 months, but it's cruel to suggest that everyone should wait 3 months. Again, this is "cover your ass" mentality"

People can get tested at 4 - 5 weeks and be at least 90% sure of the result. Re- test at 8 weeks for gauranteed accuracy.

Anyone can check this figures up on up to date medical sites that have compiled stat. over years for other medical professionals, not medical "authorities" or politicians.

Also it is well know but politically incorrect to state that the vast majority of infections occur by being penetrated in the anus ( male or female ) that would be the person on the bottom.

For non anal sex the risk of infection is very very low compared to other STD's. Estimates for one time intercourse with an infected partner vary from 1 in 200 to 1 in 2000. Men tend to have a lower risk.

Of course this is a deadly disease so even those numbers are no excuse for risky behavior, but people have the right to medical facts not worse case scenarios.

Finally, I can't find any cases of people without complicating factors (almost everyone ) testing positive only after 8 weeks. There are always clear reasons on the rare occasion that this happens

Sure, be cautious, but present the facts accurately, not politically.

Thank you for taking the time to read this rather long message.

Best Wishes,

Andrew

Response from Dr. Frascino

Hello Andrew,

You'd like to take issue with the "overly cautious and often inaccurate info (I) give regarding window periods etc." Hmm . . . Andrew, I'd like to take issue with your taking issue! Yes, I am "all professional." That includes being a board-certified clinical immunologist, certified member of the Academy of HIV Medicine, and HIV physician specialist with over a quarter century of experience treating thousands of HIV patients and I'm also a person living with HIV. Now remind me again exactly what are your qualifications???

Regarding your "basic facts," your "8 weeks is definitive" comment depends on the generation of the assay used and does not take into consideration differences in host immune response. What "all immunologists" understand is immune variability and the limitations of the assays used to detect specific immune-response proteins, such as anti-HIV antibodies! My comments here are read throughout the cyber-universe and are based on sound scientific fact. I can assure you they have nothing to do with "covering my ass" or any other body part.

I do not recommend people test at four to five weeks per your suggestion. It is universally accepted that testing that early (even in Japan!) does not give a definitive or conclusive result. Hence, the test is a waste of time, effort and resources.

Next, your comment about it being "well known but politically incorrect to state that the vast majority of infections occur by being penetrated in the anus (male or female) . . ." is just plain wrong. This would be the case for MSM (men who have sex with men), as they obviously don't have vaginas. However, looking at the global epidemic, the "vast majority" of cases of HIV are actually transmitted by unprotected penile-vaginal sex.

Andrew, you may believe whatever you like; however, it will not change reality, scientific fact or my honest, direct and science-based responses given in this forum.

Dr. Bob



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