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I'm a Hot Mess - part 2

Oct 27, 2008

Dearest Dr. Bob,

Well, unfortunately I'm back. I know that you are a very busy man and I truly apologize for bothering you. But if you could just take a moment to read this post I would be so very grateful.

I know that you told me that I was definitively HIV negative but Ive become obsessed with HIV 2 exposure. Why? Well because the person I was with often travels to South America (we both live near NY) and because of the sickness I developed 3 weeks from my last 5/19/09 encounter which included muscle aches for 2 days, fever 101.4 (1 night) and non itchy rash which disappeared by the next day.

As you know Ive tested numerous times since my last exposure on 5/19/08 with a condom for hiv1&2. Most recently, 8/21/08 (94 days after exposure) Labcorp. HIV-1 DNA PCR along with antibody test for HIV 1/0/2 NEGATIVE; 9/18/08,10/9/08 & 10/20/08 Oraquick Advance fingerprick NEGATIVE. I looked into a HIV-2 DNA PCR test but it is very expensive.

I want to truly believe my results and move with my life but unable to. I am concerned about my bodys ability to make anti-HIV antibodies if I was infected with HIV. If you would do me the honor of reviewing my May 08 blood work, I would be extremely thankful. Perhaps be viewing the following, youd be able to determine if I have a normal immune system and if I was infected I would make the anti-HIV antibodies.

Blood Chemistry Profile Glucose 71 Fructosamine - 1.8 Bun 14 Creatinine 0.8 Alk. Phos. 57 Bili Tot - 0.7 AST (SGOT) 12 ALT (SGPT) 11 GGT (GGTP) 22 TOT. Protein 7.3 Albumin 4.7 Globulin 2.6 Cholesterol 198 HDL Cholesterol 59 LDL (Calculated) - 123 CHOL/HDL CHOL Ratio 3.4 LDL/HDL Ratio 2.09 Triglycerides 79

Urinalysis Glucose Negative Protein 8 Leukocyte Screen Negative Hemoglobin Screen Negative Creatinine 85.3 Prot/Creatinine Ratio 0.09

Thank you so much and as always big cyber smooches!

P.S. I am seeing a therapist.

Response from Dr. Frascino


Your fears continue to be completely unwarranted. You state: "I know that you told me that I was definitively HIV negative . . . ." That is correct. And even with the new information, I have not changed my assessment. No additional HIV testing is warranted.

You correctly diagnosed your problem when you wrote: ". . . I've become obsessed with HIV-2." Your problem is the obsession, not the virus! You also state: "I want to truly believe my results and move (on) with my life but unable to." The evidence that you are HIV negative is overwhelming and irrefutable. How you choose to live with that reality is up to you. My strong advice is to continue working closely with your therapist. HIV is not your problem, but you do indeed have a problem! It's psychological, not virologic!

I'll reprint your original post below. My assessment and advice remain completely unchanged.

Dr. Bob

I'm a HOT Mess Sep 20, 2008

First of all, Id just like to say that you are ABSOLUTELY GORGEOUS!!! WHAT A SMILE!!! Your partner is lucky and Im sure that he cant stop smooching you!!!! Youre just too cute!!!! And also, INTELLIGENT!! WOW!!! He sure lucked out!!!! Well, both of you did!!!

That being said, as my title, Im a HOT MESS. I know that youre very busy and hope that you find the time and the patience to read my story. I am a woman and have been married for 15 yrs. and unfortunately, just recently had an affair. I had unprotected sex on 12/28/07 and 1/11/08 with ejaculation; 2/1/08 oral with ejaculation but I spit it out and rinsed mouth. Afterwards I felt strange and went to my OBGYN, I told him what happened and he ran a full std panel. That is when I found out I had HSV2 and have had it for many years...never had any sores/lesions. I have 2 children both delivered vaginally and thank God they are fine. BTW, my husband had a suspicion that he had it but never bothered to share that info. with me because he didnt think it was a big deal. He said, there are worst things out there. Which is true. Also,he is a wonderful man and father and if I had only seen this before I did what I did, I wouldnt be living this hell. The saying is true, Be careful what you wish for because you just might get it. Anyway, once I received this news I informed the man and he went and got tested. BTW he was tested for HIV 11/07 for insurance purposes...his last partner was in Aug.''07. Anyway, he went back and got checked for all stds including HIV and was negative; I never saw the paperwork but he went to the doc and called me in the car with his lab results. Unfortunately, I again had sex with him 5/19/08 but with a condom. BUT, 3 weeks later I came down with some illness, severe muscle aches and chills on one day at night and the following day I was better but the symptoms reoccurred at night but this time with a fever, 101.4. I awoke the next day and noticed that I had a rash on my arms on the inside and also on my inner thighs, top of knees and on the back of my calves. I freaked out and went to the doc. the same day. I didn't tell her anything about my history and she thought it was the 5th disease. She ran a CBC and also a test for the virus. The CBC was normal except it showed that I was battling some virus and I was neg. for the papovirus. Also, the rash was almost all gone by the next day. Well needlesstosay, I have had numerous HIV testing since March'08. I had an Elisa on 7/2/08, and Oraquick Advance fingerprick tests out to 8/18/08, which were all negative (91 days post exposure). On 8/21/08 (94 days), I decided to take the DNA PCR Test along with an antibody test for HIV 1, 2 & 0, which thank God was negative. Today, 9/18/08, I had another Oraquick Advance fingerprick test, which was negative. Even though the person I had the affair with said that he hasn't been with anyone but me since his last partner in Aug. '07, I really don't believe him. As you can tell, I am really frightened over this and truly want to believe my results but I keep reading about late seroconversion. My question is can I rely on these results or should I go for follow up testing at 6 mos. I am not an IV user and am not aware of having any immune disorders except for HSV2, which was at 3.5. Also, I just had my 2nd Hep B shot on 9/8/08. Any advice you can provide is greatly appreciated. Thanks for taking the time. And also, a lot of smooches!!!!! I just want to kiss your faceyouve got it all, looks, brains and a kissy face. Thank you for taking the time.

Response from Dr. Frascino


Are you sure you're ready to start playing kissy-face with another almost-stranger? Isn't that how you got into your "HOT MESS" in the first place?

Regarding that "HOT MESS," you can relax. Your multiple negative HIV tests and your undetectable DNA PCR out to four months from the time of your last potential exposure are definitive and conclusive. HIV is not your problem. No way. No how. (No John McCain. No Sarah "I can see Russia from my house" Palin!)

Do you have to worry about late seroconversion? No, absolutely not. (It's an extremely rare phenomenon and completely ruled out by your undetectable DNA PCR, which doesn't rely on anti-HIV antibodies.)

Your problem is guilt related to your indiscretion. My advice is that you level with your husband. It's the best way to confront your guilt and it's also the right thing to do. No further HIV testing is warranted. If you continue to perseverate on HIV, consider getting counseling to help you accept the truly wonderful news that you are definitively HIV negative.

Be well. Cyber smooches.

Dr. Bob

succinct, focused question (mutual masturbation risk)

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