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Help some students out please!
Jan 15, 2009

So I'm taking this sexuality class in college and we often project this site on the screen and read through your archives to answer some questions, as well as share a laugh with your adorably funny responses to some of these questions. Now my professor said that I will get extra credit if I could get this question answered. It was a question none of us could answer. Extra credit and extra knowledge!

Here's the question: Say a women gets an HIV test done in late August and it read NEGATIVE. She has had unprotected sex with her boyfriend after the test and now 5 months later she is experiencing abnormal periods and yeast infection. It is out of the time frame of ARS (WHICH WE UNDERSTAND IS 2-4 WEEKS AFTER EXPOSURE) So with ARS checked off the list, is this too soon for HIV to be affecting her body in this way? It is said that USUALLY symptoms of HIV will occur 8-10 years after having the virus. So is this not usually common. Would she rule out HIV?

Other question: If a man takes a rapid oraquick advance test and supposed to swab the gums, yet the counselor swabs gums, cheeks and tongue would this test be inaccurate? Considering that gums, tongue and cheek have same cells. The test read negative, is this accurate or would the test have read INVALID instead of NEGATIVE if the wrong specimin was collected?

We truly appreciate your time and look forward to reading our question on the screen in class...

we will donate! Where should we send our donations?

College kids in need! Plus you make our snooze class more exciting!!...sorry professor :( lol

Response from Dr. Frascino

Hi,

I'm truly flattered and a bit flabbergasted that my comments are being used for your college sexuality class, projected onto the big screen no less. Some colleges are afraid to even invite me to lecture due to fears that I might mention some taboo topic.

OK, regarding your extra credit, if you had really scoured the archives, you would have found answers to both of these questions, although it would have taken some digging. So, in the hopes that you'll get to graduate Suma "Cum" Laude in sex, I'll help you out.

Question #1:

There are several factors to consider here:

1. The unlikely possibility of a false-negative test in August.

2. The unprotected sex she had with her boyfriend could have resulted in STD/HIV transmission after the negative test in August.

3. The vast majority of yeast infections and problems with abnormal periods have nothing to do with HIV/AIDS.

4. You are correct: ARS resulting form any exposure prior to the negative test in August would not be the cause of symptoms five months later. So that can be eliminated from the differential diagnosis.

5. You are also correct that these types of symptoms related to chronic HIV infection would not be expected to occur after only five months. They usually would manifest themselves years later.

6. So finally to answer your question: "Would this rule out HIV?" The answer is a resounding no! And this could be considered somewhat of a trick question! The only thing that rules out HIV is a negative HIV test outside the window period. Our mystery gal has been doing the unsafe horizontal mattress mambo with her stud-puppy boyfriend since she had her last negative test and we know nothing about the boyfriend's HIV status or risk. Consequently we cannot "rule out HIV," whether or not she has any particular symptoms.

Question #2:

This one is a bit more straightforward. If the rapid OraQuick Advance test was collected improperly or did not contain adequate or appropriate oral fluid for testing, the result would have read "invalid." However, if indeed a counselor did swab gums, cheeks, tongue, tonsils, appendix and large colon, etc., I'd suggest the person return to the testing site and advise the specimen was not collected properly. This would do two things. First, it would allow the person being tested to request a repeat test using better technique to put any residual worries permanently to rest. Second, it would be a learning opportunity for the technician to review proper collection technique.

As for donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org), just click on the donate tab for all details. The foundation's address is:

The Robert James Frascino AIDS Foundation 1000 Fremont Ave., Suite 145 Los Altos, CA 94204

Now I'm counting on you doing extremely well in this course, OK? And no "snoozing" while my stuff is projected on the screen!

Dr. Bob



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