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Curiosity Kills the Cat?
Feb 18, 2009

One month last year I tested negative. A few months later I tested positive. My ID doctor assures me I was diagnosed during seroconversion. He dates the infection to up to six weeks before I got sick and was seroconverting. I made a list of my partners. A few guys in that period. I had no risky sex, no ejaculate in my mouth, no anal sex without condoms. Obviously there was transmission however.

One partner claimed, the evening we spent together, to be HIV negative. Impotent, he used a syringe to get an erection.

A few months after I converted, I learned through the grapevine he is HIV+. I asked to meet him a few times, but he avoided me. Finally we spoke on the phone. He confirmed he is positive, on treatment, and undetectable.

I asked him when he went on treatment and didn't get a clear answer. He was casual and rather creepy in his lack of concern that I was wondering if he transmitted HIV to me. When I asked why he had lied about his HIV status, he said it didn't matter.

I live in place where the police will investigate criminal transmission of HIV. If he is treated, the medical records may show when he was identified positive and when he bagan treament. Before I might file a legal complaint, I will ask him to show me his medical records because he seems too stupid or too unconcerned or too immoral to accept responsibility for his lie. Whether or not he infected me, who is to know without scientific investigation?

But, as I said, this could be asked for where I live.

I have two questions for you 1) My ID does not want to discuss anything that has anything to do with a legal issue - no comment. He says the risk is small for this person as a suspect. Is the risk small for an injected penis and lots of oral, but no ejaculation, and no unsafe anal sex? It seems small to me, too.

But if it was him, I think he should learn better practices concerning his impotence injections, and also always be honest with a partner. You know, if he was untreated when we slept with each other, maybe he had a high viral load and that led to transmission, somehow.

If he was ignorant about the small risk, I guess I can't destroy his life with a legal process.

Second quetion, would you as a treating doctor give impotence injection prescription to an HIV+ man? What would be your safe sex counseling for that? Would it matter to you if the patient were on HAART or not, to prescribe that needle?

Thanks

Response from Dr. Frascino

Hello,

Sorry to hear about your recent diagnosis.

1. I too would agree your HIV-acquisition risk was extremely low.

2. Yes, I would treat erectile dysfunction in someone with HIV disease. Safer sex techniques and advice would be the same as for anyone else.

While I strongly agree everyone should be forthcoming regarding their HIV status, I even more strongly disagree with criminalizing HIV.

Dr. Bob



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