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WIF equivocal test results
Mar 27, 2009

Doc i am back again; this time i am really stressed; if you remeber i had this unprotected encounter back in may 2006; have tested like 15 times post that till date all negative, last test being 13th dec 08. This year had a few sexual encounters post jan all protected but i went down on him unprotected on couple of ocassions; yesterday my feras started coming back so i went and got tested sure enuff the Elisa was equivocal when repeated with the same sample twice; now that got the scare back into me; the director at the lab is a friend and has drwn blood this morning for a proviral DNA PCR the results of which i am to receive tomorrow; what do you think are my chances? i am shitting BRICKS! spoke to the guy i had an encounter with back in MAY 06 (a pilot, migrated to a diff state in 06 itself) and he was upset that i keep asking him this one question more so now since hes married and expecting a baby; the guy i recently gave unprotected to is a dear friend and i have know him for a while; but u never know what your friends are up to all the time... do u?

just what should i do doc? you tell me? i am so scared, my lifes on hold untill tom. i am just hoping that this DNA PCR test is all clear; what do you think are my chances? should i get the friend tested as well; he will slap me but i know i can get him to do...

WIF

Response from Dr. Frascino

Hi WIF,

Welcome back. Sorry it's not just a social visit but rather another worry.

First, I must tell you that 15 HIV tests over the past two years are totally unwarranted and highly excessive. I'm not at all surprised one of your tests turned out to be equivocal! ELISA tests are screening tests and a small number of equivocal or even falsely positive test results are to be expected. Consequently if you test repeatedly without cause all you do is increase your risk of getting an equivocal or false-positive result! I strongly advise you (and all other worried wells) to follow the testing guidelines rather than repeatedly and excessively testing without appropriate indication to do so! Had you tested according to the guidelines, I strongly doubt you'd be stuck with your current conundrum! OK, I'll get off my soapbox now.

Next, if your screening ELISA was equivocal (or even reactive/positive), the next test to get would be a confirmatory Western Blot, not a qualitative HIV proviral DNA PCR. The DNA PCR can be helpful in sorting out unclear or indeterminate HIV-antibody test results, but if all you had was an ELISA, this would not apply to your case. For instance if you had an equivocal ELISA (or even a reactive/positive ELISA) with a negative follow-up confirmatory Western Blot, you would be considered HIV negative. The Western Blot is the more "specific" test!

Regarding your potential HIV-acquisition risk, protected sex is indeed protected, assuming the latex condom was used properly and did not fail (break). Unprotected receptive oral sex carries only a very low risk for HIV transmission/acquisition.

As for what you should do, since your DNA PCR results will be back tomorrow, if they are undetectable, as I strongly suspect will be the case, all you need to do is yell WOO-HOO. Your HIV-negative status would be reconfirmed. What you should have done was repeat your ELISA and if it was again equivocal or reactive/positive proceed on with a Western Blot.

Should you get your friend tested? No, I don't see any purpose in doing that at this point. This is your worry, not his.

Finally, you really need to get more control over your irrational HIV fears. They are causing you to test excessively and "shit bricks." They also have the capacity to totally screw up your social life and ruin any chance for a fulfilling sex life!

Good luck. I'll await your WOO-HOO.

Dr. Bob



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