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"Heart Ruling Head" - Follow Up / Updates

Apr 10, 2009

Hi Dr Bob,

Please carry on reading! My previous post to you can be found at:

I have a bit of a follow up, and a couple of questions -

*My dodgy bowel movements turned out to be giardiasis. It was fairly mild, and only came on once a month for a couple of days or so. This lasted for over a year.

*Geographic tongue is now pretty much permanent (but variable day to day). I haven't had a break from this for over 6 months!

*Thrush: Culture on the reachable bits was negative, but everything is still there (white spots behind the big papillae). Trying to get a referral.

What I didn't mention was an episode of unprotected vaginal sex an additional year before this exposure.

So, questions:

*I'm really struggling and am at the end of my tether. Can I be sure I have ruled out HIV? It's like I'm living in a nightmare. Maybe with the previously undisclosed unprotected sex you will see things differently?

*I am scared the giardiasis & (possible) thrush may indicate a condition that could invalidate the results. What do you reckon?

*Would you offer the same advice if I were a gay male and had had unprotected anal, but having the same symptoms?!

I'm pretty sure I need counseling, but my mind can't be responsible for these symptoms!


Response from Dr. Frascino


Back again with the same concerns? Hmm . . . that's not a good sign as far as your accepting my initial assessment and advice. Let me emphatically state upfront that my assessment has not changed. (See below.)

Addressing your follow-up concerns:

1. "Can I be sure I have ruled out HIV?" Exactly what part of "HIV is not your problem" and ". . . you don't have HIV . . ." are you having difficulty understanding?

2. Giardiasis and/or thrush would not invalidate HIV test results. Your thrush, if that is indeed what you have, could be due to your Beconase nasal spray, which contains a topical steroid.

3. Yes, of course. Neither I nor HIV discriminates based on sexual orientation.

4. "I'm pretty sure I need counseling . . . ." Drop the "pretty sure" and I'll absolutely agree with you. I recommend you get psychiatric help and/or psychotherapy to help you confront your completely irrational and totally unwarranted fears of being HIV infected. Therapy will help you accept the truly wonderful news that you are HIV negative.

Good luck. Remember HIV is not your problem. But you do indeed have a problem that requires intervention.

Dr. Bob

Heart ruling head? All out of logic. Help! Aug 19, 2008

So I used to be a completely logical person. However, this is something I cant shake. To the facts:

Exposure "Semi-protected" vaginal sex, but with new scratches on penis (not sure if there was any blood I doubt it) that may not have been covered.

ARS Symptoms at 2 weeks Sore throat, ulcer on gum. Eyes ache.

Ongoing symptoms

*Skin patches that Derm could not diagnose. These come and go.


*Odd bowel movements (recurrent soft stools lasting a few days)

*Frequent colds

*Geographic tongue (started at 15 months post incident)

*Oral thrush First noticed at 1.5 months post exposure. On tongue only. Doctor wasnt sure that it was, said it was more likely a combination of coated & hairy tongue. However, it also extends behind the big papillae at the back of the tongue in smaller spots as far down as I can see. This has continued for 1.5 years. There is no soreness, redness or bleeding under the patches when cleaned. Hasnt got better or worse in this time. Doctor now thinks it IS thrush and has sent off a culture & my blood for more testing (CBC, Glucose, Liver function, Kidney function, Hep B/C & HIV). I have not taken any antibiotics for since at least 4 months prior to this exposure (so two years or so now), and only Beconaze nasal spray for allergies.

But I have already tested with the following results:

4 weeks DUO Negative 16 Weeks AB with Ag Negative 52 weeks DUO Negative 15 months AB with Ag Negative

So questions: 1)Is there any reason to suspect HIV (my GP seems to think so)? 2) If it is thrush, would it normally last this long without treatment? 3) Do I need an alternative form of testing? SOOOO many people seem to get DNA PCR / RNA tests are they needed in my situation? When would they be needed?

I know I have tested well outside any window period, but it all seems too much of a coincidence. Can you help? I am 27 and shouldnt be getting thrush!


Response from Dr. Frascino


I'll be brief, because HIV is not your problem!

1. No. You are definitively and conclusively HIV negative. You've tested HIV negative repeatedly out to 15 months after your potential "semi-protected" exposure. You just can't get any more negative than that!

2. I strongly doubt you have thrush. If you do, one thing is certain: it's not related to HIV! Why? Because you don't have HIV, remember????

3. Do you need alternate testing? No, of course not. You might consider getting an alternate doctor, if your current physician can't help you, or at least consider a second opinion on your "thrush" issue.

4. Can I help? Well, I can tell you with absolute certainty that HIV is not your problem. No way. No how. Does that help? I hope so.

Dr. Bob

Risks of unprotected anal sex (HIV TRANSMISSION BETWEEN TWO HIV NEGATIVES, 2009)

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