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Dr. Bob Please let me sleep tonight.
Sep 1, 2009

Dr. Bob, I think what you do on this website is really fantastic. If I didn't I wouldn't keep coming back to get your opinion. I will donate to your foundation if you tell me if I can woohoo tonight. Here is a brief recap of what happened. I received a blowjob from a dancer at a strip club. I used a condom which stayed intact. My groin started itching a couple of days later, I went to the doctor and was told I had jock itch, not an STD like I feared. However I was/am concerned that if the dancer was HIV+ could I contract the virus through the skin with jock itch if she had blood in her saliva. I went and got a Rapid Test at 11 weeks 6 days as I was going on vacation the next day couldn't wait the extra day. It came back negative. I thought I was done. The test was in January. I have anklosing spondilytis and I am taking Enbrel. I have been reading on the internet Enbrel can lengthen the window period of HIV detection. So my questions are 1) Was 11 weeks and 6 days close enough to the 12 week mark? 2) Can Enbrel lead to a false negative test or length the time it takes for HIV to appear on a test? 3) Do I need to go back and get a 6 month test or will I be wasting the doctor's time? Thanks for your help. I will send a donation as karma is a bitch. Mike

Response from Dr. Frascino

Hello Mike,

1. Would a negative HIV-antibody test at 11 weeks and 6 days be close enough to the 12-week mark to be considered definitive? Yes, without extenuating circumstances I would consider such a test to be conclusive.

2. Enbrel is a protein that blocks tumor necrosis factor. It is considered to be an immunosuppressive agent. There are no clinical studies that I am aware of that have specifically evaluated whether Enbrel affects the production of anti-HIV antibodies or alters the duration of the window period. From its mechanism of action, I would not anticipate Enbrel would have a significant affect. However, if there remains any doubt, an alternative test that does not rely on specific antibody production could be considered (qualitative PCR DNA or quantitative PCR RNA).

3. Mike, from your description of your potential HIV risk, I do not feel HIV testing is warranted, medically speaking. Regarding your activities at the Badda Bing, protective insertive oral sex carries essentially no HIV-transmission risk. Your jock itch would not affect the potential risk, assuming you hadn't scratched the itch to the point the skin was no longer intact. The chances your Stripping Sheila had blood in her saliva are remote at best. Finally, her HIV status is unknown. Adding all this together your HIV-acquisition risk is negligible and HIV testing would not be recommended. Can you WOO-HOO? Yes, I see no cause for concern.

Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Be well Mike. (I'm confident you are!)

Dr. Bob



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