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Risk assesment ( HIV doesnt care how educated we are :(
Sep 7, 2009

Hi Dr Frascino,

You are truly an amazing guy. Im very pleased and reassured nowing there are clinical providors like yourself out there.

My question is in regard to a risk assesment and whether or not you feel a test is conclusive.

My partner of 6 years and I have recently had a few hardships in our relationship. Not to get too elaborate.. he is doing a NeuroSurg residency and I am in grad school. We currently live about 10 hours apart but prior to this lived together for 4 yrs. School and GME seperated us for this last year. I had a hard time and questioned lots of things.. got depressed Etc about not being together and began seeing another guy(s) the year we were apart. I had 2 high risk incidents where I bottomed for the guy. ... Trying to make this short.... through some behavioral therapy and a very understanding partner who loves me unconditionally... has made arrangments for us to work on our relationship... which is really all I wanted. Its going great.. he knows my exposure and is dealing with it himself...

My question is 2 part?

1) The last possible exposure of any kind I had was over 4 months ago. I tested at 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks , 12 weeks and now the last test on the 16 week mark.. or a little over 4 months. The guys I had previous sexcapades with our friends. I know them and have contact with them.. It wasnt a completely random hookup.. and they assure me they are negative to their knowledge and have said they would not lie about something like that.. even offering last testing dates. Can I consider a 4 month test under these circumstances conclusive?

Part 2) Without giving to much detail I wondered how to handle more communication with my partner. I feel like much of this wouldnt have happened if we could openly communicate more. He is closeted physician who has a hard time coming out because he thinks his colleagues will turn on him and make fun of him etc. (the feelings most gay guys go through i suppose) I dont want to force him to come out but he wont even consider getting an HIV test because he thinks if he were to test positive himslef he would never get a job and would be outcast by the medical society. Ughhhhh... I suppose alot of this frustration is why I ended up doing what I did ( Which is no justification but my therapist tried to help me process a bit) Anyways..... any advice would be beneficial.... I decided not to go into medicine myself because it has driven such a huge wedge in our relationship...

Thanks again for all you do. You are truly a light in a dark place.

-M-

Response from Dr. Frascino

Hi M,

1. Yes, I would consider your repeatedly negative HIV-antibody tests out to 16 weeks conclusive.

2. Communication is key in any relationship. I certainly understand your partner's fears, particularly considering he is still in his residency training program. However, in general closets are health hazards! And even if he isn't ready to come out, that shouldn't preclude him from getting HIV tested. He could, for instance, use the FDA-approved Home Access Express test. It's reliable and completely anonymous.

Even though you live apart now, perhaps you could arrange for some sessions of couples counseling when you are together on vacations. There is no doubt in my mind that you both have issues that need to be addressed in order to facilitate better communication.

Good luck.

Dr. Bob



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