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I'm back, ex-worry well relapse
Sep 24, 2009

Dr. Bob, thank you so much for your work. You make a difference. Don't stop, there is so much hate and misguided stigma that I think only education can help.

I have donated regularly to your foundation and will continue. I donate $100.00 each year on my anniversary of being a Worry Well. I plan to keep this up.

As the title says, Im an ex-ww that has had a relapse. I had unprotected oral sex (both gave and received with a female) and protective vaginal sex. The condom didnt break so I should be in the clear right? Well, I had played with her hot spot with my finger and got it wet. I put the condom on pinching the tip but it would not roll down. Stupidly, I turned it inside out and pinched the top and rolled it down. My concern has always been that I had vaginal fluids right on the tip of my penis the whole time of my mattress mambo. You told me little to no risk. I tested at 4, 8, 12, and 24 weeks. Even after year 1 and 2. This was four years ago. You told me to move on and get counseling and I did. At year 3, I felt like if I could get one more test from a different testing center and it was negative then I could move on. The counselor reluctantly agreed thinking I would move on without it. To my and his surprise it came back positive. The other test had been Orasure Oral (mouth swab) and ELISAs. This was a Uni-gold HIV1 rapid test so it wasnt conclusive and had to be retested at a doctors office with an ELISA/WB if ELISA was positive. I was only told it was negative. So I continue counseling but always a little doubt in my mind.

Hence this past December my wife (whom I have confessed and we worked through it) upped her Life Insurance policy which required a proof of insurability. She passed which help me as I thought after almost 4 years I would have passed it on to her if I were infected. 3 months ago, her female doctor said she was anemicran a few more test and told her to take iron supplements, which seem to fix the problem. Since then she has had a dry cough, sloughing gums (dentist diagnose), and rocesa on her cheeks.

Guess whatyep, I fell off the wagon. All the thoughts of me having HIV and now giving it to her.

Here are my questions: (1) was the Uni-gold test false-positive or did it detect a subtype that the Orasure and ELISA didnt/couldnt detect? (2) Wouldnt my wifes blood work for insurance be tested for HIV? Proof this is not related to HIV. (3) How rare is Type O (dont suspect HIV2 as some test were HIV1/2)? (4) Should I get a PCR/DNA to rule out all possibilities?

Again, thank you for your time and I look forward to your response.

Worry Well relapser

Response from Dr. Frascino

Hello Worried Well Relapser,

Welcome back to the forum!

I would't call this a full-fledged relapse. Rather, just a mild setback on your road to full recovery, OK?

Responding to your specific questions:

1. The reactive (positive) Uni-Gold test was indeed a false-positive as confirmed by the subsequent negative "ELISA/WB if ELISA was positive." Uni-Gold could not detect any subtype that the OraSure and ELISA would miss.

2. Yes, life insurance policy qualifications include testing negative for HIV. And yes, this is proof your wife's symptoms are not HIV related.

3. HIV-1 group O is extremely rare in the United States. Some HIV-antibody tests screen for group O. You have already ruled out "all possibilities." HIV PCR DNA testing is not recommended for routine HIV screening. Your HIV-acquisition risk (unprotected oral, protected vaginal) was extremely low and your multiple HIV-antibody tests are definitive, conclusive and WOO-HOO-able. HIV is not your problem. No way. No how. No further tests are warranted. Continue to work with your psychotherapist to confront and conquer your irrational and totally unwarranted fears of being HIV infected. It's worth pointing out that your current "setback" was the direct result of over-testing! Had you accepted the reality of your negative status years ago rather than continuing to test out to three years, you would not be in this conundrum! Yours should be a cautionary tale for all excessive testers who continue to doubt the overwhelming and irrefutable evidence they are HIV negative. Definitively HIV-negative folks who insist on getting unwarranted and excessive HIV-antibody tests will eventually get a "false positive" test. This, as you can see, leads to increased anxiety and the need for even more testing! My firm advice is to stick to the guidelines!!!

We have your spot in our X-Files (ex-worried wells) reserved and won't give it up. I'm confident you'll soon once again be a member in good standing! You and your wife are HIV negative. Period.

Be well!

Dr. Bob



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