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*Please Help! HIV, Seroconversion, Testing*
Oct 30, 2009

Hello Doctor, thank you for what you're doing not only through your organization, but also through this forum.

My question is this: about 7 weeks ago, I had several encounters with a guy I had only recently met. He assured me he was HIV negative and offered to show me his recent test results to prove it. However, with window periods and such, I'm still worried that exposure to HIV may have occurred.

Our sexual contact consisted of the following: french/deep kissing, unprotected oral sex, and rubbing the heads of each others penis' around the anus (without a condom) - he may have penetrated me minimally on one occasion.

I took a OraQuick Rapid HIV test at 6 weeks and it came back positive, however given the information above (and the controversy over 'window periods' being accurate at 6-8 weeks vs 12+) what would you say my risk is? Should I be worried (read: terrified, because that is more in line with what I'm feeling) or can I, given the hopefully no/low risk contact and negative HIV test, put the episode behind me and play safe in the future?

Regardless, of your answer, I do have plans to be tested again at 12 weeks just to cover my bases. I appreciate everything you do and I wish you nothing but happiness and well-being. I look forward to your response.

Sincerely,

Keith

Response from Dr. Frascino

Hello Keith,

I'll make several points:

1. Even if someone slapped a lie detector on their Mr. Happy, I would't believe their claim regarding their HIV status. Yes, the window period can confound HIV tests for three months. Also, 20% of HIV-positive Americans have absolutely no idea they are infected with the virus. Consequently, we must always assume our sexual partners could be HIV positive and take all the necessary precautions to prevent spread of the virus.

2. Kissing is not considered a significant HIV risk. Unprotected oral sex carries a very low risk. Anal penetration (even "minimally") carries a much higher risk.

3. You report your six-week OraQuick rapid test was "positive." I'm not sure if this was a typo or not. If it was "positive," please note this would be considered only "preliminarily positive" and a confirmatory Western Blot would be needed for the test to be considered a true positive. If the "positive" was a typo and you really tested negative, you'll still need a repeat test at the three-month mark, because HIV-antibody tests taken prior to three months are not considered definitive or conclusive.

4. I agree your overall HIV-acquisition risk is low.

Good luck. Be well.

Dr. Bob



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