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Sneaky Test After PEP
Oct 31, 2009

Right I'll be totally honest with you doc , 2 months ago I had a gay anal (insertive) encounter where the condom came off and we had unprotected sex for a few moments (I think!!!) the next day I discovered a tiny bit of red coloured damage to my penis head. 36 hours later and after convincing my GUM clinic they gave me pep, they advised against it but I insisted on them giving it to me by telling them I knew he was hiv pos when I didnt!! The situation was high risk (sauna) so I lied because I was that worried. Anyhow I took the course fully. When I finished the course the GUM clinic said to come back in two months (ie 3 months from the incident and then hopefully it will be all over). I felt like I couldnt wait this long so I went to another GUM clinic yesterday (1 month after finishing the course of PEP and two months after the incident) and just asked for a test but didnt tell them the circumsatnces I just said it was a hetrosexual incident 3 months ago to keep it simple!!). It came back negative!! BUT this hasnt made me feel any easier even though I thought it would. I will still go for my 3 month after incident test with my original clinic but here are my main questions:

1) Will the 3 month after incident test be conclusive? Ive read in places that you should have a test 3 months after pep finishes so that would make it 4 months. Which is right?

2) Can I draw any comfort off my 2 month 'sneaky' test?

3) Are different tests given for different circumstances? such as after a pep course will they use different methods to test and could my 2 month 'normal conditions' test be worthless? (ps I live in the UK, not sure of the tests they do!!).

I only did all this becuase Ive been so so scared for 2 months and I needed something to give me hope. Your probably gonna tell me off for all this carry on, I know, but some people just worry themselves sick and Im one!!!!

last question: How do I donate? You have helped me through a very lonely dark time doc with your help for others and im thankful!

C

Response from Dr. Frascino

Hello C,

It's true I am an "honesty is always the best policy" type of guy. Deceiving doctors or clinics often leads to less than optimal outcomes and sometimes can be downright disastrous. As you can see, despite your deception, you report ". . . This hasn't made me feel any easier even though I thought it would."

Turning now to your specific questions:

1. The recommendations for post-PEP HIV-antibody testing are six weeks, three months and six months from the date of exposure. (If PEP really wasn't warranted, you would have had a definitive result at the three-month mark; however, now you'll need to wait for the six-month test result, because you took PEP. I rest my case about "honesty!")

2. All negative HIV tests can be considered encouraging; however, as noted above, you'll need testing out to six months post-PEP.

3. No. The tests are the same.

4. Donation information for The Robert James Frascino AIDS Foundation can be found on the foundation's Web site at www.concertedeffort.org. In return I'm sending you my good-luck karma that your definitive post-PEP HIV-antibody tests remain negative. The odds are very much in your favor they will! Good luck.

Dr. Bob



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