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young and blue in the city III
Dec 10, 2009

Hi Dr. Bob I wrote you a few times earlier this year with a similar title: Young and blue in the city. http://www.thebody.com/Forums/AIDS/SafeSex/Archive/disclosure/Q204696.html

I just wanted to update you and let you know that i got tested at 6 weeks and although i know this is not yet conclusive i wanted to get this done so i can have a little comfort. I do realize that it's not yet conclusive and will test at 3 months too.

Also just wanted to say thank you very much for all your efforts. And I really thank you taking the time to walk with me a little (if you will). I donated this morning (Ref number: EPCE4CA11F96) and continue to wish you all the best. You are appreciated.

Response from Dr. Frascino

Hello Young and Blue in the City,

Welcome back to the forum and thanks for the update. Your negative six-week test is extremely encouraging. The vast, vast, vast majority of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks following primary HIV infection. Consequently, your odds of being conclusively HIV negative at your definitive three-month test are now astronomically in your favor. (You can begin practicing your WOO-HOO! But don't let it out quite yet!)

Thanks also for your tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly welcomed during this holiday season when so many folks are desperately struggling with the challenges of living with HIV/AIDS.

It's a privilege and pleasure to walk with you . . . . Hey, let's skip and strut for a while and then cha-cha-cha across the three-month finish (WOO-HOO) line, OK?

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

Dr. Bob

young and blue in the city II Oct 25, 2009

Hi Dr. Bob.

I wrote you earlier about fears of my bed buddy being positive. Today i convinced him to go with me to get tested and he was indeed positive. Ironically he was not too phased by it. I sorta think he already knew. He thanked me for getting him to go out and get tested but now i don't know how to feel. I did have sex with him on two occasions last week without protection. And it seems he was newly infected because in May (his last test) he said he was negative. It's too late for me to try PEP because the last encouter was 4 days ago. I just don't have any feeling right now. I just literally feel like a zombie going with the wind/flow. is there anything i can do. I read through all your similar articles today. He told me to get tested in 30 days and that he's sorry he initiated the contact but understand its not a death sentence.... I make a careless mistake in the end and kinda just wanna hibernate for a bit. Should i at least try PEP? Thank you very much for any advice.

Response from Dr. Frascino

Hello Young and Blue in the City,

It appears your suspicions about your barebacking Internet-guy were indeed unfortunately true. That he "was not too phased" by testing HIV positive does indeed strongly suggest he already knew he was positively charged! This, of course, makes him even more of a duplicitous scumbag.

It is also true that you made a careless mistake and now must face the consequences of your lapse in judgment. PEP is no longer warranted or recommended, as you are well beyond the 72-hour cutoff for PEP efficacy. Your only option at this point is to wait and get HIV tested at both the three- and six-month marks. Often, a negative three-month test could be considered conclusive; however, the CDC recommends a six-month follow-up test in cases where there has been a significant documented exposure to HIV. This would now include you. Despite the fact that your disingenuous buddy is now confirmed (or reconfirmed) HIV positive and that you broke Dr. Bob's two cardinal rules (see below), do not feel that it is a forgone conclusion that you are now HIV infected. In fact the statistical odds still argue against your being HIV positive. The CDC's estimated per-act statistical risk for acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV positive is 6.5 per 10,000 exposures. Rather than hibernate for the net six months waiting for your test results, I suggest you use the time to learn more about HIV and HIV prevention. This Web site with its extensive archives is an excellent resource. Spend some time perusing the information.

Good luck. I'm here if you need me, OK?

Dr. Bob

young and blue in the city Oct 21, 2009

Dear Dr. Bob,

I'm from a very small town and have moved to the big city in hopes of a better gay life. I've been here for 4 years and things are so tough. I recently logged online and met a guy 15 years older than me that appeared to be very mature, honest and concerned about his health. we had sex on 4 occasions; the first two times protected and the second two times unprotected. I never saw any blood on my penis or the condom afterwards. I was the top on all occasions. This gentlemen informed that he was negative from the beginning and as we begin to talk more and more it appeared to me that he didn't really know his status. I asked him to come with me to get tested and he refused and said he need to go alone first and then he could go with me. This really has me freaked out and i realize i made a stupid mistake by sleeping with him without a condom. He told me that im worrying too much and that my behavior is typical of those being an only child. He told me i was trying to rationalize my feelings and fears too much. Does this make any sense to you? I'm afraid! i'm scared! shouldn't i be?? Is there some sort of cure for HIV that i have missed out on? I was thinking of going to get tested ASAP, will this do me any good? Should i just stop having sex altogether for a while? Please respond, please. (i'm just so anxious and can't sleep)

Response from Dr. Frascino

Hello Young and Blue in the City,

You unfortunately broke Dr. Bob's two cardinal rules:

We must consider all our sex partners could be HIV infected and take all necessary precautions to prevent transmission of the virus.

Always remember rule #1.

There can be no denying that unprotected sex places you at some degree of risk for STDs, including HIV.

If your "old, mature, honest, concerned-about-his-health" dude decides to get tested and is indeed negative, your risk of being infected would be very significantly decreased to the remote possibility that he is within his "window period." The window period is generally defined as the first three months following primary HIV infection. During this time the infected person could still test HIV-antibody negative, because his immune response hasn't kicked in enough to produce detectable levels of anti-HIV antibodies in the blood.

I would not recommend you get HIV tested now, as HIV-antibody tests taken prior to the three-month mark are not considered definitive. Wait until three months (or longer) from the time of your last potential exposure to get a conclusive rest result.

As for your bed partner telling you that you are "trying to rationalize your feeling and fears too much," no, I have no idea what he's talking about. And no, it doesn't make any sense to me. That your Internet-guy had bareback sex and mislead you regarding his HIV status reveals he is anything but "honest, mature, or concerned about his health!" I suggest you dump this loser! Spend some time reviewing the wealth of information on this site and in the archives. You should find it enlightening and encouraging. Also, rest assured your Mr. Right is indeed out there somewhere waiting for you to find him and your very own happily-ever-after!

Good luck.

Dr. Bob



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