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A classic tale from Indonesia.
Dec 11, 2009

Dear the honorable dr. Bob

To be honest, I have never even have the slightest thought that I'd be writing a question in this forum. But I did anyway. I did not want to bother you with this "classic" questions, but since this is Indonesia and all your "patients" asking you are in the USA (has modern labs and technologies), I feel that I have to ask you.

My name is Herman, and I have a friend who works as a volunteer down at the "Komuniti Peduli Aids" or KPA for short, and she told me about this forum to ask for a clear-of-mind because apparently she couldn't assure me enough.

To cut the "tale" short, here goes:

I had an unprotected oral sex with an Indonesian sex worker here in Jakarta, which then followed by a protected vaginal sex that ended up with a condom slippage as I withdrew my penis out after cumming inside her.

Then:

I took 3 tests after the exposure here in the most prominent lab facility (not government) called "PRODIA" and got back the results being "NEGATIVE" at 1 week, 1 month and 3 months exactly.

My questions are:

1) Being this is Jakarta, Indonesia (not high-tech or modern enough), and also because of the lab physician's advice to get tested at 6 month, and another say 1 year, should I re-test myself again?

2) In the USA (according to this forum and you), a 3 month test is CONCLUSIVE. BUT TO ME, is that the case when in Indonesia? Considering maybe Indonesia is a third-world country and may not have the best (4th generation test) and thus provide an in-accurate result? (I remembered them saying about using 2nd or 3rd generation test, which I am sure it must be the 2nd generation since it's Indonesia and thus won't have the best in modern technology)

3)Is my test at 3 months already enough (meaning including HIV-1 and HIV-2) and conclusive??

That would be just all dr. Bob. I don't know where else to turn to, and here in Jakarta it's very hard for me to discuss such matter since it seems like a taboo thing to talk about and people will not want to befriend with you anymore.

Would not it be from my friend, I won't even have the chance of "asking" or reading whatever it is in this forum, moreover to be able to "communicate" with you.

I really hope you can reply me and help me move on with my life.

I greatly appreciate it!

Herman K.

Response from Dr. Frascino

Hi Herman,

Actually, questions to this forum come in from around the globe and not just from the U.S.! Have a look in the archives!

Responding to your specific questions:

1. Generally speaking, a negative HIV-antibody test at the three-month mark is considered conclusive (barring extenuating circumstances). HIV-antibody tests taken prior to the three-month mark are not considered definitive.

2. The generation of the HIV-antibody test (2nd, 3rd, 4th) does not change the window period guidelines! The newer generation tests may be able to detect HIV infection a bit earlier than older generation tests, but that has no effect on the three-month guideline.

3. If you had a negative HIV-1 and HIV-2 test three months after your episode of unprotected oral sex and protected vaginal sex (with condom slippage) with an Indonesian sex worker of unknown HIV status, I would advise your negative test is conclusive (barring unusual extenuating circumstances).

It's unfortunate that HIV is still such a taboo subject in Jakarta!! That must change or we'll never defeat HIV/AIDS. My advice is that just as your friend talked to you and helped you find this Web site, I recommend you talk to others. There are AIDS service organizations in Jakarta that could use help in increasing HIV/AIDS awareness and prevention. Consider contacting them and working with others to lift the taboo!

Good luck!

Dr. Bob



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