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PLEASE, Please Help!! Jock Itch/HIV/repeat exposures related questions
Dec 19, 2009

Dear Dr. Frascino,

Thank you for offer us this great forum to resolve our confusions and assure our concerns.

I have had two regretful protected oral and vaginal sexes with two CSWs 21 weeks ago (in 2 consecutive days, and I wont do this any kind and any more in my rest of life after suffering in various anxieties) during my buddys bachelor party in Hong Kong. Personally, I have persistent jock itch at my groin and buttock for at least 10 years. I remembered 30 minutes or maybe one hour before intercourse with one CSW, I have a serious itch of my jock itch of my buttock. I scratched a lot and caused some bleeding. I wiped the blood with tissue couple times and then stopped scratching it. Since then, for the next couple weeks, I dont feel any presence of HIV related symptoms till now except some dry cough and headache due to smoking. I did a test of HIV (Doctor told me he used rapid HIV test, however, they only collected my bold sample and I wasnt there when they conducted the test), other STDs as well as whole body physical examination in a physician immediate care center in my city on week 17, all results turned out pretty good. In my deeply mind, after keeping browsing your website, I know I can let it go, however, I still anxious because I wasnt there while doc conducted the test) and keep testing with Abbot Rapid test on week 19 and 21, all negative. Now, I have several questions wanna consult with you not only assure myself but also educate myself. Please help me!

1)During the intercourse, I believed the virginal fluid flew on my groin area, where the jock itch at that area was a little bit itchy before the intercourse and might have some tiny scratches over there(overall I believe its intact because I didnt fell burn or hurt when I took a hot shower before sex). In this circumstance, can HIV transmit into my body through my groin jock itch area? Additionally, I believe I have a little bit virginal fluid (I wiped but not completely) on my finger and fingernail after fingering her, then, I felt itchy of my buttock due to sweat flew through the jock itch area (where was bleeding 30 mins before), then I scratched it lightly with my finger, am I putting myself in high risk of HIV infection? I did some researches in the matter, I saw I docs replied for a patient isIn general however, surface contamination of sores/wounds with blood is not likely to lead to transmission. Is he correct in this matter? Should I keep worrying about this kind of exposure?

2)I know the window period is 3 months as to most majority of people. However, due to my personal characteristic of easy nervous for everything, I did another two tests. The test on week 19 turned out negative; however, the one on week 21 made me a little bit worry. After rapid test, I check the test result frequently in the first one hour, a solid pink line was presence at C. However, after four hours while I ready to dump it, I rechecked the test again, I took out the cassette, I saw a pretty thin line (as compared to the line at C ) exactly located at T. I wonder is it the dried blood mark or a weaker positive result? PLEASE ADVISE ME.I also wonder HOW LONG after rapid test the test can be treated as invalid because the blood starts drying.

3)Last question, since you have been practicing in the profession of HIV/AIDS for last decades, is it any possible the result turns to positive after 3 months? Can my result be conclusive now (week 21)? I am a health male only have average one flu alike sick per a year for almost last couple years. I only have jock itch this problem. I can expect your answer, however, just wanna check for your professional advice again! I am going to marry to a beautiful lady next summer, so I wanna make sure about it not only protect her but also assure myself.

After this long story, I really appreciate your time! I would like to make my donation after holiday season. I already know how to donate my money to your foundation. I will post to you again once I am ready to make my donation. Again, Thank you very much, Dr.

Have a wonderful and health holiday!

Christopher

Response from Dr. Frascino

Hi Christopher,

Protected sex is indeed protected, assuming the latex (or polyurethane) condom was used properly and did not fail (break).

". . . Virginal fluid flew . . ."??? Hmm. "Virginal" fluid would mean your CSW was a virgin. That seems a bit incongruous! Also, fluid doesn't really fly; it usually drips or flows. So we'll just assume some "vaginal" fluid may have somehow made it to your itchy booty, OK?

Now on to your specific questions:

1. Assuming your CSW was HIV infected (which we certainly do not know to be true), there is essentially no significant HIV-transmission risk if the skin is intact. (Essentially no open sores or bleeding wounds.) Regarding your scratched butt, I would not be able to advise over the Internet if indeed you had damaged your skin enough to put you at some degree of risk. However, what's important to note is that even if you had open wounds, you did not contract HIV. Your negative tests are definitive and conclusive. (See question 2 and 3 below.)

2. Your repeatedly negative HIV tests out to week 21 are definitive and conclusive! Your 21-week test is negative. Results on rapid tests are to be read at 20 minutes, not 4 hours! Your fears are unwarranted! You are HIV negative. No ifs, ands or buts!

3. Rarely someone who tests HIV negative will seroconvert to HIV between three and six months. However, in situations such as yours, your repeatedly negative tests out to 21 weeks can be considered definitive and conclusive. HIV is not your problem. No way. No how.

Two other health-related issues I should comment about:

1. Jock itch! This is a very treatable condition. Why scratch yourself to the point of bleeding? I suggest you see a dermatologist and get this treated once and for all!

2. Smoking! This is a very serious health risk for you! I urge you to quit immediately. If you don't, cigarettes will kill you in a very painful and undignified fashion. I watched my brother die from cigarette-induced lung and brain cancer. At this point, cigarettes are a much more significant health risk for you than HIV!

Thanks for your willingness to make a donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Be well. Stay well. (You are indeed well.)

Happy Holidays!

Dr. Bob



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