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Need for 3rd Testing, Need some advise
Dec 19, 2009

Hi Dr. Bob! I am an Asian working here in Thailand! OK here is my story, I have 2 possible exposures dated May 12 and June 6 with a Sex Worker here at Thailand. The first one I might say is very intimate I have an oral sex with her (3 times) then have protected sex for about 20 minutes and cummed inside her with condom (the condom did not broke as I saw my semen when I removed it) second one is also protected sex but not so intimate, we had a lot of kissing but no oral sex. I even masturbate myself to cum. Here are the symptoms after the last possible exposures: 1. Scrotal Rash - 1 month after last exposure 2. Rash on chest, back and forehead (acne like) - 1 month after last exposure and still present until now 3. recurrent diarrhea 4. Lower left side abdominal pain - last week of october (i decided to went to doctor but doctor said no infection) 5. Weight Loss @ May-61 kgs Now - 58 kgs. 6. Sore Throat - Since Nov. 5 until now (Again I decided the doctor about this and they just gave me an antibiotic and injection) 7. both side of tongue is white (look like leukoplakia) and oral thrush - last month until now.

I took a rapid antibody test (MEIA) on 21st week after possible exposure and also at 24th week (here at Thailand) which came back negative. My questions is do I need further testing after my two rapid antibody test are negative.The doctor says I don't need any testing they say 3 months is enough to produce antibodies for testing but some websites says it will take up to 6 months so Im having confusion about this matter. Is 24 weeks after possible exposure a conclusive and woo hoo able even here in Thailand w/c maybe not using latest equipment for testing? Is MEIA an ELISA? I'm afraid that maybe they are not using the latest testing equipment here. Please give me some advise I'm too depressed now and even having many sleepless nights because of this. Looking for your kind advise. I promise I will donate on your foundation after this.

Regards, Stressful Guy

Response from Dr. Frascino

Hello Stressful Guy,

Your worries are unwarranted!

Your HIV risk was negligible. "Protected" sex is protected, assuming the latex condom is used properly and doesn't fail (break). "Symptoms" are not reliable in predicting who is or is not HIV infected. Your negative HIV-antibody tests out to 24 weeks (six months) are definitive, conclusive and WOO-HOO-able!

MEIA stands for Microplate Enzymatic Immunoassay. It's a type of ELISA. The HIV testing in Thailand is accurate. Your concerns that the equipment might not be up to date are unfounded.

HIV is not your problem. No way. No how. No additional HIV tests are warranted. I agree you are "too depressed." Your irrational fears of being HIV infected have caused anxiety and depression. Simply put, your problem isn't HIV, but rather "fear" of HIV. You now have overwhelming and irrefutable evidence that you are HIV negative. If, despite this and my reassurance, you remain worried, I would advise you seek counseling (psychotherapy) to help you confront and conquer your unwarranted worries.

Thank you for your desire to make a donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck/good-health karma.

Be well. Stay well. (Yes, you are indeed "well.") Happy Health Holidays.

Dr. Bob



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