Jan 14, 2010
Hi Dr. Bob,
I've been frequenting your site since the early 2000s (i was posting here when Dubya had the drums of war banging and liberalism was routinely mocked by members of the forum), and have come to see you as a voice of reason in difficult times. A few months ago, my psychiatrist passed away at the young age of 58. It was a shattering blow. Over the years, he was the one person I could turn to about my mental health issues and HIV fears, and his sudden death has really made me think about the fragility of life and the possibility of turning the corner and going to get tested.
I don't know why, but I stopped regular HIV testing five years ago. In that time, I have had 4 female sexual partners, and with each one I had sex with latex condoms everytime, no exceptions. I did not observe any breaks, but who knows right?
What worries me is an odd conglomeration of symptoms which are not that specific. If I don't wash my face with head and shoulders shampoo, I get seborrheic dermatitis in small patches on the sides of my nose and the scalp. My treatment keeps it at bay, but of course I worry about the connection. You have advised me before that it doesn't equal HIV by any stretch of the imagination, and that the 'vast majority of cases' have nothing to do with HIV.' But there's more. Over the past few years, about once a year, I get a 2 day episode of stomach virus or food poisoning. I wonder if my immune system is to blame, or if it is just normal as I eat out a lot. I had an episode of jock itch a few years ago too, but I wrote that off to sweat.
Other than this, I have not had other worrying symptoms.
I guess I am just seeking your advice and encouragement on testing. You are pretty much the only person I have left who understands my case history.
Do you think I'll come out of this ok? It is really just the seborrhea that worries me, but i have a close member of the family with a minor case of it which makes me think that there is a possibility it is genetic.
I know the right thing to do is to be tested just to know, but I am just concerned it won't go the way I hope it will.
To progressive liberalism and life, D
Response from Dr. Frascino
Sorry to hear about your shrink. Yes, life is indeed fragile. It also should not be wasted with needless worry. Your "worrying symptoms" in reality, are not worrisome at all for HIV disease!
You've had essentially no HIV risk exposure, assuming the latex condoms were used properly and did not break. (You would have noticed a break, because when a condom fails, it's generally not subtle. Mr. Happy's head comes poking out just like your head pokes out of a turtleneck sweater!)
Yes, of course you should get tested (see below). I'm absolutely confident you will test negative. You should also consider establishing care with another psychiatrist just to provide ongoing support against your irrational fears.
pregnant and affraid of HIV test (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Nov 30, 2009
I am a 38 year old mother of two, ages three and five. I am pregnant again and was thrown when my doctor sent me for an HIV test with my other routine blood work. I don't believe they tested me with my other pregnancy's. I started thinking of the unprotected sex I had in my late teens early twenties with more men than I would like to admit. I'm thinking oh my god what if I have had HIV all this time. Now I'm scared to find out and what about my other two children could they be infected too? I've been with my husband 9 years faithfully. Before that I dated and had sex with one man for a year and before him I was in a serious/faithful relationship for 8 years. I know the other two men are now married with children but I don't speak with them just friends of friends type thing. What are the chances of going 10 plus years symptom free? Would the children be showing signs symptoms by now? Thanks for any answers.
Response from Dr. Frascino
Your fears are unwarranted. It would be extremely unlikely that you are HIV infected. I'm also fairly certain you were HIV screened during your previous pregnancies. You (and all our readers) should not fear getting HIV tested. When it comes to HIV, it's what you don't know that can hurt you! (See below.)
Get tested and stop freaking out. You'll be glad you did.
benefits of knowing (pick me) (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Nov 15, 2009
In short I am afraid of perhaps being hiv positive. I was in a relationship for two years with someone and kind of left condoms out of the equation without testing. He didn't seem to be high risk having had a previous hiv test and 5 sexual partners with condoms as he has told me. The fucktard that I am now two years in to the relationship I'm very anxious of dying and having put myself in a bad situation. It seems like all men who have sex with men end up with hiv somehow. I don't know what to do I pray for god to help me, anyway I was sort of thinking to wait it out until one of us got sick before testing. I don't really want to know but part of me does because I want to obviously live longer and get treatment before aids. Is this fear normal or am I a special case I was so happy in my life before my hiv anxiety started to act up again. My last test was 2006 and all my sex had been protected no condom breaks I test the condom after with water. I do not give fellatio so the oral risk would be negligible for me as well as the anal since I was safer sex. As for the relationship I'm still not oral with my bf but I have topped him for two years essentially rubber free. Should I start using condoms now and not bother testing as the prospect of testing positive is frightening to me in my current mental state or shall we eventually test together.
Please Help Me although you must get tired of helping everyone being virally enhanced yourself with no one going out of their way to help you with your worries and fears. Maybe I have a fear of dying over all? because I'm 26 and relatively healthy I just wish I could bury my mum and live to middle age at least and be happy but life is full of awful things.
Why is HIV so prevalent in the gay community in developed countries? Is it every gay mans destiny to be positive it seems cruel as no one chooses to be gay. I want a cure for this already. Why don't they give us dead hiv vaccines like the flu shot? wont we be immune to that strain of hiv then?
sorry for my rant....please answer some of the important issues of the written diarrhea
Response from Dr. Frascino
In essence you're wondering about the "benefits of knowing." See below. I've addressed this issue recently.
Regarding a cure for HIV, we have an entire chapter devoted to that topic in the archives of this forum. I have nothing new to add since I last addressed that topic. Check it out!
Regarding your question "Should I start using condoms now and not bother testing as the prospect of testing positive is frightening to me in my current mental state or shall we eventually test together?", this is not an "either or" question! You absolutely should start using condoms immediately. (You knew that already didn't you? Of course you did!.) Also you should both get HIV tested without further delay. (Deep down you knew that as well, right?) Remember what you don't know can kill you! (See below.)
Fear and Shame..affraid to get tested (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Oct 22, 2009
I'm a hetero guy who is very ashamed as I made a big mistake. In a drunken state I let another guy perform unprotected oral on me. I don't know what I was thinking.It lasted all of a few seconds until I realized what was going on and I stopped it. I know this guy was Bi but I don't know his status. I've had some really strange symptoms since the incident that occurred back in August such as loose movements, occassional chills, persistent painful swollen glands in my neck and occassional night sweats but no fever. I'm sure I've got HIV. I'm affraid to get tested because it will be a confirmation of what I fear most. Then, I'll have to tell my girlfriend what I did and my family will find out. I will be stigmatized for the rest of my life. I have read alot about oral exposure being a low risk...but it is a real risk. I'm sure I am that one in 10,000 that contracted HIV throught oral contact. How else could you explain the symptoms? I was completely healthy before the encounter. Dr Bob. do you have any suggestions? This is really tearing me up.
Response from Dr. Frascino
Do I have any suggestions? Sure! Your HIV-acquisition risk is extremely low. I'd put it in the negligible category. Your statistics are off. The estimated per-act statistical risk for acquiring HIV from unprotected insertive oral sex with a partner confirmed to be HIV infected is 0.5 per 10,000 exposures. Your estimated statistical risk would be much less, as we do not know the HIV status of your bi-buddy and your exposure was incredibly brief. Your fears about being blown are themselves blown way out of proportion compared to the degree of real risk involved. This is due to the "fear and shame" component of your predicament. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. Your symptoms are not worrisome for HIV acute retroviral syndrome (ARS). I'm very confident you did not contract HIV from this event. At this point your problem is primarily irrational fear and anxiety. I'd suggest you seek treatment for that very real problem (anxiety/irrational fear). Counseling and/or anti-anxiety medication can help. Once you get a handle on that, you should get a single HIV-antibody test three months or longer from the date of potential exposure. As I stated, I'm very confident the result will be negative. In fact, I'd be willing to wager a bet on it!
Get the help you need to face your fears and then get tested. You'll be glad you did. Your WOO-HOO is waiting for you.
I'll repost below some information from the archives discussing why you should man up and get tested.
So anxious please help?? posted once before (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Oct 10, 2009
Hi Doctor. I can see you are really the person to ask about hiv you seem to know everything. Im very concerned as I was promiscuous at university. I gave several men blow jobs without knowing status. I did not allow any to ejaculate in mouth. I didnt notice any ulcers in my mouth but was often drunk. Does using deep throat increase risk to as I sometimes did. Anyway 2 years on now and im having horrible weight loss of 7 pounds and look very thin on my arms and face. Also extreme fatigue certain days as well as some burning tingles occasionally. Please help me? Im so scared that im positive and i don't know how to cope as I have a phobia of hiv anyway. the doctors have done cbc and many other test which have all been negative so im scared about hiv. what is your take? thank you so much for response
Response from Dr. Frascino
Oral sex carries only a very low risk for HIV transmission. Deep throating or playing tonsil hockey with a stiff stiffy would increase risk if such acts traumatized the mucosa or tonsils.
"Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. The only way to determine whether someone has acquired the virus after a potential exposure is to get an HIV-specific test. That said, your symptoms, two years out, are not consistent with or suggestive of HIV infection.
I agree you "have a phobia about HIV . . . ."
I suggest you man-up and do what needs to be done: get tested. You'll be glad you did. What you don't know about HIV can kill you. (See below.) The odds are astronomically in your favor that you did not contract HIV from your university sexperience. However, the only way to be certain is to get tested! I would also suggest you get counseling (psychotherapy) to help you confront and conquer your HIV phobia. These irrational fears can ruin not only your future sex life, but also general physical and psychological well-being.
Get tested. I'm confident your WOO-HOO is waiting for you.
Is it better not to know? ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Sep 16, 2009 The mind is powerful. When people think they are experiencing ARS a lot ot times it is attributed to their psyche. Would a person who is HIV positive but thinks he is negatve be better off not knowing since the stress of knowing could cause a host of illnesses by itself. I have tested 3 times. non reactive antibody at 32 days, non reactive antibody at 16 weeks 6 days and less than 50 copies RNA by PCR at 37 days post. Do I need further testing?
Response from Dr. Frascino
"Is it better not to know" you are HIV positive???? No, absolutely not. In fact what you don't know in that situation could kill you. Delayed HIV diagnosis is still the number one cause of HIV morbidity and premature HIV-related mortality. Knowledge is power! If you test and find out you are indeed "virally enhanced," you and your HIV specialist can better plan early treatment and intervention, improving your chances of slowing down the progress of HIV disease while protecting your immune system from begin silently decimated by the virus. If, on the other hand, you test negative, you will feel less anxious and be able to yell WOO-HOO! Also, by knowing your HIV status, you will better understand your risk of possibly infecting others. And clinical studies have shown those who know their HIV status are more likely to use precautions to protect their negative status or to prevent infecting others. Regardless of the HIV test results, testing tends to increase one's commitment to overall good health habits. Also, if someone is considering starting a family, knowing one's HIV status allows her to take advantage of treatments to dramatically decrease the risk of mother-to-child HIV transmission.
Now, let's have a practical example of what I discussed above, OK? You have tested HIV-antibody negative out to nearly 17 weeks and have an undetectable HIV plasma viral load by PCR RNA quantitative analysis (less than 50 copies) at day 37. Your test results are definitive and conclusive. You are HIV negative. Now are you glad you know your HIV status or not???? Sir, sir, could you please stop doing cartwheels and yelling WOO-de-frickin'-HOO long enough to answer my question? Sir, sir, thanks for the hug and kiss, but could you just put me down and answer the question??? Oh, never mind, I rest my case!
"What you dont know can kill you" and a further donation (WHAT YOU DONT KNOW CAN KILL YOU) Jul 18, 2009 Hi Dr Bob I wrote you last week to say that after over a year of feeling really ill following some risky sexual behaviour - Shingles,chronic fatigue, joint aches, gum disease, rash etc etc, and being 100% convinced I had HIV I still couldn`t bring myself to get tested due to being in total fear of being positive until discovering your site and hearing your words "What you don`t know can kill you" over and over again in my head, which finally gave me the kick up the ass to get myself tested(twice)for HIV, which were thankfully both negative. However my story doesnt end there. After I received the negative tests and could discount HIV I, this week saw a specialist for a full physical and blood work. Yesterday he called me back in to do some strange blood tests and gave me an injection of some sort. Today I saw him again and have been diagnosed with something called Addisons Disease, a quite rare auto immune disease which thankfully can be treated. Whilst I`m not suggesting that worried people who think they hav HIV symptoms will also have it or anything similar, in my case it was only once I had taken the test and received a negative result that I felt able to get professional help for my real symptoms(not the imaginary ones brought on by the stress of thinking I had HIV). I just started thinking how many people are out there convinced they have HIV when they havn`t, and are not getting the peace of mind a negative result brings or who are not receiving treatment for other(real)illnesses. The specialist doc told me that undiagnosed, Addisons can be fatal but treatable now diagnosed. So Dr Bob in my case without your site and in particular your powerfull phrase "what you dont know can kill you" convincing me to get tested it could so easy have come much quicker than I thought and not because of HIV! I cant honestly thank you enough or tell you what a great job you all do and how powerful the advice given is. I will be making a further donation to express my sincere gratitude and hope that you convince many many more that if theres any risk or doubt, getting tested is really the ONLY course of action.
Response from Dr. Frascino
Thank you for your kind comments, for taking the time to write back and for sharing your experience with the readers of this forum. Hopefully your true-life testimonial of "what you don't know about HIV can kill you" will give many others a swift kick in the ass so they too will get tested.
The three primary reasons to get tested are:
1. If you are HIV infected you need monitoring and treatment. Otherwise HIV will kill you. Plus you may unknowingly transmit the illness to others.
2. If you are HIV negative, you'll be able to put your fears and anxieties to rest.
3. If you have another illness (Addison's, psychosomatic disease, Lyme's disease, etc.), you'll be able to get the treatment you need.
Thank you for your donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). They are urgently needed and warmly appreciated. Your one gift will touch many lives.
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