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Advice on past tests and recommendation for more
Feb 10, 2010

Hello Dr. Frascino,

You were kind enough to respond to my post dated Nov. 23, 2009 with respect to an encounter I had with a woman of unknown HIV status in which we briefly performed unprotected oral sex on each other, engaged in deep kissing, and I also fingered her front and back doors (as you put it). The woman also stole my wallet while my pants were down and I wasnt paying attention. Today marks just over 17 weeks since the incident and the following has occurred:

1. Tested negative for HIV at 4.5 wks, 9 wks, 11.5 wks, and was tested last week at 16.5 wks (or 116 days). All negative results. 2. At the 11.5 week mark, gave blood for Syphilis, HSV 1 and 2 and also gave urine and throat swabs for Gonorrhea and Chlamydia. All negative results. 3. Tested for Hep B sAg and Hep C Ab at 16.5 weeks. Apparently negative.

The general practitioner who ordered the 16.5 week HIV test and Hepatitis test was not the same doc I had seen for the other tests (apparently the first doc did not have his contract renewed at the practice). This other doc at the practice said I was wasting my time and that my insurance may decline payment and that I needed to wait for at least 6 months after exposure so that enough antibodies were present in my blood to be detected. I practically had to beg her for the tests. In fact, I originally also wanted to ask her to be tested for some other things such as Hep A, CMV, EBV, as well as a PPD skin test for TB (recommended by a military friend). It was such an effort to get her to sign off on HIV and Hepatitis B and C, that I didnt even mention the other stuff. In fact, her office just called me to give me my results and the woman said that the doctor had made a "note" on the lab slip saying that the tests I took last week should be done in May.

My questions are as follows:

1. I dont intend to visit that doctors office again. Would you recommend that I find an Infectious Disease specialist and have a one time visit at the 6 month mark to retest for HIV, Hep B and C, as well ask to be tested for the other things I have mentioned above? Would 6 months be an appropriate test time for Hepatitis? 2. The lab that has been performing my tests is Quest. The HIV test that has been performed is called HIV Antibody, HIV , EIA, with Reflexes (which also screens for Group O). The test info from the labs website says that If the HIV-1/HIV-2 EIA Antibody screen is reactive, HIV-1 Antibody WB will be performed. If the HIV-1 Antibody, WB is negative or indeterminate, HIV-2 EIA will be performed at additional charge. If the HIV-2 Antibody EIA is reactive, HIV-2 Antibody WB will be performed at an additional charge. Should I take this description to mean that the lab doesnt test for the HIV-2 antibody at all unless the HIV-1 Antibody WB is negative or indeterminate? Should I ask for a separate HIV-2 Antibody EIA?

I readily admit that all of these tests may seem excessive, but since I have never been quite that concerned about my sexual health prior to this incident, I have had quite a scare put into me since the woman did steal my wallet and I do live near a Naval Station (God only knows what those sailors and marines bring back from deployment) and if this woman is a working girl, well, I think I have both an obligation and a right to know exactly what I have and dont have. Also, I shouldnt have to beg a doctor in order to gain that knowledge, especially since I have had too many physical and mental symptoms to just ignore this. Something does not feel right with my body, I want to get to the bottom of it.

I would greatly appreciate any professional advice you can give on this as I am tired of looking and feeling like crap. I just want to move on with my life with whatever knowledge I can get.

Thank you for your time and another donation is on the way. Best wishes.

Response from Dr. Frascino

Hi,

1. I would consider your repeatedly negative tests out to 16.5 weeks definitive. And infectious disease specialist is not needed. You are HIV negative. The three-month window is also adequate for hepatitis screening. The other tests you mentioned are not necessary based on the information provided.

2. No, an HIV-1/HIV-2 EIA screens for both viral strains. The other phraseology just delineates how the follow-up or confirmatory tests are performed.

Your current problem is anxiety and fear of being infected. It's time you stopped worrying and started WOO-HOO-ing, OK?

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

Be well.

Dr. Bob



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