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Things standing in my way
May 1, 2010

6 and a half months ago I had sex with an hiv positive person. I have tested negative today at 6 and a half months, but casting shadows on my happiness are differences of opinion between my doctors. The Infectious disease specialist I saw said after 6 months no chance of HIV. I don't have a family doctor so I was refereed to one an 80 year old British guy who told me he's happy he didn't learn medicine in North America and the CDC and Public health are both evil suppressing information about two people who became positive 11 years post contact and 13 years. He also mentioned people who took 11 month to a year he said I have to bell curve that and realize that it's just a matter of lady luck being on my side but science doesn't know a for sure time. I went back to the Infectious disease specialist who disagreed and told me I am now obsessing and need to go on a combination of pills, a therapist and a mild anti psychotic. Keep in mind this is me telling him the opinion of the british guy and asking for a PCR to rule out false negative in light of what the other doctor had said. I mean I feel like I'm stuck between a rock and a hard place. Is what the doctor saying about the one year post exposure and 11 years true, if so why did it happen like that in those cases and why has the CDC not lengthened the window period in that case. I have already come to the conclusion that my ID specialist is rude and arrogant I've seen him all of two times one for a baseline before pep test and another time to inform him for my subsequent tests and to relay what the other physician had said only to be told I'm obsessive (I mean what a prick he's only met me twice and I've been calm considering the circumstance).

I have been an avid reader of your blog in my difficult time and even though I can't physically see you I would appreciate your input.

1) Is my physician an idiot and should I leave him? or does he bring up valid points.

2) if above is true who much longer should I extend the window period?

3)are fourth generation rapid tests as accurate as Elisa's? Mine was 99.6 or something to that affect for accuracy.

4) if delayed serconversion has happened past 6 months in the medical literature what was wrong with those tests? or people or combination of both.

I was going to ask you if I will ever be happy again but I must admit that is beyond your control. Please give me good solid advice, I'm not one of those people who write scared out of their mind or saying they will commit suicide. I just want to know my status and all the good and bad that comes with it.

Grazie

R/heem

Response from Dr. Frascino

Hello R/heem,

I'm definitely siding with the infectious disease specialist on this one! Maybe not his bedside manner or his recommendation that you have one foot in the loony bin and the other on a banana peel, but as far as his assessment of your HIV status I concur 100%. HIV is not your problem. No way. No how. No additional HIV testing is warranted, including a PCR.

Your geriatric British guy may be happy he "didn't learn medicine in North America", but it seems like he didn't learn it any place else either. His comments and conspiracy theories about the CDC being "evil and suppressing information" are totally insane! You're not "caught between a rock and a hard place," but rather between a rock and a nut case! Fire grandpa and find a more competent primary care doctor!

Responding to your specific questions:

1. I think Dr.. Grandpa needs the shrink and antipsychotic drugs, not you!

2. The window period hans't changed in the past three decades.

3. Yes.

4. I've discussed the extremely rare occurrence of delayed seroconversion many times over the years. Check the archives. There is nothing new to report.

5. Will you ever be happy again? Yes, of course you will. I can feel your smile breaking through as you read this! You're definitively, conclusively, WOO-HOO-ably, and move-on-ably HIV negative!

Be well. Stay well.

Dr. Bob



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