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CAN I CALL IT QUITS?
Jun 8, 2010

Dr. Bob, If you could please answer the following question I would be VERY VERY grateful. I have had numerous episodes of encounters with asian massage parlors. During my visits there nothing was done more than a handjob and them giving me a prostrate massage(digital insertion of their finger into my anus), although be it without protection. My last episode was end of September 2009. Since then I have had wierd symptoms (sore throat six months, wierd smell/odor, lots of muscle twitches, and most recently more floaters. I think what I have is a fungal infection, but noone has been able to diagnose. I have had two ENT look at, had upper GI done, CT of sinus, chest x-ray, and mri of brain. All within normal limits. I have tested NUMEROUS times by EIA with Quest through online testing(14,17,19,22,26,34 weeks), by ICMA labcorp (13,24,28,31 weeks), PCR proviral DNA HIV-1 at (6,31 weeks) and numerous Oraquick rapid fingerprick in between as well(latest at 30 weeks). 1)How likely is it that I could have a strain that is NOT DETECTABLE by all of this testing? 2)Being that I was with an Asian girl, does that make any difference in the test results/validity secondary to different strains/CRF's from that area of the world? 3) I have been told that fingering is not a risk, but might it be if she possibly had a bleeding cut/cuticle? 4) How confident can I feel in these tests since they were ordered online but drawn at national labs? 5)Also, previously at 7 weeks post exposure I ordered myself a CD4/CD8 panel and CD4 was 697 and CD8 was 337. The ratio was 2.07 and CD4 % was 49.8% and CD8 % was 24.1%. Does the CD4/CD8 concern you at all? I want to make sure that I can resume normal sexual relations with wife without worrying. If you could PLEASE and answer, I would appreciate it and make sure to donate to your cause. Thank you for your time.

Response from Dr. Frascino

Hello,

You've had:

1. Six negative EIA tests out to 34 weeks.

2. Four negative ICMA tests out to 31 weeks.

3. Two undetectable qualitative HIV PCR DNA tests out to 31 weeks.

4. "Numerous" negative OraQuick rapid tests out to 30 weeks.

5. A completely normal CD4/CD8 panel at seven weeks.

WOWZA! That's quite impressive! Exactly what part of "HIV negative" are you having difficulty comprehending?

The impetus for all this testing was numerous encounters with Asian massage parlors where, in addition to the usual rub-and-tug, you received "unprotected" digital "prostrate" massage. Hmm. Assuming your "prostrate" and "prostate" are located in approximately the same anatomical location, your HIV-acquisition risk would be essentially nonexistent. So you've had a nonexistent HIV exposure followed by a gazillion negative HIV tests! WOW, who would have guessed those results, eh?

You've also had "weird symptoms," including sore throat, weird smell/odor, muscle twitches and floaters, which you feel are related to a fungal infection. WHAT? These symptoms are not even suggestive of a fungal infection. Shockingly, "no one has been able to diagnose" your fungal infection! Care to take any guesses as to why that might be? Your million dollar (literally!) workup has included two ENT physician consultations, an upper GI, CT of the sinuses, chest x-ray and MRI of the brain. "All within normal limits!!!"

To briefly respond to your specific questions:

1. Not at all likely.

2. No.

3. There would have to be very significant active bleeding.

4. Extremely.

5. No, of course it doesn't concern me. It, like all your other tests, is completely normal!

The title of your post is "CAN I CALL IT QUITS?" That's an excellent question. Can you? There was no medical justification for any of your numerous (highly excessive) negative HIV tests. I also doubt there was clinical justification for the extensive radiology studies (MRI, CT, x-rays, upper GI, etc.). (I can only assume you are independently wealthy or have a very generous insurance policy to cover the truly astounding medical workup to date. You have now spent more money on this non-exposure than the combined gross national products of several African countries!) You should have called it quits long, long ago! My advice is simple:

1. Level with your wife if you haven't already done so. Many of your symptoms may be related to guilt or anxiety.

2. Consider getting counseling (psychotherapy) to help you confront your irrational fears of being HIV infected and you impressive urge to keep testing despite overwhelming evidence you are not infected.

3. Get an evaluation for psychosomatic disease. Your fears could be manifesting themselves as very real somatic complaints (physical symptoms).

4. Stop testing and perseverating on a disease you could not possibly have.

Thank you for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's very much appreciated.

Dr. Bob



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