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I am 99% +ive (please read. also for donation)
Jun 18, 2010

Hi,

I am no different from guys who engage in unsafe sex, put themselves in a position of extreme high risk, and then fret over the signs and symptoms and then self-diagnose themselves. I am no different. I engaged in an unsafe sexual encounter with a positive bottom guy on May 16th, 2010, and then came home crying my heart out. I was the top and came inside the guy. I am not even sure if its worth mentioning here that this was only my second time barebacking (the first was several years ago with a negative guy and I have tested negative ever since) and I am a circumcised 29 yr old. I dont know what I was thinking and anything I can say will no justify it. I spend hours everyday cursing myself, surfing the internet for my chances, my risk, early signs and symptoms and that has destroyed my nerves completely.

Long story short, I realised my mistake and went on PEP medications ( Truvada and Kaletra for 28 days) 36 hours after the exposure. I finished my PEP course this last Sunday on June 13th, 2010. Didnt have many side effects, luckily but some diarrhoea here and there. My doctor performed baseline tests before the PEP and everything came out fine. 2 weeks into PEP and after exopsure, I ended up with a fever, which I dont know if it was due to some really intense exertion at the gym or dehydration, but it lasted 6 days and I am now convinced it was my early HIV symptom. I also had some aches and diarrhoea but did not notice any sore throat, swollen glands, or rash. I dont know what it was, but those 6 days, I lost 3 kgs and was on the verge of dying. I thought my life was coming to an end. I stopped eating, stopped going to the gym, lost focus on everything. I dont know how I managed to get myself to work in extreme fever, and took only a day off. I went to my doctor and he said he could do a viral load test but that would result negative as I was on PEP and yes it resulted in negative as expected. My questions are in the backdrop of this whole saga and I am really hopeful that you can be brutally honest and tell me what I must hear now, and what I must endure to prepare myself for the worst.

1. Now that my PEP course is over, when at the earliest should I take a test. My doctor tells me 4 weeks but he also tells me that if I want to calm my nerves, I could do one in just about 2 weeks and that would give me some comfort. It will not be conclusive but it will be indicative. I have also read somewhere on the internet that I can do an antibody test right away and that it would be pretty accurate right now. I am only on day 4 after my PEP medication finished, as I type this. How quickly does the effect of PEP wear off and I can have a reliable result? I cannot possibly wait any longer. The anxiety will surely destroy whatever is left of me.

2. I know it only takes one unsafe encounter to change your life and that being a top I know my risk is lesser than it would have been if I was the bottom, but I still have to ask this. Can I be so unlucky to get infected from a positive bottom after one encounter who tells me he is not even on meds. Is the HIV virus so easily transmissible from ONE unsafe encounter? What do the statistics say ?

3. The symptoms, I am told, are never a reliable indicator of your status, but yet, there is a wealth of information on the web that speaks to early HIV infection symptoms. I believe fever is experienced by most, but should I feel any comfort in not having swollen glands or a rash or a sore throat?

4. I have spent a lot of time on your website the last one month and appreciate the service youre doing to people. I would surely like to donate to your cause. I have noticed on many questions that you give out the details for receiving donations. Just want to confirm if they are still the same.

I would really appreciate a response from you.

WorriedINCanada

Response from Dr. Frascino

Hi Worried in Canada,

1. The recommendations for post-PEP HIV-antibody testing are six weeks, three months and six months from the date of exposure.

2. Could you acquire HIV from a single exposure? Yes, it is possible. The CDC's statistical per-act estimate for acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV infected is 6.5 per 10,000 exposures. However, please note each exposure has many variables that can affect transmission. These include viral factors (viral strain, viral load, etc.) and host factors (immune integrity, concurrent infections, local trauma, etc.).

3. "Symptoms" are notoriously unreliable in predicting who is and is not infected. Consequently you can't rely on them for comfort and shouldn't use them as a cause for excessive worry.

4. Donation information for The Robert James Frascino AIDS Foundation can be found on the foundation's Web site at www.concertedeffort.org. Thank you for your support. In return I'm sending you my good-luck/good-health karma that your definitive HIV tests remain negative.

Finally I should mention this is your "second time barebacking." I sincerely hope it will be your last!

Good luck! Be well!

Dr. Bob



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