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Death Wait
Jun 29, 2010

To begin, I must state that I would be considered high risk with my past sexual history. I am 24 year old heterosexual African American female. I became sexual active at an very early age. I previously had two STD's at two separate occasions when I was 15 and 20. I routinely get tested and I am not a sex worker or anything just very active. I do try to practice safe sex but I am not perfect. Recently, I returned from a military deployment in May 2009 and I tested negative. I have had unprotected sex about 10 times since that test. Only two of those times were outside my relationship with two other men on separate occasions (March 26 and April 16). I was tested May 14, 2010 and my results read positive Elisa and the Western blot test indeterminate. I am now freaking out because I knew the consequences yet I was still irresponsible. I immediately asked for another test. I was tested June 14, 2010 and today my doctor said the results was the same and I had no detectable viral load. I informed the doctor that I had a flu vaccine in Dec but I am now terrified my bad ways have caught up with me. I was told to come back in August then November for further testing. I am going crazy. I know my sex life was not the safest but I live a very successful active life. I am now having to wait six months before I can really understand if I am positive or not. I really just want to know what my odds are? I am a very logical person but this wait is turning my life upside down. Can you please help with any inside thought. Also, I am not pregnant.

Response from Dr. Frascino

Hello,

Your decision to have unsafe sex does place you at risk for STDs, including HIV. But it appears you already knew this: ". . . I knew the consequences yet I was still irresponsible." I certainly hope this entire anxiety-provoking experience serves as a wakeup call never to put yourself at risk again.

The sum of your HIV tests to date would indicate you are not infected. Your positive ELISA and indeterminate Western Blot (WB) on May 14 might suggest you were in the process of seroconverting to HIV positive. However, if that were the case, your follow-up test a month later would have been definitively positive (positive ELISA plus positive WB). Your follow-up tests were unchanged: positive ELISA plus indeterminate WB. In addition you had an undetectable quantitative HIV PCR RNA plasma viral load. Taken together these tests indicate you are HIV negative and probably have cross-reacting nonspecific antibodies in your blood that are confounding your HIV-antibody tests, resulting in the false-positive/indeterminate results.

It is worth noting your last potential risky exposure was April 16, 2010 and your most recent HIV tests were only two months later (June 14, 2010). My advice would be that you get retested at the three-month mark: mid-July 2010. If your ELISA/WB is still indeterminate, I would recommend you get a qualitative HIV PCR DNA test. If either the ELISA/WB is negative or the follow-up PCR DNA is undetectable, you can rest assured you are not HIV infected.

The odds at this point are all in your favor that you have not contracted the virus. However, I do advise you wake up and smell the AZT and stop having unsafe sex!

Good luck.

Dr. Bob



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