What exactly is considered '3 months' and the world cup follow up
Aug 8, 2010
In regard to the questions below- is 3 months considered 12 weeks or 13 weeks?
Does it make that much difference if your tested at 11 weeks?
And finally, why do the UK guidelines say testing at 3 months is considered conclusive but CDC guidelines say 3 and then 6 months? Is this for everyone? Why do just Americans get 6 months advice to test?
I didnt have any PEP... so surely you would seroconvert by 11 weeks - my last test.
And if two people were infected- wouldnt at least one expect to seroconvert or is (delayed) seroconversion more down to the specific subtype/ strain than down to genetics?
I still havent had a repeat test - quite scared! HELP...
Developed additional lymphadenopathy in neck (two small nodes on one side) and then got swollen lymphnodes in groin also - both sides- enlarged quickly and then went down in 2 days, but still feelable after 4-5 days - no doubt this all doesnt happen for no reason?!
Can sercoconversion happen at 16-20 weeks?
Surely P24 always has to be detected before 12 weeks mark anyway?
If your getting ANY symptoms - doesnt that mean you have to have seroconverted at or shortly after that time?
Can you convince me to test?
Realistically, what are the chances that these tests were wrong before 12 weeks (at 11 weeks).
PS. you were wrong about Brazil but right about Spain - so I'll double the donation!
Just a quickie - can you help us to enjoy the world cup? Jun 25, 2010 Dear Bobinino (that is if you were a brazilian soccer player),
Just a quickie.
Me and my partner are very worried and just wanna to enjoy the world cup.
One of us was exposed to HIV via heterosexual contact about 13 weeks ago and since had intercourse (unportected). Weve had the following tests:
Me - PCR RT Viral Load at about 4-5 weeks (Undetected), DUO test at 6 and 10weeks (Neg). Rapid test (negative) at 11 weeks.
Partner - DUo test at 5 weeks and 10 weeks (both negative).
Weve both been ill and had various things gowrong probably due to stress in the meantime. My partner had flu & pharyngiotis and I had chest infection, rash, oral candida and enlarged lymph nodes (confirmed by a doc). My blood results showed a dip in the lymphocyte count but now its nearly ok.
Can we stop worrying? Do we need to test anymore?
Theres too much online to know what is right or wrong...?
By the way, who do you think will win the world cup?
If your right, Ill make a double donation to your foundation.
Response from Dr. Frascino
The gold standard for HIV diagnostic tests remains an HIV-antibody test at the three-month mark. The negative tests you and your partner have to date, including your negative rapid test at 11 weeks and an undetectable quantitative HIV PCR RNA viral load, are extremely encouraging. The vast majority of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks following HIV primary infection. That said, you have not had a negative three-month HIV antibody test yet and most viral load tests are not FDA approved for diagnostic purposes. My advice would be to stop worrying and enjoy the World Cup games. The person who had the HIV exposure should get one additional HIV-antibody test (rapid test, ELISA, EIA, Duo, etc.) at the three-month mark. I'm quite confident the result will once again be negative.
As for who will win the World Cup, both Brazil and Spain look good to me. I guess I'll root for Brazil because I like the Bobinino name!
Response from Dr. Frascino
Different folks calculate "3 months" differently. For instance for some 3 months x 30 days per month = 90 days while for other 12 weeks x 7 days per week = 84 days. It really doesn't matter. The immune system is not a clock or a calendar. What we know scientifically is that the vast majority of HIV-infected people will have detectable levels of anti-HIV antibody in their blood within four to six weeks following HIV primary infection. However, some folks may take a bit longer for their immune system to adequately kick into gear. Hence the "3 month" guideline is designed to make sure we don't miss those folks. As for 11 weeks, that is not considered three months by any calculation, including "fuzzy math." Certainly it's well beyond the four-to-six-weeks mark, but would not be considered three months.
As for the difference between various sets of guidelines, it's difficult to explain. No one wants to miss a case of HIV by advising someone he is HIV negative when in reality he is still in his window period. The window period has tended to get somewhat shorter as newer, more sophisticated HIV testing methods have come online. (See below.)
Delayed seroconversion has nothing to do with subtypes.
What's all this nonsense about being too scared to get retested? Come on Stevie, time to man-up, grow a pair and just go do it. You'll be glad you did. See the post below discussing "what you don't know can kill you."
Swollen glands are an extremely common occurrence and are certainly not only related to HIV. What you described is not at all worrisome for or even suggestive of HIV.
It would be very extremely unlikely to experience HIV seroconversion at 16-20 weeks.
P24 is generally detected well before the 12-week mark. However, p24 alone, either negative or positive, is not diagnostic.
Symptoms are unreliable in predicting who is and is not HIV infected.
As for can I convince you to test, I don't know. Can I? The decision is totally up to you. I do, however, suggest you carefully read the information below.
Tests taken prior to the three-month mark are not considered definitive or conclusive; therefore, there are no "chances" or "odds" I can provide.
Thanks for the double donation! In return I'm sending my good-luck karma that your definitive HIV test remains negative.
Be well. (I'm very confident you are indeed well!)
if Dr. Bob was French... ? (SIX WEEKS VERSUS THREE MONTH HIV TESTS) Feb 10, 2009
suppose for a minute you were French - or just being in doctor in France. The authorities there consider an Antibody/Antigen test conclusive at 6 weeks. (For standard Ab tests, they say 3 months, like CDC). Ok. Now, someone asks you in this forum, is a 6-week Ab/Ag test conclusive? Do you still reply that only a 3-month test is conclusive?
(My exposure: wild making out with another guy - but no penetration of any kind (neither oral nor anal). We did however deep kissed and tight embracing while naked, in the possible presence of cuts on our bodies. Got an 8-week negative Ab/Ag test).
Would French Dr.Bob advise me to retest? What about the real Dr.Bob?!
Thank you. You're an awesome person.
Response from Dr. Frascino
Bonjour Monsieur Dan!
Je parle la langue de Molière. Alors, peut-être je suis français !!!??
My job as "Dr. Bob," whether French, Italian or Zimbabwean, is to provide science-based factual information. I'm really not here to criticize or support one set of guidelines versus another. Also, guidelines are only that: "guide"-lines. They are not absolutes. For instance, if someone decides to calculate three months as 90 days (3 months x 30 days) rather than 84 days (7 days x 12 weeks), does that make his method more accurate or definitive than the other? And of course if someone is comfortable with an 84-day test result, what about a negative test at 83 days? If I were to say 83 days is fine, then someone would write in immediately and ask about 82.5 days, etc., etc., etc.
That was a longwinded introduction to a specific answer to your question. I don't make the guidelines and I have no reason to criticize the French guidelines. Obviously those who devised and approved these guidelines have sufficient data using their specific type of combination HIV-antibody plus HIV p24 antigen tests to support their recommendations. One of the reasons I cannot/do not generalize this recommendation is that all the eyeballs currently reading this response do not reside in France. HIV testing is not exactly the same worldwide. The availability of different generations of HIV tests varies considerably from place to place. So if you and I were both in Paris, I would advise if the French guidelines suggest a six-week "test" is conclusive, then a six-week test is conclusive; however, I would also advise many other published guidelines recommend a three month test for a definitive result. I would then review the level of HIV risk and make a recommendation for the specific situation. The patient, of course, always has the option to retest at three months or six months (old guidelines), if he so desires. That said, if you showed up in my office in Paris, San Francisco or Zimbabwe with a risk of "wild making out with another guy but with no penetration of any kind . . ." I would advise "A l'aise Blaise," (in Paris) "Relax Max" (in San Francisco) or "whatever relax is in Ndebele, the language of Zimbabwe" (in Chitungwiza), your HIV risk is nonexistent and HIV testing of any type is not warranted medically. The only reason to consider testing is a psychological one: to put your unwarranted HIV fears permanently to rest.
Hope that helps.
This One's A Doozy (WHAT YOU DONT KNOW CAN KILL YOU, 2010) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010) Jun 16, 2010
Of all of the inquiries posted in this forum over the years, this one may well take the cake. But since, at this point, I really don't know where else to turn for help, please hear me out:
Back in the spring of 1996, I engaged in prolonged, unprotected cunnilingus on three separate occasions with a woman whom I later discovered was definitely HIV+ (she showed me her printed test results). We did not have intercourse, only the oral-vaginal contact that I mentioned.
Three months after my last sexual encounter with her, I went to my private physician to get tested. He was supposed to have ordered only a regular antibody test, but after my blood was sent to the lab, it turned out that the doctor had apparently inadvertently checked off a request not just for the antibody test, but for the more unusual P24 antigen test, as well.
The upshot of this error was that the original lab, not possessing the capability to perform the P24 antigen test, sent my blood on to Labcorp for analysis. A week went by, and finally Labcorp issued results -- Negative for both the antibody and P24 antigen test. While I was initially relieved, I was nonetheless very shaken by the whole episode, and even though all parties involved (my doctor and spokespersons for both of the labs) insisted that the blood had been properly stored and handled and its integrity never compromised, I couldn't shake lingering doubts that the entire testing procedure had been marred by the confusion.
Undoubtedly, I should have just retested, but I was so spooked by what happened the first time around, and so afraid that a new test would yield less favorable results than the first one (questionable to me though those results may have been), that I was just too scared to take another test.
About four months after all of this occurred, I started noticing the appearance of occasional spontaneous bruises on my arms and legs. I did some research and thought that I might have ITP, even though a standard CBC blood test that I had taken 19 days before the first of these bruising incidents showed my platelet count to be 237.
I went to an HIV specialist in New York for a consultation, and began seeing a psychiatrist who specialized in treating HIV+ patients. Neither believed that I had ITP nor that I was HIV+, and both tried to convince me to retest, but to no avail.
Years passed, and other than the occasional bruising (along with a few subconjuctival hemorrhages, which, as with the bruises, pretty much stopped about five years ago), the only other suspicious symptom that I developed was some peripheral neuropathy in my feet, which was diagnosed by a neurologist in 2004. Both the neurologist and my psychiatrist felt strongly that the neuropathy wasn't caused by HIV, but rather, by some lower back trouble that I had had.
Around this same time in 2004, I also started experiencing a stinging sensation around the tip of my penis. I went to a urologist, who drew blood for a PSA test. The reading was somewhat elevated (4.0), and the doctor put me on a one-week course of Cipro. That seemed to do the trick: The stinging sensation dissipated, and a follow-up PSA test showed a decline to 0.7.
In time, the neuropathy also went away, and for the last few years, I had been quite healthy and free of any afflictions, either usual or unusual.
Since my last exposure to that HIV+ woman in 1996, I have been completely celibate, but about two-and-a-half months ago, I met a wonderful woman with whom I wanted to commence a relationship. Soon after we began discussing the prospect of sleeping with one another, I began to experience a simultaneous recurrence of both the neuropathy and the stinging sensation at the tip of my penis. This time, however, unlike six years ago, I also began experiencing some erectile dysfunction and what seemed like a decline in sensation of the penis, especially around the head (whether this is truly an organic physical manifestation consistent with the other symptoms, or simply psychosomatic, I can't say).
I decided to go for another PSA test, this time, accompanied by a CBC and metabolic panel (the first of these types of blood tests that I had undergone since 1997). The PSA came back at a very healthy 1.0, and most of the results of the other tests were normal, but there were a few potentially disturbing exceptions. My Blood Glucose was 114 (somewhat high) and BUN was 21 mg (3 mg over the upper end of the normal range). In addition, a detailed urinanalysis revealed Protein at 30 (the upper end of the normal values is <30); Ketone, trace (normal reading is negative); SpGravity, 1.036 (just outside the normal upper end of 1.035); and manual exam of Microscopic Crystals showed 50/HPF (normal is 0-1/HPF).
The urologist that I saw didn't think that these abnormalities were anything about which to be concerned, but doing a little investigating on the Internet, I found that even though most of the aforementioned numbers were just slightly above the normal range, they could possibly point to potential kidney problems (or, at least, the start of them), and so my mind immediately raced to think about a possible link to HIV.
As I said, all other results of these recent tests (among them, the entire CBC panel) were normal, including a Total Lymphocyte Count of 1910 (25.4%), a WBC of 7410, and Hemoglobin of 15.8 g.
I realize that I've delineated a lengthy amount of background information here, but I deemed it important as prefatory to the questions that I wanted to pose:
1) I've read in various places (including in answers provided in this forum) that advancing lymphopenia is characteristic of HIV infection. Given that fact, would it be possible for someone to be HIV+ for 14 years without any medication or treatment and still have a Total Lymphocyte Count as I currently do of 1910 (as well as normal WBC, RBC, Hemoglobin, Hematocrit, and other test results)?
2) Could the few out-of-range test results that I recently had be indicative of the early stages of HIV-related kidney disease, even though all of my other results were normal? If not, are there other non-HIV-related causes that could account for those out-of-range results?
I realize that the only true solution to my quandary is to once and for all take the HIV test again. But given the fact that I have been so petrified for the last 14 years about retesting, some answers to the questions that I've asked above could help motivate me to finally take the plunge. Thank you in advance for taking the time to read this opus and (hopefully) offering me some help.
Response from Dr. Frascino
Your problem is psychological (psychiatric), not virological! HIV is not your problem; fear of HIV is.
Responding to your specific questions:
1. If you had untreated HIV disease, the chances you would be completely asymptomatic and have totally normal blood counts out 14 years would be extremely slim at best.
2. No. Your results are not suggestive of HIV-related kidney disease. Yes. There are a number of non-HIV-related potential causes for the mild abnormalities noted on your laboratory studies. You should follow up with the urologist as needed.
Continue to work closely with your psychiatrist to overcome your irrational and totally unwarranted HIV fears. As for being too petrified to retest, when it comes to HIV it's what you don't know that can hurt you. See below. Get tested.
HELP - very scared (concerning oral sex risk) (WHAT YOU DONT KNOW CAN KILL YOU, 2010) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010) Jun 16, 2010
Hi Doctor, Thankyou for your help.
If I were exposed, it would have been about 2 1/2 years ago, November/December of 2007. I am a heterosexual female and lost my virginity to someone with a very iffy past. We only had sex once, it was protected - however, the condom broke and we realized it right away. He wanted to continue without it, but I refused, and he did put another one on. But this is not the exposure that I am worried about. On many occassions, maybe 7-8, I performed oral sex on him with ejaculation. Now I know that I should not have done this, and my fear has kept me from having sex since or possibly exposing anyone else to it. I later found out that he had 80+ sexual partners (disgusting, I know). He claimed to be HIV- but also revealed that he hadn't been tested in awhile.
I know that the risk for oral sex is very low, but I have had many frightening symptoms. Several lymph nodes in my neck are swollen, and will sometimes become painful. I have also had reccurring bouts of alternating diarrhea and constipation. There hasn't been any weight loss though. I have actually gained weight due to my paranoia and thinking that if I don't lose weight, I don't have the disease. Sometimes I do get a white tongue, but I am also taking asthma medicine which may cause that. Since my exposure, my asthma symptoms have become worse and I have had to return to the doctor a few times. Also, January of last year I was diagnosed with mono, which I found to be strange. The doctor said I had many abnormal lymphocytes (sp?) in my blood work, but I had none of the symptoms of mono. I have literally become obsessed with finding out if I have HIV without actually being tested. I am young and fear the results. This is constantly on my mind, and I have no doubt that it makes my symptoms worse than they really are.
My questions are: 1) How high would my risk be, based on my exposure/symptoms? 2) DO these sound like symptoms? 3) Could HIV cause a false positive on a monospot test? 4) Do you think I should get tested?
I am so scared and do not know what to do! Please reply - I will be very grateful & make a donation. Finding out everything about my exposure and symptoms has literally become my life. I am also worried that if I do not have HIV, and have something else that is causing my glands to swell, it could be dangerous to my health since I have waited so long.
Thankyou so much.
Response from Dr. Frascino
"I have literally become obsessed with finding out if I have HIV without actually being tested." WHAT? As Star Trek's Mr. Spock would say: "Captain, that is just not logical!" If you want to know if your HIV infected, there is only one way to find out: get tested. A simple rapid HIV test can give you an accurate answer in as few as 20 minutes. So what are you waiting (and worrying) for? When it comes to HIV it's what you don't know that can hurt you! (See below.)
Responding briefly to your specific questions:
1. Extremely low.
2. Symptoms are notoriously unreliable in predicting who is and is not HIV infected.
3. Yes, false-positive Monospot tests can be caused by acute HIV infection.
Yes, primarily because you are so freaked out and need peace of mind.
HIV Risk for a Top (WHAT YOU DONT KNOW CAN KILL YOU, 2010) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010) Apr 22, 2010
I'm a 29 year-old male who was recently in Miami for work conference. I'm a total top (never have bottomed) and had unprotected sex with a guy I met from online. We probably had sex for what seemed like 10 minutes (15 max) and I lost my erection because I was so nervous having unprotected sex. We basically just stopped and I couldn't get hard again. The guy "said" he was HIV negative, but within a week of getting back I started developing a productive cough (yellow plegm), nasal stuffiness and laryngits. Theses symptoms went away for 2-3 weeks and now I have the same exact symptoms again ...the cough is 80-90% non productive, but in the mornings when I wake up I bring up yellow phlegm. I dont have any rashes, lymphadenopathy, or fevers. But i do feel achey in my neck and head regions. I am petrified of getting HIV testing (although I know I just need to) and just wanted to gauge my risk of this representing an ASR? Many thanks Joel
Response from Dr. Frascino
Obviously you understood the potential catastrophic consequences of playing Brokeback Mountain with Mr. Miami McBarebacker and that was enough to scare the happy out of your Mr. Happy. As for the dude claiming to be HIV negative, I would't believe him even if he strapped a lie detector to his throbbing tallywhacker. Remember, one fifth of the over one million HIV-positive Americans have absolutely no idea they are infected with the virus.
OK, so now we've established you had a colossal lapse of good judgement and common sense. Regarding "symptoms," they are notoriously unreliable in predicting who is and is not HIV infected. The only reason to worry or get HIV tested is potential HIV exposure risk.
As for being petrified to take the test, Joel, it's time to grow a set and do what you know must be done! When it comes to HIV, it's what you don't know that can kill you! (See below.)
scared of testing (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010) (CONSEQUENCES OF LATE DIAGNOSIS, 2010) Mar 8, 2010
Hey....I am thirty years old..have never done an hiv test.....found someone who is just remarkable....who insist that we have one done before we become intimate......he did his today it was negative.....but I'm scared to death in doing mine......I really need some advice.
Response from Dr. Frascino
While I'll certainly admit getting HIV tested can be anxiety provoking, it's important to note that when it comes to HIV, what you don't know can kill you.
See below, and yes, by all means, take the test before your Mr. Happily-Ever-After become the one who got away.
accepting possibility, need strength to test (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010) Feb 17, 2010
Dr, this past summer I had an unprtected encounter. The gay male asked to but i said no. He assured me he was negative of anything and he had just returned from serving and said the armed forces required testing and had since been tested again. i was slipping in and out while we were safely fondelling, (under the influence) but unfortunately remember feeling him penetrate me briefly. I asked him to stop and I was very upst with him and called it a night. i kno technically i was at risk and should be tested but I am so scared, i can't go. I see no evidence pointing in a good outcome. i am contstantly convincing myself he is a bad person who woudl lie about it and every little ailment I have had since, i blame on decreased immune system. i literally have nervous breakdowns everyday and want to throw up when i'm alone. I I think if i believed there was a chance i was okay, i could go. But i am so sure i have forever hurt my family and can't bear the pressure. everyday becomes harder and harder to function. Please tell me to go test and tell me there is still a chance....please.
Response from Dr. Frascino
Your HIV-acquisition risk is brief unprotected anal receptive sex with a partner of unknown HIV serostatus. I agree you need to be HIV tested; however, your pessimistic fears are way out of proportion to your real risk. The CDC's estimated per-act statistical risk for unprotected receptive anal sex with a partner confirmed to be HIV infected is 5 per 1,000 exposure. Your statistical estimated risk would be significantly less, as we do not know the HIV status of your top gun. Plus, your exposure was brief. Consequently, the odds remain very much in your favor that you did not contract HIV from this sexperience. After a potential or even certain HIV exposure, testing is always the right thing to do. See below.
That you are experiencing "nervous breakdowns every day" and that "every day becomes harder and harder to function" reveals considerable anxiety and depression related to this incident. Yes, of course, you should get tested and there is an excellent chance you are HIV negative. Stop procrastinating; it's only making you more anxious and depressed. I would also suggest you consider seeing a psychologist or psychiatrist for psychotherapy (counseling) and/or medication to help with your anxiety, depression and "nervous breakdowns."
Good luck! Be well!
caring for full blown aids friend Feb 12, 2010
My friend was just diagnosed with full blown aids. The doc says he has probably been infected 8 yrs but had refused to be tested. He had a sudden onset of dementia and stroke like symptoms. I will be taking him into my home to care for him as he dies. He is my best friend of 35 years, is 54 years old, and is a gay male. I am a hetero female who is a nurse but who has never cared for anyone in end stage AIDS. Once someone who has never been treated is at this stage, what is the average prognosis/life expectancy?
Response from Dr. Frascino
Your friend's story -- someone who refused to be tested (perhaps feared to be tested) until a catastrophic event occurred -- is all too common. There is no doubt had he come to medical attention sooner he wouldn't be in this predicament now! Hopefully his story will encourage others too afraid to get tested that the alternative of not getting tested is a very poor option! (see below)
I should mention we no longer use the term "full blown AIDS," because there is no such thing as partially blown AIDS.
Regarding prognosis, unfortunately no one has a crystal ball and clinical courses can vary considerably from person to person with HIV/AIDS. It's worth noting that your friend has not had any treatment to date. With aggressive treatment, his health may improve. People can recover significantly from strokes and even symptoms of dementia can sometimes improve. I would suggest you talk with your friend's HIV specialist. He will be able to provide you with the best information regarding your friend's clinical course, treatment options and prognosis.
Thank you for helping someone in desperate need. Yu are indeed a true friend.
benefits of knowing (pick me) (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Nov 15, 2009
In short I am afraid of perhaps being hiv positive. I was in a relationship for two years with someone and kind of left condoms out of the equation without testing. He didn't seem to be high risk having had a previous hiv test and 5 sexual partners with condoms as he has told me. The fucktard that I am now two years in to the relationship I'm very anxious of dying and having put myself in a bad situation. It seems like all men who have sex with men end up with hiv somehow. I don't know what to do I pray for god to help me, anyway I was sort of thinking to wait it out until one of us got sick before testing. I don't really want to know but part of me does because I want to obviously live longer and get treatment before aids. Is this fear normal or am I a special case I was so happy in my life before my hiv anxiety started to act up again. My last test was 2006 and all my sex had been protected no condom breaks I test the condom after with water. I do not give fellatio so the oral risk would be negligible for me as well as the anal since I was safer sex. As for the relationship I'm still not oral with my bf but I have topped him for two years essentially rubber free. Should I start using condoms now and not bother testing as the prospect of testing positive is frightening to me in my current mental state or shall we eventually test together.
Please Help Me although you must get tired of helping everyone being virally enhanced yourself with no one going out of their way to help you with your worries and fears. Maybe I have a fear of dying over all? because I'm 26 and relatively healthy I just wish I could bury my mum and live to middle age at least and be happy but life is full of awful things.
Why is HIV so prevalent in the gay community in developed countries? Is it every gay mans destiny to be positive it seems cruel as no one chooses to be gay. I want a cure for this already. Why don't they give us dead hiv vaccines like the flu shot? wont we be immune to that strain of hiv then?
sorry for my rant....please answer some of the important issues of the written diarrhea
Response from Dr. Frascino
In essence you're wondering about the "benefits of knowing." See below. I've addressed this issue recently.
Regarding a cure for HIV, we have an entire chapter devoted to that topic in the archives of this forum. I have nothing new to add since I last addressed that topic. Check it out!
Regarding your question "Should I start using condoms now and not bother testing as the prospect of testing positive is frightening to me in my current mental state or shall we eventually test together?", this is not an "either or" question! You absolutely should start using condoms immediately. (You knew that already didn't you? Of course you did!.) Also you should both get HIV tested without further delay. (Deep down you knew that as well, right?) Remember what you don't know can kill you! (See below.)
Fear and Shame..affraid to get tested (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Oct 22, 2009
I'm a hetero guy who is very ashamed as I made a big mistake. In a drunken state I let another guy perform unprotected oral on me. I don't know what I was thinking.It lasted all of a few seconds until I realized what was going on and I stopped it. I know this guy was Bi but I don't know his status. I've had some really strange symptoms since the incident that occurred back in August such as loose movements, occassional chills, persistent painful swollen glands in my neck and occassional night sweats but no fever. I'm sure I've got HIV. I'm affraid to get tested because it will be a confirmation of what I fear most. Then, I'll have to tell my girlfriend what I did and my family will find out. I will be stigmatized for the rest of my life. I have read alot about oral exposure being a low risk...but it is a real risk. I'm sure I am that one in 10,000 that contracted HIV throught oral contact. How else could you explain the symptoms? I was completely healthy before the encounter. Dr Bob. do you have any suggestions? This is really tearing me up.
Response from Dr. Frascino
Do I have any suggestions? Sure! Your HIV-acquisition risk is extremely low. I'd put it in the negligible category. Your statistics are off. The estimated per-act statistical risk for acquiring HIV from unprotected insertive oral sex with a partner confirmed to be HIV infected is 0.5 per 10,000 exposures. Your estimated statistical risk would be much less, as we do not know the HIV status of your bi-buddy and your exposure was incredibly brief. Your fears about being blown are themselves blown way out of proportion compared to the degree of real risk involved. This is due to the "fear and shame" component of your predicament. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. Your symptoms are not worrisome for HIV acute retroviral syndrome (ARS). I'm very confident you did not contract HIV from this event. At this point your problem is primarily irrational fear and anxiety. I'd suggest you seek treatment for that very real problem (anxiety/irrational fear). Counseling and/or anti-anxiety medication can help. Once you get a handle on that, you should get a single HIV-antibody test three months or longer from the date of potential exposure. As I stated, I'm very confident the result will be negative. In fact, I'd be willing to wager a bet on it!
Get the help you need to face your fears and then get tested. You'll be glad you did. Your WOO-HOO is waiting for you.
I'll repost below some information from the archives discussing why you should man up and get tested.
So anxious please help?? posted once before (WHAT YOU DONT KNOW CAN KILL YOU, 2009) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Oct 10, 2009
Hi Doctor. I can see you are really the person to ask about hiv you seem to know everything. Im very concerned as I was promiscuous at university. I gave several men blow jobs without knowing status. I did not allow any to ejaculate in mouth. I didnt notice any ulcers in my mouth but was often drunk. Does using deep throat increase risk to as I sometimes did. Anyway 2 years on now and im having horrible weight loss of 7 pounds and look very thin on my arms and face. Also extreme fatigue certain days as well as some burning tingles occasionally. Please help me? Im so scared that im positive and i don't know how to cope as I have a phobia of hiv anyway. the doctors have done cbc and many other test which have all been negative so im scared about hiv. what is your take? thank you so much for response
Response from Dr. Frascino
Oral sex carries only a very low risk for HIV transmission. Deep throating or playing tonsil hockey with a stiff stiffy would increase risk if such acts traumatized the mucosa or tonsils.
"Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. The only way to determine whether someone has acquired the virus after a potential exposure is to get an HIV-specific test. That said, your symptoms, two years out, are not consistent with or suggestive of HIV infection.
I agree you "have a phobia about HIV . . . ."
I suggest you man-up and do what needs to be done: get tested. You'll be glad you did. What you don't know about HIV can kill you. (See below.) The odds are astronomically in your favor that you did not contract HIV from your university sexperience. However, the only way to be certain is to get tested! I would also suggest you get counseling (psychotherapy) to help you confront and conquer your HIV phobia. These irrational fears can ruin not only your future sex life, but also general physical and psychological well-being.
Get tested. I'm confident your WOO-HOO is waiting for you.
Is it better not to know? ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2009) Sep 16, 2009 The mind is powerful. When people think they are experiencing ARS a lot ot times it is attributed to their psyche. Would a person who is HIV positive but thinks he is negatve be better off not knowing since the stress of knowing could cause a host of illnesses by itself. I have tested 3 times. non reactive antibody at 32 days, non reactive antibody at 16 weeks 6 days and less than 50 copies RNA by PCR at 37 days post. Do I need further testing?
Response from Dr. Frascino
"Is it better not to know" you are HIV positive???? No, absolutely not. In fact what you don't know in that situation could kill you. Delayed HIV diagnosis is still the number one cause of HIV morbidity and premature HIV-related mortality. Knowledge is power! If you test and find out you are indeed "virally enhanced," you and your HIV specialist can better plan early treatment and intervention, improving your chances of slowing down the progress of HIV disease while protecting your immune system from begin silently decimated by the virus. If, on the other hand, you test negative, you will feel less anxious and be able to yell WOO-HOO! Also, by knowing your HIV status, you will better understand your risk of possibly infecting others. And clinical studies have shown those who know their HIV status are more likely to use precautions to protect their negative status or to prevent infecting others. Regardless of the HIV test results, testing tends to increase one's commitment to overall good health habits. Also, if someone is considering starting a family, knowing one's HIV status allows her to take advantage of treatments to dramatically decrease the risk of mother-to-child HIV transmission.
Now, let's have a practical example of what I discussed above, OK? You have tested HIV-antibody negative out to nearly 17 weeks and have an undetectable HIV plasma viral load by PCR RNA quantitative analysis (less than 50 copies) at day 37. Your test results are definitive and conclusive. You are HIV negative. Now are you glad you know your HIV status or not???? Sir, sir, could you please stop doing cartwheels and yelling WOO-de-frickin'-HOO long enough to answer my question? Sir, sir, thanks for the hug and kiss, but could you just put me down and answer the question??? Oh, never mind, I rest my case!
"What you dont know can kill you" and a further donation (WHAT YOU DONT KNOW CAN KILL YOU) Jul 18, 2009 Hi Dr Bob I wrote you last week to say that after over a year of feeling really ill following some risky sexual behaviour - Shingles,chronic fatigue, joint aches, gum disease, rash etc etc, and being 100% convinced I had HIV I still couldn`t bring myself to get tested due to being in total fear of being positive until discovering your site and hearing your words "What you don`t know can kill you" over and over again in my head, which finally gave me the kick up the ass to get myself tested(twice)for HIV, which were thankfully both negative. However my story doesnt end there. After I received the negative tests and could discount HIV I, this week saw a specialist for a full physical and blood work. Yesterday he called me back in to do some strange blood tests and gave me an injection of some sort. Today I saw him again and have been diagnosed with something called Addisons Disease, a quite rare auto immune disease which thankfully can be treated. Whilst I`m not suggesting that worried people who think they hav HIV symptoms will also have it or anything similar, in my case it was only once I had taken the test and received a negative result that I felt able to get professional help for my real symptoms(not the imaginary ones brought on by the stress of thinking I had HIV). I just started thinking how many people are out there convinced they have HIV when they havn`t, and are not getting the peace of mind a negative result brings or who are not receiving treatment for other(real)illnesses. The specialist doc told me that undiagnosed, Addisons can be fatal but treatable now diagnosed. So Dr Bob in my case without your site and in particular your powerfull phrase "what you dont know can kill you" convincing me to get tested it could so easy have come much quicker than I thought and not because of HIV! I cant honestly thank you enough or tell you what a great job you all do and how powerful the advice given is. I will be making a further donation to express my sincere gratitude and hope that you convince many many more that if theres any risk or doubt, getting tested is really the ONLY course of action.
Response from Dr. Frascino
Thank you for your kind comments, for taking the time to write back and for sharing your experience with the readers of this forum. Hopefully your true-life testimonial of "what you don't know about HIV can kill you" will give many others a swift kick in the ass so they too will get tested.
The three primary reasons to get tested are:
1. If you are HIV infected you need monitoring and treatment. Otherwise HIV will kill you. Plus you may unknowingly transmit the illness to others.
2. If you are HIV negative, you'll be able to put your fears and anxieties to rest.
3. If you have another illness (Addison's, psychosomatic disease, Lyme's disease, etc.), you'll be able to get the treatment you need.
Thank you for your donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). They are urgently needed and warmly appreciated. Your one gift will touch many lives.
Is abstience the answer? Feb 28, 2010 Dr Bob- My partner recented contracted pneumonia (pcp). He was unaware of his HIV status until this 1st oportunistic infection. His T Cell count is 125 and viral load about 500,000. He began Atripla last week.
As a result of this situaiton, I resteseted as well. I am HIV negative. I have been reading the forum on magnetic couples to learn more about this new situation.
My question: Is abstinence the way to go until his viral load is down? We primarily engage in oral sex. I was less fearful of transmission when I understood him to be HIV+ (condoms, etc) but now that I realize he has clincal AIDS, I am much more fearful. Is it safest to wait until his lab work looks better?
Response from Dr. Frascino
Situations like your partner's are tragic, preventable, and all too common! Being diagnosed at the time of a significant opportunistic infection and profound immune deficiency means that your partner most likely has been infected for the past 7 to 10 years, perhaps longer. Had his infection been recognized sooner, appropriate intervention with combination antiretrovirals could have preserved his immune system function and prevented this opportunistic infection. Your partner's story should serve as a sober warning to others who don't know their HIV status or are too afraid to test.
As for preventing HIV transmission, certainly not having sex is one option, but not one most of us would find desirable or acceptable. An AIDS diagnosis itself does not increase the risk of HIV transmission. Certainly an elevated HIV plasma viral load (whether "HIV positive" or "AIDS") does increase the risk. Proper condom use is essential for all penetrative sex, no matter what the viral load or stage of illness. Continue to peruse the information in the chapter on magnetic couples, and you'll read testimonials of how other serodiscordant couples have handled this problem.
Regarding your recent HIV test, you'll need to be retested at three and six months from the date of your last exposure to confirm your HIV-negative status.
Good luck to you both.
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