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All I can do is fess up
Oct 15, 2010

Dr. Bob,

I'm a doctor. But all of my training at this point has gone out the window as I'm just not thinking clearly. I love the work you do on here and you've inspired me to try to get something of the like started myself...if I can make it through my current dilemma.

Ten nights ago I met this guy who I really ended up liking. He came over to my place and we engaged in pretty intense open-mouth kissing, oral sex, and anal licking on both our parts. He did not ejaculate in my mouth although there may have been some small amount of precum. I'm not sure. There was NO anal intercourse whatsoever (protected or unprotected). I also used some of his semen as lubricant to masturbate myself with but I'm 99-100% sure none got near my urethra.

He comes out two days later and tells me how much he likes me and that he has to tell me that he's HIV positive. His CD4 count is pretty high (630s) and his viral load is 10-15K which is around the lower side. He is not on HAART. I'm so scared. I know it sounds like a low risk but we had some rather intense kissing and I did lick the outside-near inside of his anus for approx 10 seconds. Didn't see any blood, there were no lesions in my mouth and (reportedly) none in his.

I prescribed myself Combivir and Kaletra which my ID friend says is the standard with PEP. I'll be tested at 1,3, and 6 months. Please offer me some comfort with this. I'm prepared to be tested in 1,3 and 6 months but I'm a worry well right now. The most sickening part of all this is that I'm an internist (albeit young and dumb) and should KNOW BETTER. What makes me feel somewhat better is that had I never found out he was HIV positive, I would've felt comfortable with what we did as far as risk is concerned. It's funny how you can counsel a hundred patients with HIV but when it's you, all your training goes out the window. I'm so ashamed.

Response from Dr. Frascino

Hi,

I remember learning in medical school that any doctor who treats himself has a fool for a patient and an idiot for a physician. Chances are you learned something similar, right?If you had been evaluated by an HIV specialist, it's doubtful PEP would have been recommended. Your HIV-acquisition risk (kissing, oral sex, rimming) is very low. If you choose to complete your 28-day course of PEP, you should be followed by an HIV specialist.

Good luck.

Dr. Bob



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