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Hello from Australia Dr. Bob

Jan 5, 2011

Hi Mr. Funny, I wish we had super cool doctors like you over here, we probably do, but I haven't found them yet! I have a case study I am hoping you may be able to assist with please: * Information - male to female (heterosexual) monogamous relationship with regular unprotected sex. Both parties tested for HIV (both negative) prior to commencing unprotected sexual relationship and neither had sexual contact 6 months prior to their HIV testing. * Male received tattoo December 10th 2010. Tattoo became infected and required intravenous antibiotics for treatment. Male displayed no symptoms associated with ARS from December 10th 2010 to current. Approximately December 28th when female commenced vaginal yeast infection, it was noted that male had some symptoms of a penile yeast infection. * Female party - December 25th - 27th 2010 experienced diarrhea, vomiting and headache for 48 hours, visited emergency and although no medication was given the symptoms stopped. Doctor took temperature, which was normal and no other symptoms present. December 28th - December 31st - quite bad vaginal yeast infection treated by oral tablet and external/internal cream. Another family member experienced the same vomiting diarrhea and vomiting symptoms 2 days after the female party. Questions - is it likely the male got HIV from the tattoo and the female received it? Timelines are correct for ARS, however most research in your archives indicates that diarrhea and vomiting are not as common as fever, rash, etc? Is it likely the male passed on the thrush penile to vaginal due to the intravenous antibiotics? Would the symptoms mentioned and the timelines be indicative of ARS for the female or do diarrhea and vomiting usually present with other more common symptoms such as fever and rash? Have you ever seen a situation like this with these symptoms presenting as I could not see anything in your archives? I realise the likelihood of transmission through tattoo is lower risk, but both parties were sexually active with unprotected sex during the period of events described. Any assistance you could provide would be appreciated. Thanks in advance and have a fantastic 2011. Aussie Study Bug

Response from Dr. Frascino

Hey Aussie Study Bug,

1. Is it "likely"? No.

2. ARS symptoms are very variable from person to person. That hers lasted only 48 hours and that a family member subsequently had similar symptoms would strongly suggest viral gastroenteritis ("stomach flu"), not HIV!

3. Nope.

Of course the bottom line here is that if someone is concerned they may have contracted HIV from a tattoo or sexually or via intravenous drugs or whatever, they should get an HIV-antibody test three months after the potential exposure. HIV diagnostic testing is very reliable and straightforward. Rapid tests provide definitive answers in just a few minutes.

As for super cool doctors in the land down under, yes, they exist and some are buddies of mine. I'll be visiting Oz in February and March. Looking forward to surfing, but still won't eat that vile Vegemite stuff.

Cheers mate,

Dr. Bob



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