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Possible Worried Well-Please Help
Jun 25, 2011

Hi Dr. Bob,

I just donated $100 to the Foundation. You have done a great job on the site and I believe your answers to be extremely helpful. I had an experience over a year ago with protected sex with a prostitute, who removed the condom and finished by using her hand. The next day I became very sick (ARS symptoms) and have never felt the same ever since this experience (malaise and out of it feeling). I have had HIV anti-body tests at 2,6,9, and 13 months and have all came back negative. The last test I had a full STD screening done and my Hep B came back negative but showed that I was not vaccinated against it. I am 100% sure I was vaccinated as a child, so does this mean the anti-body tests for HIV are not accurate. I was so worried I went to have a PCR test which I am currently waiting on. My doctor thinks it is all anxiety and has put me on medication. Do you think there is a chance all my tests are false negative? Are my worries unrealiastic? Please Help!

Nick

Response from Dr. Frascino

Hey, Nick.

I agree with your doctor! Here is why:

1. Your exposure was "protected sex." Protected sex is indeed "protected". That's why we cll it protected; clever eh? Assuming the latex condom was used properly and didn't break, your HIV-acquisition risk would be nonexistent.

2. Your symptoms are not consistent with HIV. Symptoms that begin "the next day" after a potential HIV exposure would not be HIV ARS (acute retroviral syndrome)-related, because ARS symptoms generally manifest two to three weeks after an exposure.

3. Your repeatedly negative HIV-antibody tests out to 13 months are definitive, conclusive, WOO-HOO-able, excessive and move-on-already-able! Not responding to hepatitis B vaccination is not uncommon. It does not mean your HIV-antibody tests are invalid. I have absolutely no doubt your PCR test will be undetectable. Once you get that result I hope your worries will be put permanently to rest. If not and you still have difficulty accepting the overwhelming and irrefutable evidence that you dodged the HIV bullet, you should consider getting psychotherapy (counseling) in addition to your anti-anxiety medications. You should also be re-vaccinated for hepatitis B.

Finally, Nick, thank you for your generous donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's urgently needed and warmly appreciated. In return I'm sending you my good-luck/good-health karma that you are now and will forever be HIV free.

Good luck. Be well!

Dr. Bob



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