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Weird testing situation and other concerns!
Jul 12, 2011

Hi doc thanks for all the work you put into this site, it has been incredibly helpful to me. I'll do my best to be concise. A little over six weeks ago I engaged in what is a low to no risk sexual behavior. Heterosexual mutual masturbation and naked grinding, aka frottage with a girl at college. There was no penetration but my mr happy likely had some contact with her vaginal fluids. If it weren't for an unfortunate timing in some symptoms I wouldnt have given this encounter a second thought in terms of HIV. 4 days post I developed flu like symptoms that lasted for a week, fever sore throat, night sweats etc. About 5 weeks after this encounter I noticed a rash of about 10-20 small bumps on the left side of my trunk, on an area covering 6-10 inches, they were by no means highly condensed, ranging from small pimple size to ball point pen size. The skin surrounding them was normal colored not red or raised. I have had this rash for going on two weeks now and I have no idea what could have caused it. I had an antibody test performed at near six weeks that was negative. The appearance of the rash is what is causing me to worry and even lose some hair! Haha and that really sucks!

My questions for you sir, 1)how likely is it that ars symptoms could present themselves either multiple times over a period of weeks aka flu and then rash or that it could show up as a rash with no other symptoms? Also does that rash sound suspicious? 2) would you recommend further testing in terms of actual risk or need? 3) finally I tried ordering the duo antigen/antibody test online. The company said they provided it but it turns out the use a western blot as their p24 test. Can the western blot be used that way and would you recommend that I have blood drawn for that purpose or not?Thank you for your time and I look forward to making a donation to your foundation!

Response from Dr. Frascino

Hi.

Your HIV-acquisition risk is so remote that it's essentially nonexistent.

Your symptoms are not consistent with or worrisome for HIV acute retroviral syndrome (ARS). Symptoms of HIV ARS generally manifest two to three weeks after exposure, not four days. The typical HIV seroconversion rash would occur with the other symptoms during the ARS period and would be a spotty red, somewhat papular eruption on the face and trunk. It can sometimes involve the arms, legs, palms and soles. Some cases involve ulceration of the mucous membranes in the mouth, esophagus or genitals.

Responding to your specific questions:

1. See above.

2. HIV testing is not medically warranted for this level of potential risk. Your negative HIV test at six weeks is extremely encouraging. However, if you wanted a definitive HIV test result, you would need to wait until the three-month mark.

3. Western Blot tests should only be ordered to confirm a preliminarily positive ELISA, EIA or rapid test. It should not be ordered for routine HIV screening.

Thanks for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Be well. Stop worrying.

Dr. Bob



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