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New Boyfriend is Positive
Jul 13, 2011

Hi Dr. Bob,

I have been dating a new guy for just a couple of months. The first time we had sex, we didn't use a condom. We discussed it and decided since we had both recently been tested, we would continue but get tested again-a silly plan. His test came back positive, mine negative. I have been a top 100% of the time, with at least 12 unsafe anal sex encounters. We did change our behavior upon hearing the news.

I know being a top lowers risk, but I also contracted a UTI (lab results pending) and had unprotected sex with him several times during this time. Also, about two weeks after we started being sexually active, I had a severe flu that lasted nearly 3 weeks. I am still suffering from muscle aches and low grade fever, but no rashes and only one swollen gland, which could be from the other sicknesses. We were also unsafe during my flu (if thats what it was), and Im not sure if this puts me at higher risk. I also suffered from bad diarrhea and headaches that no medicine could touch together for two days.

I have accepted that the chance I am infected is high-but I'm not running off into paranoia or worry. My question is because I am at such a high risk, when should I be having tests done? My plan is to have an Elisa with a RT-PCR test at 30 days after the last unsafe encounter and only the Elisa for every 30 days after (if the first are all negative). I know results won't be definitive until the 90 day mark, but the earlier I know the better.

Response from Dr. Frascino

Hi.

I agree with your assessment of your risk and your plan. If your flu-like illness two weeks after you started having unprotected sex with your new positively charged buddy was HIV acute retroviral syndrome (ARS), your HIV-antibody test as well as p24 antigen and PCR (RNA or DNA) would most likely be positive/detectable now. Most folks infected with the virus have detectable levels of specific anti-HIV antibodies in their blood within four to six weeks of exposure. You could get your tests now, as you've been exposed over the past two months and experienced a very suspicious flu-like illness in the exact timeframe we would expect ARS symptoms. In addition your virally enhanced buddy was apparently unaware of his status and consequently not on antiretrovirals. Therefore his HIV viral load could be quite high, making him more infectious.

Good luck. I'm here if you need me, OK?

Dr. Bob



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