Is guilt or was I exposed?


Hello Doc. I have been regularly checking your website after developing HIV related anxiety and guilt from a single protected encounter in a massage parlor. I really appreciate what you do and admire your dedication to help others. Here is my situation: On April 5, I went to a massage parlor and did accept the offer when the lady offered to perform oral and vaginal intercourse. I received the oral unprotected. On my request the lady brought a condom and we had vaginal intercourse. All was good until guilt and fear of contracting HIV kicked in. You see, I am married. Two weeks after the encounter I had cold sores on the shaft of my pennies. I thought it was herpes outbreak since I have herpes. I went to see my doctor who prescribed Valtrex and ordered blood test. The test came back HIV negative but reactive syphilis with low titer 1:1H. I then went to see an infectious disease specialist who started me on Pencillin treatment. I was diagnosed and treated for syphilis a year before and thought the low titers indicated that. But the ID specialist said I need to get treated again which is fine with me. But then I got a call from my Stateâs health office who said that treatment was not warranted since my numbers are low. My question to you is 1) does the ID specialist do the right thing by ordering treatment (which I liked), 2) even though you are treated does syphilis stay with you with low titers and last but not least why do I keep worrying about HIV, is guilt my problem or was I really exposed to HIV? Although I have no visible symptoms and even did not get the flu when my wife and daughter are struggling with it. I am not a wild person but that one single incident seemed to turn my life around, please help. Thank you very much, I will consider donating to your foundation. God bless for what you do.



I would agree with the state health department on this one.

A very low antibody titer can persist even after syphilis has been appropriately treated and the patient cured.

Certainly guilt is playing a major role. I'd suggest you level with your wife. It's not only the best way to confront your guilt; it's also the right thing to do.

I'm still a bit concerned about the "cold sores" on the shaft of your "pennies." Certainly herpes would have to be considered. Hopefully the infectious disease specialist will be able to conclusively sort this question out for you.

Good luck! Thanks for your consideration of a donation to The Robert James Frascino AIDS Foundation (

Be well.

Dr. Bob