[Question #10193] Quick advise
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25 months ago
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Good evening Doctors.
It's been over a year and I made a stupid mistake again.
2 days ago, I had brief unprotected sex with an black lady from Houston. I am a circumcised male. She is middle class, with kids. Due to my worry, she agreed to have a 10 panel test done with LabCorp today. Hopefully get results tomorrow. I am at about 40 hours post, do you suggest I seek out PEP? Reading online had me worried talking about black females being 16 times more likely to have HIV.
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25 months ago
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Specifics. Unprotected oral (receiving) and vaginal. She is a 40 year old.
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Edward W. Hook M.D.
25 months ago
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Please don't seek PEP. This was low low risk exposure. That black women have higher rates on HIV does not mean that most do. In fact, less than 1% of black women have HIV. That she has kids meant that she did not have HIV when she was pregnant (all women are tested during pregnancy) and being middle class puts her in the wrong demographic group. Finally, even if she did have intreated HIV, your risk of infection from a single episode of vaginal sex is, on average, less than 1 infection per 1000 exposures (i.e. chances are more than 99.9% that you would NOT be infected). There are no proven cases of HIV acquired from receipt of oral sex.
I would not worry and I definitely would not seek PEP. I hope this perspective is helpful. EWH
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25 months ago
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Dr, thank you for that response.
Today she told me her test results came back from stdcheck.com - 10 panel tests and all was clear. Guess I believe her.
She tested 2 days after our intercourse.
I have a significant other, what testing do you suggest I pursue? I know she could have passed me something during the eclipse phase. What stds am I in the clear with? I don't know her sexual history, but she said she had sex end of June (don't know the date). Her blood was drawn on July 19th for these tests that just came back. We had sex on the 17th.
Thank You,
Your anxious customer.
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Edward W. Hook M.D.
25 months ago
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If you believe her, and I would, then you could be confident that you were not exposed to an STI. As a result, there is no medical or scientific reason for testing unless you just want added assurance. Any pathogens which she might have had would have been apparent with the testing she told you she had. If I were you, I would move on without continuing concern. EWH.---
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25 months ago
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Thank you Dr Hook. Should I not be worried about hiv incase she acquired it end of June? Her testing was only 19-20 post?(July 19) Not sure a test would pick that up that soon.
And also, I never asked her about her Biotin intake. Could this have affected her results?
Am I just being paranoid?
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Edward W. Hook M.D.
25 months ago
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I think you are being paranoid. If she was negative in June, having avoided the disease for about 40 years, it is unlikely that she would have acquired infection in the three weeks since she was tested.
Concerns about Biotin are seriously overstated. The Biotin "effect" is in large part overstated and an internet based exaggeration. To get enough Biotin in the blood to reach the levels required to effect test results in the laboratory (the only place biotin has been shown to effect tests) one must take huge doses far greater than what is normally in multivitamins or even biotin supplements and test soon after ingestion.
Your questions suggest that your concerns have taken you to the internet. This is a bad idea. Much of what is there is incorr3ect or overstated, sometimes because it is taken out of context, sometimes because it is out of date or like the biotin concerns, translating a laboratory artifact into misplaced concerns, and sometimes because it is just plain wrong.
Let me remind you that we provide up to three responses to each client's questions. This is my 3rd response and therefore the thread will be closed shortly without further responses.
In closing let me remind you of the following facts- there is statistically a less than 1% chance your casual partner had HIV and that even if she did, there is a far less than 1% chance you would be infected through a single encounter. Thus, even using the most conservative estimates of risk there is a less than 1 in 10,000 chance you were infected in the encounter you describe and probably far, far lower. To address your concerns you will probably want to test. A PCR test any time more than 11 days following your encounter will be virtually conclusive and at 4 weeks testing with a4th generation, combination HIV antigen/antibody test would be more than 99% conclusive. Results of 4th generation tests at 6 weeks are entirely conclusive. I am confident that if and when you test, no matter how you test, you will find that you did not acquire HIV form the exposure you have described.
Take care. Please don't worry. EWH
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