[Question #10830] Anxiety over broken condom - High risk vaginal exposure

19 months ago

Test

19 months ago

For some reason it doesn't let me enter my question. I will try again.

19 months ago

Trip after Christmas, hooked up with a woman at my hotel. After drinks we ended up in my room and during vag sex condom ripped open. The act lasted 15 mins and I think condom broke at the beginning. She is an immigrant from Nigeria but became a resident of Canada 4 yrs ago (You have to test neg for HIV to get Canadian PR).

Freaked out and asked about HIV; she said that she "usually takes precautions" and then she got offended and said "Are u asking just because Im black?" "Not everyone in Nigeria has it" and stopped answering. My tests:

- NEG test at 6 days for gono, chlamydia and trich.

- At 7 days I got a bad sore throat that lasted a week

- Panicked because of sore throat, tested at 2 weeks (Ag/Ab 4th gen): NEG

- I know test at 2 wks isnt conclusive but I know that if the sore throat was caused by ARS, test wouldve been positive so I did it to rule it out.

- So far NO fever, rash or swollen lymph nodes.

19 months ago

I’ll get tested again at 4 weeks but anxiety is eating me alive and wanted to ask a couple questions:

- 15 days after exposure got a strong headache that radiates down neck to shoulder muscles. Would the neg test the day BEFORE mean that headache is not ARS? Have you ever seen this as only ARS symptom?

- Been holding off sex with my GF but I am not sure I can do that for much longer. Is the risk low enough or should I wait for a conclusive test?

Edward W. Hook M.D.

19 months ago

Welcome to the Forum. Thanks for your questions. I'll be glad to comment.

This was a virtually no risk encounter. Most CSW's do not have HIV and most single exposures to untreated infected partners do not lead to infection.

As you indicate, your tests PROVE that none of the symptoms you experienced before testing were due to HIV. Further when testing is performed at 4 weeks as you did. more than 99% of infected persons will have positive tests.

Your Headache is not due to HIV- your tests prove this.

Bottom line, Put your concerns aside. There is no reason for concern and virtually no reason for further testing. I would certainly NOT abstain from unprotected sex with my G'F if I were in your situation. EWH

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19 months ago

Hi Dr. Hook,

Thanks for the quick answer and the reassuring comment.

The woman was not a CSW, just a regular woman on a business trip.

Just to clarify, I didn't test at 4 weeks. The incident happened 15 days ago and I only tested at 2 weeks, that's why I am so concerned right now and my anxiety is through the roof.

With that in mind, I'll rephrase the question: with a negative Ag/Ab test at 14 days and this headache starting on day 15, is the negative test enough to rule out the headache as an ARS symptom?

Also, since my negative test is only 2 weeks old, does that change your answer about sex with my regular girlfriend (do I have to wait for conclusive test)?

Thanks again

Edward W. Hook M.D.

19 months ago

I understand that she was a CSW. Perhaps you missed my initial comment. Most CSWs do not have STIs.

Your risk is minuscule. Headache is not a typical symptom of recently acquired HIV but is a symptom of anxiety. A negative test in the presence of symptoms is proof that the symptoms are not due to HIV.

My opinion regarding risk to your GF is unchanged

You have one follow-up remaining

EWH

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19 months ago

Thanks Dr. Hook.

Regarding this statement: "A negative test in the presence of symptoms is proof that the symptoms are not due to HIV"

Does this hold true even if the symptoms started the day AFTER the negative tests?

My negative Ag/Ab was done on January 9 and the headache started on January 10.

Edward W. Hook M.D.

19 months ago

As I said- in the presence of symptoms. There are no data on how soon before symptom onset tests become positive.

As I said as well, I suspect your headache reflects your anxiety.

This completes this thread which will be closed shortly without further responses. EWH

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