[Question #11472] Condom Slippage and HIV Test Reliability

14 months ago

Hello Doctors,

Thank you for providing this service; you are truly wonderful professionals.

Here’s my background:

I am a heterosexual, 30-year-old man living in Brazil.

On May 8th, I engaged in protected vaginal intercourse and unprotected oral sex with a long-time female friend.

My concern arises from a moment during intercourse when I withdrew and noticed the condom was no longer on me. Alarmed, I began searching for it and discovered it had remained inside my friend’s vagina.

This leads me to wonder: Did it slip off as I was withdrawing, or had it come off earlier, leaving me exposed for the entirety of our intercourse? This has caused me considerable anxiety.

I've experienced some symptoms that could be associated with Acute Retroviral Syndrome (ARS), but I've tried to remain calm. Precisely 12 days later, I had diarrhea for three days, which coincided with a work trip to another city where I ate poorly: hot dogs, fries, and pizza. I had no other symptoms.

However, almost at the fourth week, I developed a cold, nasal congestion, cough, sinusitis, sneezing, throat itchiness, green phlegm, and pain while swallowing. These symptoms lasted for a week, with no fever or body aches. My roommate had the same symptoms during this time.

On May 12th, I took a fourth-generation HIV test for antigens and antibodies, exactly 34 days after the incident. The result was negative (non-reactive).

Is this result reliable at 34 days, and can I be at ease? Or should I get tested again later?

Thank you, doctors.

14 months ago

I made a typographical error in my previous message: the HIV test was actually taken on June 12th, not May 12th, just two days ago

Edward W. Hook M.D.

14 months ago

Welcome to our forum. Thank you for your questions. Thank you for the appreciation of our service as well. I’ll be glad to comment.

When a condom slips off during intercourse and goes deep into the vagina, the intercourse is unprotected putting you at risk for STI‘s if your partner happens to be infected. Most people, however, are not infected and single exposures to infected partners do not lead to infection as well, thus your risk for infection is low.

The symptoms you describe, including nasal congestion, cough, sinusitis, sneezing, as well as diarrhea or not suggestive of the ARS. The symptoms of the ARS typically occur at about the same time with their onset, occurring between 10 and 21 days and never more than 30 days after an exposure. The symptoms of the ARS include high fever, severe sore throat, and widespread muscle and joint aches. The upper respiratory tract symptoms you describe are not suggestive of the ARS. Even more importantly, your negative 4th generation HIV test 34 days after your exposure proves that your symptoms were not due to HIV. When symptoms are due to HIV they are due to the interaction of the virus and the antibody response to the virus and the result tests are always positive . You can be confident that your testing proves that you were symptoms were not due to HIV. In addition, in general testing at 34 days provides would detect more than 99% of recent HIV infections. We have never seen a person with a negative test at 28 days or beyond go onto to become positive.

If I were in your situation, I would put my concerns aside and move forward. I see no medical or scientific reason for additional testing. I hope this assessment is helpful to you. EWH.

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14 months ago

Thank you very much, Dr. Hook! You are a great scientist.

I am pleased to read your response.

So, is my test conclusive and can I move forward?

Edward W. Hook M.D.

14 months ago

Your test result is virtually conclusive. Technically, tests for HIV are conclusive after 42 to 45 days following an encounter however as I already mentioned less than a fraction of one percent of persons with negative tests at 28 days go on to become positive. We have never seen someone, go on to become positive, but it is reported.

In addition, your test certainly prove that the symptoms you experienced were not due to HIV

If I were in your situation, I would accept these results conclusive and move forward with no concerns whatsoever. EWH

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14 months ago

Thank you again, Dr. Hook. I will definitely move forward. Your answers have greatly reassured me and were the best $25 USD I've ever spent.

Thank you.

Edward W. Hook M.D.

14 months ago

I'm glad I could help. We'll be closing this thread shortly. EWH---