[Question #11493] Risk assessment, testing accuracy and symptoms

14 months ago

I am 31 year old male and circumsiced. I had one exposure status unknown involving kissing, fingering and protected vaginal intercourse for 4 to 5 minutes in one position cowgirl. The condom was durex extra safe latex one. Before putting condom i sprayed head of penis with alcohol spray for delay evacuation however it didnt work as i cum in 4 minutes maximum. However, when i pulled my penis out i felt air on the head of my penis maybe condom torn i dont know as it was dark.

Symptoms no fever, no sore throat in 9 weeks. Only diarrhea day 20 and 47 lasted for one day and got settled by taking imodium.

Tests carried Day 18, 33 and 47 (7th week) syphilis tested 3 times negative.

( Gonnareha and clymadia day 18 negative. )

Day 18 hiv 1 pcr qualitative in a private lab = not detected.

Day 19, 20, 28, 33 and 47th day (7th week) blood from vein Abbott generation test in lab= all -ve negative.

Question

1 - how likely hiv transmission considering sprayed head penis, latex condom which maybe broke during during 2nd or 3rd minute? I dont know

2- how satisfied i should be from above tests? Day 20th 4th generation blood taken from finger..does it make any difference?

3- have you ever seen with your patients or practice history anyone tested positive after day 33 or 47th day 7th week?

4- should i worry about diarrhea and sometimes red pimple on shoulder or leg last for few days?

Edward W. Hook M.D.

14 months ago

Welcome to the Forum. Thanks for your questions and your implied confidence in our service. I'll be glad to comment.

The exposure you describe was virtually no risk- there is no risk from kissing, fingering (masturbation) or condom protected sex when the condom does not break (your condom did not break- if it had it would have been obvious). Further your test results are absolutely conclusive. 4th generation, combination tests for HIV are conclusive when taken any time more than 6 weeks following an exposure. Thus is response to your questions:

1 - how likely hiv transmission considering sprayed head penis, latex condom which maybe broke during during 2nd or 3rd minute?

There is no evidence your condom broke. In the future however, please do not spray yourself with alcohol before putting a condom on. This can weaken the condom and increase the risk of breakage.

2- how satisfied i should be from above tests? Day 20th 4th generation blood taken from finger..does it make any difference?

The 20 day test was too early to be conclusive. Finger stick tests are just as reliable as tests performed on blood from the vein when taken at the appropriate time. At 20 days a test will pick up some but not all recent infections.

3- have you ever seen with your patients or practice history anyone tested positive after day 33 or 47th day 7th week?

No we have not.

4- should i worry about diarrhea and sometimes red pimple on shoulder or leg last for few days?

No- if your diarrhea or skin rash were due to HIV your test would have been positive.

Be confident you did not get HIV from the exposure you describe. There is no need for further testing and no need for continued concern. EWH

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14 months ago

Thank you so much great doc....

I understand and i wish the condom wouldn't have broken.

However, in worst case scenario if the condom was broke...do you think a short vaginal intercourse for 3 to 4 minutes enough to catch infection ?????

Also, the blood taken from vein for 4th generation Abbott test i had on day 19, 20, 28, 33 and 47th day....how confident are you on abbott 4th generation performance because i have seen on Internet that there are abbott 4th generation rapid test strips as well...i am worried on the reliablity of the test method whether if the lab carried out test on 4th generation abbott strip rather abbott assay since assay machines produce more accurate results?

- do you think have i been infected and 5 times 4th generation test would have not picked p24 antigen or antibodies over the series of testing from day 19 to day 47? 7th week

And, the pcr qualitative test i did in private lab on day 18th was given result by text message in 1.5 hour....whereas on Internet it says pcr takes around 2 to 3 hours to produce results? Do you think i should be worried about the genuinty and reliability of that pcr qualitative?

And in terms of symptoms i read that diaherrea caused by hiv last 1 or 2 weeks whereas mine was for one day or 2 although i taken imodium pills.?

Can i resume sex with my regular partner without any worry.

Thanks a lot for this act of kindness

Edward W. Hook M.D.

14 months ago

The condom DID NOT BREAK. If it had, it would have been obvious. Irrespective of whether it broke or not however, your test results PROVE you were not infected. Your PCR test results (which were available at an appropriate time confirm this. Of this there is no doubt- your results are conclusive!!!!

Abbott tests for HIV are reliable- they are respected and trusted throughout the world.

Your diarrhea was not due to HIV- your tests prove this.

You need to get over your inappropriate distrust of your results and accept them. You do not have HIV. There is no reason for you to abstain from unprotected sex with your regular partner. EWH

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14 months ago

Thanks for the prompt response doc....

I appreciate your and believe your words and i am well aware that you have published more than 300 papers and practising in this diseases since 3 to 4 decades....last 2 questions before the end of this thread

...when i was fingering her she bleed little bit and when i asked her she said maybe because of your nail......one of my thoughts in mind that i have broken skin cuticles above my nail most of the time. Do you think the vaginal bleeding or vaginal secretion could infect through that little tissue seen above nails through dry broken skin (nail curticles)???? And, if someone has sensitive gum which sometimes bleed when brush....do you think during french kiss it could be dangerous in terms of hiv transmission?

- Also, i have read that 4th generation detects antibodies for hiv 2...and p24/ab for hiv-1.........my test on 47th day 7 weeks should include hiv-2 as well? I am asking this because i have read one of your answer that most of the people turn positive by 28 to 30 days 98% and very rare and few people take up to 6 weeks.....however, just out of any doubts i waited not till 45th day and tested on 47th day 7.5 week....Can i be totally out of this stress and exclude hiv infection ?

Thank you ever so much

Edward W. Hook M.D.

14 months ago

The presence of cuts or scrapes on your nail cuticles or other sources of bleeding do not change the no risk nature of the exposure you describe. This is a common misunderstanding.

Similarly, the presence of gum disease, bleeding mouth sores in the mouth also do not meaningfully increase the risk of HIV acquistion. This is another common misunderstanding.

You are correct that 4th generation tests for HIV 1 and 2 test only for HIV-2 antibody, not antigen. If you had acquired HIV-2 which is quite rare, your antibody test would have still be positive by the time 6 weeks had passed.

Have confidence in your test results. You did not acquire HIV-1 or -2. There is no need for further testing and no need for continuing concern.

As you know, we provide up to 3 responses to each client's questions. This is my 3rd response. Therefore this thread will be closed shortly without further response. Take care. EWH

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