[Question #11687] HIV Exposure Risk - Need Some Comfort Pls

12 months ago

Hi doctors, I'm a 30 year old male. Last Friday, I ended up in a stupid situation and had unprotected vaginal intercourse with a female with an unknown status. I'm generally healthy. The facts - Had unprotected vaginal sex last Friday around 11:30pm EST. - She is a 34 year old, white female. Not a sex worker but used to strip a while ago. Had no visible signs of illness - Intercourse lasted 5-10 minutes - I semi ejaculated inside but as I was, I pulled out quickly and ejaculate on her What I did - I Have been stressing non-stop, of course - I Researched the facts about HIV using the forum here and general internet - I meticulously analyzed all the stats nationwide, within NJ, in terms of demographics, age group, etc. to try to calm myself down - Yesterday, the 5th day post-exposure, went to PP for a rapid test. Both Syphilis and HIV were negative. I know this test isn't very accurate because it hasn't been that long but I was looking for anything to calm down. Currently waiting on their results for Gonorrhea and Chlamydia - Asked the female when she last got tested. She said 3 months ago and was clean. She says she's clean and doesn’t sleep around but I don't have any way of confirming that, of course. She also mentioned that she had a one night stand briefly last month What I will do - On Tuesday, I will get a sensitive PCR/RNA test from stdcheck to be 100% sure. From what I have read here, you guys say that this test is 100% accurate 10-12 days after exposure. Tuesday should be day #12. Or should I/can I do it Monday so I can find relief (hopefully) quicker?

H. Hunter Handsfield, MD

12 months ago

Welcome. Thanks for your question.

The tone of your questions, and the level of stress you describe, suggests you have a very unrealistic understanding of HIV risks. Having "meticulously" analyzed the data you found online, I don't really understand why you're so concerned. Probably you could have similar contacts every day for 20 years and expect to never get HIV. Here are some facts you might not have found in your searching. In most of the US and other industrialized countries, the chance such a woman has HIV is under one in a thousand. For your partner it's even lower; people rarely lie about HIV/STD status or test result when asked directly. And if indeed she had a "one night stand" recently, why would you think her partner might be more likely to have HIV than you? Finally, when a woman has confirmed HIV, the risk to her male partner from a single episode of unprotected vaginal sex averages one in 2,500 (equivalent to daily sex for 7 years before HIV transmission might be likely). All things considered, your chance of HIV from this event is under one in a million.

For those reasons, if somehow I were in your situation, I would not be tested at HIV. The chance of other STDs is higher but still very unlikely. You are correct that your syphilis and HIV tests at 5 days are meaningless, and assuming you have no symptoms of gonorrhea or chlamydia (penile discharge, painful urination) you can expect those test results to also be negative. A negative HIV PCR RNA test is nearly 100% conclusive 12 days (but I wouldn't advise it any sooner).

Stay mellow while you await the results. Another factoid that might help you do so: in the 20 years of this and our preceding forum on MedHelp, with thousands of questions from persons worried about HIV and their test results, nobody has yet turned up positive. You will not be the first. If and when it finally happens, it surely will be a genuinely risky exposure and not a near-zero event of this sort (think unprotected anal between men who have a hundred separate partners a year).

I hope these comments are hepful. Let me know if anything isn't clear.

HHH, MD

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12 months ago

Hi Dr. Hunter,

Thank you so much for the quick, prompt, and comforting response. You definitely helped calm my anxiety a lot.

Admittedly, I do have an inclination for OCD (that I can generally control well) but couldn't mention it in my original post due to the character count limit and lower priority.

To your point, I highly doubt I have chlamydia or gonorrhea (not too concerned since those are curable anyway) because I have zero symptoms so far. No painful urination or burning sensation or anything.

The HIV test will be more to put this behind me and get over this. Thank you so much! I will post my results here once I get them back.

H. Hunter Handsfield, MD

12 months ago

Thanks for the thanks. I'll be happy to comment further when you post your test results.---

12 months ago

Good morning Dr. Hunter,

Happy Friday!

I just wanted to come back and post an update. My results came back negative/normal for everything! I'm very thankful and this was certainly a massive learning experience for me. For reference, I did an RNA test on the 13th day post-possible exposure.

Thank you and the team for all you do and for comforting me.

H. Hunter Handsfield, MD

12 months ago

I'm glad for you -- but of course not surprised by the test results.

Thanks for the thanks; I'm glad to have helped. Best wishes and stay safe.

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