[Question #12117] Recent exposure opinion
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10 months ago
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Been feeling very low mentally since the last encounter which I asked you about! So stupidly whilst on a work trip to Barcelona, I visited a Transexual Brothel after a night out! Where I had unprotected oral and deep kissing! There was also anal penetration condom used for about 10 seconds Max! After realising what I was doing I pulled away! Condom was fully intact and there was no breakage or slippage. Trans CSW said she recently had a negative HIV test two weeks ago and started taking Prep only for 1 week! However I was still worried and went to a health centre in Spain to seek PEP! They said if the condom was intact then the risk was low and PEP isn’t needed. However after 2 days I developed a sore throat, muscle weakness, fatigue and headache. Now I feel like the cycle of HIV anxiety has started again. I think I should of pursued PEP
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Edward W. Hook M.D.
10 months ago
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Welcome back to the Forum. On this occasion I will be responding to your current questions. In preparing to respond, I reviewed your interactions with Dr. Handsfield several weeks ago and agree with all that he said.
Your recent encounter, similar to your previous one, was virtually no risk for all of the reasons explained by Dr. Handsfield. Deep kissing and receipt of oral sex are no risk activities as is masturbation through insertion of a finger in the anus. The fact that your partner had been recently tested and started on PrEP is further reason to not be concerned about this encounter. Like the healthcare professionals who you spoke with in Spain, I see no reason for taking PEP. Finally, the symptoms you described have occurred too early to be due to recently acquired HIV. They are far more likely to be due to one of the more common non-STI viral infections such as influenza or Covid that people get regularly.
I’m sorry to hear that once again you are worrying. I hope the information I have provided will help you to appreciate the fact that you are not at risk for HIV and should look for other causes for your symptoms. EWH
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9 months ago
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Thanks for the response a couple things from me
Since the first exposure I had with all the symptoms and what I referred to in #11988 I have recently tested negative 4th gen 108 days after exposure! So I’m hoping now I can 100% rule out HIV - 2
However based on the recent exposure
How soon after exposure can one test for chlamydia and Gonnoreha with accurate results?
Secondly, I tested positive for HSV1 IGG, does this mean it was an old infection and does this increase the likely hood of acquiring HIV
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Edward W. Hook M.D.
9 months ago
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Yes, you can entirely rule out any possibility of HIV-1 or HIV-2.
Tests for gonorrhea and chlamydia will provide accurate answers any time more than 3 days after an exposure.
A positive HSV IgG test is close to worthless. It may well be falsely positive or it could reflect an infection acquired long ago. Over 60% of American adults have had HSV-1 in the past- most of those infections were acquired during childhood
EWH
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