[Question #12143] HIV Question

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9 months ago
Doctors, I know I have asked a few questions on here.  My previous question was related to multiple sex workers in one night. Being drunk I don't remember a lot but the brothels require condoms. I know sometimes, people might pay more to not use one. My question is, if that were the case, and my condom slipped or broke, can a previous customers fluids infect myself as well if they were still inside the brothel worker? I also performed cunnilingus as well on one. I have tested negative with pcr at 15 days as well as a rapid ag/ab duo at 34 days and an HIV 1 and HIV 2 +p24 at 42 days. I realize I may be over the limit of questions but I have seen in the past that if a different question was asked you have answered it. The reason I doubt the test are because I am away for business now in Africa (exposure was in Germany) and while the lab is trusted it seems, I still have my doubts because I am not at home. I ask that you please not delete my question as this is the last one.
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H. Hunter Handsfield, MD
9 months ago
Welcome back. However, prior questions usually are helpful in properly understanding and enhancing the advice we give, but you have deleted your three previous ones (11917, -29, -58). All I can say now is that the tests you had all are highly automated and even the exact same equipment is used in almost all labs world wide and the result equally reliable, especially in industrialized countries. Also, that all the several tests you had would have falsely negative result is untenable. For sure you do not have HIV. And the idea that you were provided a used condom is also pretty ridiculous.

Perhaps I'll have more to say if you would like to summarize your previous three questions and the advice we gave. Otherwise this thread shortly will be closed.

HHH, MD
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9 months ago
Sorry for the lack of context. I was drunk in Germany, I visited a red light district where I engaged in sex with multiple brothel workers. I do not remember everything. What I do remember, is that I engaged with multiple workers, possibly 3 or 4 and I engaged in cunnilingus on one which you have said is very low risk. The law in Germany is everyone must wear a condom. I did not mean I was given a used condom. I have heard that some people pay more to not wear a condom. My question was that if that was the case, and my condom had slipped off or broken ( night is very fuzzy), and the client before me had HIV and somehow their fluids were still inside the brothel worker, could their fluids also infect me from the sex or cunnilingus. Like I said, the law is condoms, but being that I dont fully remember if one broke or slipped off, I wanted to verify my risk. I was also curious as to the timing of the AG/AB rapid combo test. I have read online that it takes 90 days to be conclusive but this some doctors (such as yourselves) indicate that they are approved and held to the same standards as lab tests.
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H. Hunter Handsfield, MD
9 months ago
If I correctly understand, today's question asks about the same exposure events as your previous three. And my reply above seems to address all these issues. For sure you do not have HIV; and hence the risk of HIV at the time no longer matters (e.g. if you had been given a previously used condom -- which I still judge as exceedingly unlikely). As for other STDs, you would be wise to consider testing potentially exposed sites for gonorrhea and chlamydia and a syphilis blood test if these have not yet been done.

Three months to conclusive HIV testing is old news, out of date by at least 20 years. As I imagine we told you a month ago and as implied above, your current tests are conclusive. Indeed, each test you had was conclusive all by itself at the times you had them.
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9 months ago
I do not think I was given a used condom. I meant to ask, if someone else before me had seen the sex worker, and hypothetically got his fluids inside her (semen), and I was after him and I was exposed to his fluids in her vagina (either by sex or cunnilingus) can I be at risk. As in IF my brand new condom broke or slipped off, and his fluids inside her, touched me. Thank you for the clarification. I have seen all over the internet that Rapid Tests are only conclusive at 90 days. It was blood from a vein but used on 4th gen ag/ab rapid. 
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9 months ago
And I tested for Syphillis at 5 weeks and was Negative. I will be testing for Gonorrhea and Chlamydia this week. 
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H. Hunter Handsfield, MD
9 months ago
Sorry I misunderstood that detail. In theory it might be possible to acquire HIV or other STD by vaginal exposure to semen deposited by another partner, if within a few hours, but for obvious reasons there are no data. If it happens, undoubtedly it is exceedingly rare. But still, now knowing you are not infected, this possibility (or other risks at the time) makes no difference.

I don't care what you have seen "on the internet". Ninety days is BS, even for the rapid fingerstick tests. The oral fluids test reaches maximum performance at ~8 weeks (it's an older, second generation technology) and some advice about it might still say 90 days to provide a margin of error. But that's the last test anyone should use after a worrisome exposure, since up to 5% of infected people NEVER develop positive test results.

You'll be a lot safer in online searching, whether about HIV or any other health problem, by sticking with professionally run or moderated sites, and staying away from those by and for people with or worried about that particular health issue. Like Reddit, for example.

That concludes this thread. In case you weren't advised last time, please note the forum policy against repeated questions on the same topic. This being your fourth in a few weeks about the same exposure and HIV testing, it must be your last. Repeated anxiety driven questions are subject to being deleted without reply and without refund of the posting fee. We're not keen on collecting fees for questions with obvious answers; repeated replies often prolong anxiety rather than relieving it (there's so often a "yes but" or "could I be the exception" sort of thinking); and such questions have reduced education value for other users, one of the forum's goals. Thank you for your understanding.

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