[Question #12439] Update... Please help

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7 months ago
Hello, if you read my previous message about a week ago, this is just a follow-up to that. I had sex with a 52-year-old woman Tuesday December 17th and it was unprotected, vaginal, oral and kissing just once she was with a previous guy Saturday December 7th she said he wore a condom. She was with him a handful of times. But anyway, the following day last Wednesday December 18th she went to get tested for HIV and STDs Aunt. The HIV test was negative and that was about 10 days after she was with that guy on December 7th. So is there any way that I can still get HIV from her if she tested negative 10 days after him and then I was with her last Tuesday December 17th. Is there any way I could still be positive or know if she tested negative?. Do you think I could still get HIV if she had it if she tested negative the day after we got unprotected? Also, she said she tested positive for syphilis and she's going to start penicillin so I was with her 10 days ago. Should I be tested for syphilis now? Also, I am going to get a HIV RNA test.. is it okay to take the RNA HIV test tomorrow or Saturday? I was with her Tuesday, December 17th
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H. Hunter Handsfield, MD
7 months ago
I'm sorry you found it necessary to return.

Your focus on HIV is misplaced. The chance your partner acquired HIV recently enough to infect you and nonetheless test negative is nearly zero. And looking back at your older threads, on at least one occasion you were informed of the numerical risk of HIV from a single episode of unprotected vaginal sex, if the female has HIV:  one chance in 2,500. If we guess one chance in a thousand she had been infected just before your sex with her, the odds you caught HIV are one chance in 2.5 million. Obviously that's zero for all practical purposes. Feel free to be tested for HIV if you wish, just don't do the RNA test until 11 days after sex with her. That's when the RNA test becomes conclusive.

The bigger deal here is your partner's newly diagnosed syphilis. If her positive test is confirmed, and if her doctors believe she caught it recently, then you not only need testing for syphilis -- you must be treated for it with penicillin. If you're in the US, it's likely the public health department in your area already knows of her infection and likely will be contacting you in order to assure you get treated, perhaps in public health's own clinic. If they don't contact you, you should phone them. If your story is accurate, they'll be on you like white on rice. When you're in touch with PH, also make sure they understand your HIV concerns:  they will provide the most accurate information about HIV testing, tailored to your needs. (If you're not in touch with PH for some reason, still you need to find a doctor or clinic knowledgeable about both syphilis and HIV -- then follow their advice.

I look forward to hearing back from you about all this, after you have been in touch with public health or your own doctor or clinic. I won't have much if anything more to say until then.

HHH, MD
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7 months ago
Ok will do... I'll update your accordingly..... Can I take the HIV RNA test Saturday Dec 28 in the morning ??? I had sex with her Tuesday night Dec 17.. 

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H. Hunter Handsfield, MD
7 months ago
There are no data by which to know if there's a difference in reliability at 10.5 versus a full 11 days. Why not avoid the uncertainty and wait another day (until 12/29) before testing?---
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7 months ago
Hello, update here... So, as for myself I went to my doctor yesterday 12/27.. told him the entire story.. he wanted me to have all HIV / STD testing regardless.. so it was 10 days after my unprotected encounter these tests were taken.. the syphilis test came back negative; though the woman I was with tested positive for it Dec 18th..  I have no symptoms etc... thoughts? I read for a person to acquire syphilis from one unprotected  encounter with someone who has it already is a 10-30 percent chance.. you agree? Also, the last time the person I had unprotected sex with on December 17th.. she said her last time before me was December 7th...then me Dec 17th .. she took a HIV RNA test yesterday morning (20 days ) after Dec 7th.. this is conclusive for her right? I am going Monday for my HIV RNA test in bought as well... It'll be 12.5 days since December 17th - Dec 30th.. that ok? Should be negative? 
So what do you think about me and the syphilis thing?? Good chance I didn't catch it? Also, I asked my doctor if I should take any antibiotics/ pennecilin, he said no... And for sure I will be a tested again after 6 weeks... For HIV and STDs.. then I have my physical the second week of April which I'll be tested again for everything because it's mandatory with the test that my facility doctor office..

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H. Hunter Handsfield, MD
7 months ago
The 20-30% risk of syphilis for sex with a newly infected person is probably about right. So the odds are in your favor there. Still, if your partner's positive syphilis test result has been confirmed (i.e. positive on a confirmatory as well as the initial screening test), you should be treated with long acting penicillin. I'm surprised (and disappointed with your doctor) that this hasn't been done yet. Failure to treat you flies in the face of all standard recommendations by all authoritative, knowledgeable experts and agencies for several decades. (As suggested above, you could call your local or state health department to confirm this. Or just show this discussion to your doctor.) Of course this makes assumptions about the certainty of your partner's diagnosis. In any case, your negative syphilis test at 10 days is only valid as a baseline to know you didn't have it before. If not treated, you should be tested at least at 2 week intervals; and you'll need to hold of on any sex with anyone for the next several weeks until you've had another negative test result in 6 weeks.

As for HIV, you're home free there. Your partner's negative RNA test at 20 days is solid proof she didn't have it and you cannot possibly have HIV. You don't need your own RNA test or any further HIV testing.

Threads are routinely closed after two follow-up exchanges and this is the third. Goodbye and good luck.
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