[Question #12557] Hiv concern
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7 months ago
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Hello,
Several days ago, beeing drunk i had an encounter with few minutes of unprotected vaginal sex (i am male). The next day i got paranoid and talked with the girl if i should be concerned of any diseases. It seems that she had a full gynecologist check up and tests for chlamidia, hpv etc, but no hiv test whatsoever. But she told me that her doctor said that her negative ureaplasma and mycoplasma tests should give an indication that she has no hiv or other infections. Is there any truth to that? At least, ar there just a few chances that those tests should hint about her hiv stats? I read everywhere that the only tests for hiv are by blood samples.
Thank you!
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H. Hunter Handsfield, MD
7 months ago
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Welcome. Thanks for your confident in our services.
Even among the most sexually active women, the large majority are not infected with important STDs at any point in time; and it sounds like your partner is especially unlikely to be infected (people uncommonly lie about HIV/STD status or testing when asked directly). It's interesting that she apparently wasn't tested for HIV, which usually is automatic when STD testing is done. Maybe that means she also didn't have a syphilis blood test -- but syphilis is especially rare in this situation.
Your partner's negative tests for Ureaplasma and the genital mycoplasmas doesn't mean anything one way or the other. These are normal bacteria in the genital tract and, contrary to lots of online information, generally do not cause symptoms and do not need treatment if present. That said, it is true that their absence is at least a little bit reassuring, since these bacteria are shared by sex partners and might suggest low risk of other, more important infections. But as for HIV, even among the most sexually active women in industrialized countries, typically under one in a thousand persons is infected.
In absence of symptoms you can be confident you weren't infected. However, for proof and for reassurance you could have a urine test for gonorrhea and chlamydia, which are valid now (any time more than 4-5 days after exposure), and blood tests for HIV and syphilis after 6 weeks. A PCR blood test for HIV RNA could be done and is conclusive only 11 days after exposure, but the chance of HIV is so low that I really don't recommend it. Whatever you do, stay mellow as you await results: the chance you were infected is very low.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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7 months ago
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Thank you for your prompt answer. As it seems that she was tested for chlamydia and gonorrhea, i will include those later in a bigger anually set of tests. Beeing in a relationship...i thought about the hiv rna test. Your 11 days conclusive seems so reassuring. (I will definitely do some antibodies tests, later, but i want some tangible result just for the sake of my mind) My only problem with the pcr test is that is made only for hiv 1 version? What about the second type of virus?
I will take that pcr, and antibody tests at 11, 28 and 45 days, hopefully until the final one i won.t feel the urge to come back with questions, and that i will have no symptoms or other worring signs whatsover.
Thank you alot!
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H. Hunter Handsfield, MD
7 months ago
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PCR tests that detect both HIV types have been developed recently and are commonly available. Check with whatever lab you're considering. In any case, HIV2 is nearly absent in the US and your chance of having acquired it are in the same range as the possibility you'll be struck by a meteorite. It's really not a realistic concern.
Once you've had a negative PCR at 11 days or later, you won't need the additional HIV tests.
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6 months ago
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Hello again Mr Handsfield.
I took your advice and did the rna pcr test at 11 days after the encounter. It came back undetectable, thank God.
Now for my last concern: i know regarding the antibody tests that the "conclusive" time range has shrinken from 6 months to 3 then 45 days and some may say 28 and i understand that because of the tests evolution. But regarding the PCR RNA tests, i ve seen again lots of opinions regarding it.s timeline: 11, 12, 15, 21 or even 28 days for it being conclusive. I know that "conclusive" it.s a big word because the test it.s not designed as an ultimate solution for revoking this virus. But i.ve seen on the internet many questions about the rna.s test accuracy at a certified no. of days and if you may want to elaborate a bit why there are some that go for different time intervals eg 11 vs 28 days, just for my peace of mind (i value your opinion more as you are a somity in this domain).
Also i am not from US, i am from Romania, i just hope we have the same quality standards as you in the US have.
Thank you!
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H. Hunter Handsfield, MD
6 months ago
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This may be a bit more information than you were expecting, but I'm taking this question as an opportunity for one of my occasional blog-like (i.e. long winded!) replies that might be useful in responding to future questions or concerns.
It isn't primarily the evolution of the tests themselves that have led to changing statements about times for conclusive results ("window period"). For the most part, the tests have not changed. However, improved data become available with increasing use of the tests. Soon after a new test becomes available, obviously there is limited experience, but over time, more and more people are tested and different data emerge, resulting in modified advice to the public. Thus the advised time to conclusive testing for the RNA/PCR tests has declined from 2-3 weeks to 11 days; and the AgAb (4th generation) tests were originally considered conclusive by 4 weeks, but this was extended to 6 weeks as data showed rare patients in whom it took that long for a positive result.
The scientific data and resulting standards ideally should be the same world wide. However, some public health agencies, government-funded prevention programs, etc may take more or less conservative stances -- either because they may wish for confirming other countries' data in their own populations, or because of social or political considerations. For example, my impression is that religiously conservative countries (or some clinics and agencies in them) tend to state very long window periods, perhaps in hopes of influencing sexual lifestyles. (Which probably doesn't work!) I have no knowledge about how these factors play out in Romania -- but for the most part, I believe Central and Southern European countries use the identical tests in common use in North America and Western Europe, so the actual data on window periods probably are valid in all those countries.
That completest the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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