[Question #1282] POSSIBLE RISKY EXPOSURE

47 months ago

Dear Dr. Handsfield OR Dr. Hook

 

I am a straight married male and I had a risky experience in a massage parlor here in southern California. For about 2 months ago I was drunk and visited this massage place and initially I had protected vaginal sex with this Chinese girl, after some time my erection was failing and I withdrew, then I took the condom off and she started to give me a hand job, when I had erection again I think we had brief unprotected sex but I barely remember if we did or not. There is a time lapse where I cannot remember what exactly happened. I do remember that she, at the last, gave me a hand job and I ejaculated. I came some days later and the girl said we did use the condom all the time and that she is healthy. I don´t have reasons to believe or not in her version and that is not the point at this time, the doubt was there and therefore I decided to test in order to check my HIV status and clear up my mind. I haven´t had any symptoms, just a little discomfort in a lymph node under the jaw. I have read you say that test results rules, despite symptoms and the level of the risk of exposure.

 

After 20 days of this exposure I had an antibody only test, which was negative and a HIV-1 RNA qualitative also negative. At 6 weeks after exposure (5 weeks, 6 days, 12 hours) I had a HIV1/2 Antigen/Antibody 4th generation w/rfl test and this was also negative (non-reactive).

 

I have these questions for you:

 

1.- Do you know the HIV rate within female Chinese CSW in California?

2.- How accurate/definitive are these results

3.- Is it possible to test positive at 8 or 10-12 weeks? Need more tests?

4.- May I resume my unprotected sexual life with my wife?

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome to our Forum.  I hope that the comments that I am about to make will be reassuring and convince you that your exposure was low risk and that there is nothing further to worry about.  the general, statistical fact is that most commercial sex workers are very careful in terms of their STI/HIV risk (much more careful than a partner who might be met casually in a bar for instance) and check themselves regularly.  If she said she was healthy, she probably was.  Even in the unlikely situation that she had HIV, the likelihood of transmitting infection through a single unprotected exposure is only 1 infection per 1000 to 2000 acts of intercourse.  At this time, your test results absolutely confirm that you did not get HIV.  Your HIV RNA test would have been positive by 20 days after exposure if you were infected and the HIV antigen/antibody tests are completely reliable at 28 days (4 weeks following exposure.  You are in the clear and do not need further testing.  I suspect that your tender jaw lymph node is due to some other cause like an every day sore throat.


In answer to your specific questions:

1.  I do not know the specific rate of HIV among oriental CSWs in California but I am sure it is less than 2%.

2.  see above.  Your test results are definitive and should be believed.  No need for further testing.

3.  There is no need for additional testing.  Your results are definitive.

4.  Your results are definitive. there is no risk for you transmitting HIV to your wife through unprotected intercourse. 


I hope these answers are helpful.  EWH

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47 months ago
Thanks Dr. Hook, It is a relieve to read your answer. I forgot to tell you that at 20 days I also had a gonorrhea and chlamydia test, both negative. Thanks again. 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
thanks for your thanks.  Your negative tests are still further evidence that you were not infected.  Take care.  EWH
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