[Question #1299] HIV Scare

47 months ago
Hello Dr.
Hope all is well.  On 4/24/16 I had protected vagina sex with a CSW worker.  As I was about to ejaculte I pulled out and realized the tip of my condom was broken.  The whole encounter lasted 2-3 minutes.  She looked at me and said I am fine. On 4/26/16 i went to my DR and asked for lab work.  4th gen HIV test was non reactive and negative for all other STDs.  On 5/3/16 I had a RNA HIV test done 9 days after exposure and it was non reactive.  After further research I understand that test at 9 days is to early.  On 6/15/16 I had a 4th Gen HIV test done again and it was also non reactive.  On 7/18/16 I had my three month follow up with DR, to revisit lab work again including 4th Gen HIV and all other STDs, came back non reactive and negative.  On 8/2/16 I had another 4th gen HIV test done at lab which also came back non reactive. After reading on line, I see that the 6 month period is the definite conclusive report. Is that still the case?  Or are all of my test done so far  prove that I am HIV negative? The anxiety has gotten the best of me and I am looking for some closure. I am also held up on 6 months because my DR recommended 3 & 6  month follow up.  Thanks for your support.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome to our Forum.  I'll start by congratulating you on your commitment to safe sex and acknowledgement of the fact that when used properly condoms break about 1% of the time.  Please don't let your prior condom failure keep you form using them in the future.  Condoms remain the best method for prevention of STI acquisition when exposed to an infected partner.

As far as your HIV test results. I can confidently and emphatically inform you that you were not infected by HIV at the time of your 4/24 condom failure.  Fourth generation HIV tests are definitive at any time more than 4 weeks after an exposure.  Unfortunately some very conservative governmentally funded sites continue to state that results are not conclusive until 3 or rarely, even 6 months after an exposure but this is clearly overly conservative based on many, many carefully conducted studies from around the world.  Sadly, when people mention these conservative guidelines they fail to appreciate the harm and anxiety they provoke by keeping people worried for longer than is needed.

You are clear.  Believe your tests. There is no need for further testing of any sort related to the 4/24 exposure you have mentioned.  I hope my comments are helpful.  EWH

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47 months ago
Dr. Hook,

Thanks for your fast reply.   Some days I do good and some days I worry that I have contracted HIV.  As I briefly glanced over some of your publications, understanding that you are an expert in this field I fill somewhat relieved by your reply.  Thanks for all that you do.  Time for me to put this behind me....
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Great, glad I could help.  EWH
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47 months ago
Hey Dr,

Quick question, I forgot to mention the tip of the condom was completely missing.   So I could have been in the female unprotected for 2-3 minutes. Does that change your reply?  Sorry...
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago

No change in my assessment or advice.  Believe your test results. 

This will end this thread.  Take care.  EWH

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