[Question #13141] Worried about HIV
2 months ago
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I had an HIV antibody and p24 antigen test 14 days after having UNPROTECTED intercourse with a female (I am 29, male). We had unprotected intercourse THREE times.
I now understand that my ‘not detected’ result was meaningless for this type of test in this timeframe.
Given my stress about HIV, a different clinic recommended the HIV 1&2 RNA Qualitative PCR. They advised that the results would be 100% concrete at 14 days.
For peace of mind, I waited until 21 days after the last intercourse exposure to have my blood samples. The results for both HIV 1&2 RNA were ‘not detected’.
Please can you help me? Am I clear of HIV?
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H. Hunter Handsfield, MD
2 months ago
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Welcome to the forum. I'm happy to help.
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You have greatly overestimated the risk of HIV in this situation. First, the chance your partner has HIV probably is low. Even if she does, the average risk of catching the virus is under one chance in 2,000 for a single episode of vaginal sex with an infected female partner. If we assume a 1% chance your partner had HIV (which probably is far too high), plus three exposures, the likelyhood you would have been infected was under one chance in half a million. (Let me know if you need help with my calculation.)
Perhaps most important to reassure you, the clinic was absolutely right about the PCR test and its reliability. That test detects 100% of infections any time after 11 days. No matter how high the risk of HIV at the time of exposure, your test results prove you were not infected. You could have told me you mainlined blood from a person known to have HIV: my reply would be the same.
In other words, yes: you definite are clear of HIV. Stop worrying and don't have any more HIV tests!
That said, you might want to consider a urine test for gonorrhea and chlamydia; the risk of these is far higher than for HIV. And maybe also have a syphilis blood test when you reach 6 weeks after the event. You can expect negative results.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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2 months ago
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Hello Doctor - thank you for taking the time to comment.
Please correct me if I am wrong, however I have read that being uncircumcised doubles the risk of HIV? (I am uncircumcised).
Some additional points (not sure if they add anything):
1. My partner was not a sex worker (a girl I knew from University). I just know she had been seeing a few guys.
2. These exposures happened in the UK (we are both Welsh).
3. These exposures happened in January 2025 (I have had NO physical symptoms since, save for a small rash on my hand the size of a quarter which comes and goes. However, I think this could be a heat rash as I understand STD rashes do not disappear?)
Please let me know if this changes your advice for me to move on without worry regarding HIV.
Thank you for your help.
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H. Hunter Handsfield, MD
2 months ago
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These questions show you didn't fully understand the important part of my reply above. All aspects of the exposures and your symptoms are entirely irrelevant. No matter how high or low your risk at the time, and no matter what symptoms you have now or in the future, your test results are proof you do not have HIV. Believe it and move on!
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Being uncircumcised doubles the risk of HIV if sexually exposed. But you have to be exposed; and even then, double risk is pretty meaningless. Look at it this way: if the risk of HIV from a particular exposure is one in a million, as yours probably is, then being uncircumcised means the risk becomes one chance in 500,000. That's still zero for all practical purposes.
OK?
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2 months ago
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Thank you for your assistance Doctor and I apologise for any misunderstanding. The last few months have been extremely stressful for me thinking about HIV from these exposures.
I understand that you and Dr Hook have never been wrong with a single analysis regarding HIV in the 21 years of your forums, therefore this is very comforting.
Thank you once again.
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H. Hunter Handsfield, MD
2 months ago
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Yup -- that's true. In the 21 years of this and our previous forum, with thousands of questions from persons worried about HIV, nobody has yet told us they eventually tested positive. If and when it finally happens, it will be from a far higher risk exposure than yours and their first test results will not be false.
Thanks for the thanks. I'm glad to have helped. Take care and stay safe.
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