[Question #134] HIV Potential?

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104 months ago
About 7.5 months ago I had protected sex during a one nighter with a woman whose HIV status is unknown. Never saw her again and of course when I asked her at the time she indicated that she was free of all STD's. There was some unprotected oral involved briefly where I performed and mostly received. All penetration was protected.

At the time I had some imaginary symptoms like most of us do and was extremely paniced. So I went to see an infectious disease specialist and an urgent care physician a few days apart. Both performed full panel of STD tests on me. One set was done at 5 weeks and another set at 5.5 weeks of potential exposure. The 5.5 week test was done by the infectious disease specialist and he indicated that the way he ordered his tests was much more comprehensive then basic testing and he had looked at every potential risk in a more detailed way. I'm not sure what that exactly meant medically but all results including HIV was negative on both sets of tests. Thereafter I never followed up with 3-month or 6-month tests as both doctors told me that I could follow up with another test in a few months just to be text book proper but the chances of anything turning positive was highly unlikely given the specifics of my potential exposure and the test results. So I never followed up.

The last couple of months I've been experiencing some significant joint pain in my shoulders, neck, wrists, elbows and lower back. The joint pain in the shoulders, elbows and wrists is symmetrical on both sides when it comes on. I went to see my primary care physician with the complaint. After extensive blood work he determined that my vitamin D levels were significantly low. He had me on substantial doses of Vitamin D which has reduced the joint pains and fatique significantly but hasn't cured it completely.

So of course I am now thinking is this an HIV symptom by any chance dating back to the potential exposure 7.5 months ago. Do you think I should go get tested for HIV again?

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H. Hunter Handsfield, MD
104 months ago
Welcome to the Ask the Expert forum.

Straight to your key question:  There is absolutely no chance you have HIV.  With the standard HIV tests, the results always overrule both exposure history and symptoms, as long as testing is done sufficiently long after the last possible exposure. That time varies with the type of test done, but my guess is that your ID specialist's "much more comprehensive" test(s) were either a 4th generation ("duo", "combo") test, i.e. for both HIV antibody and p24 antigen; or that you had a PCR test for HIV DNA (or RNA) plus an antibody test. If so, those results are conclusive any time 4 weeks or more after exposure.

The risk of HIV from the exposure 7 months ago was virtually zero anyway (protected, plus the chance a woman of "unknown" HIV status is infected is probably under one in a thousand), and your symptoms are not at all typical for HIV. But even if the risk were high or the symptoms typical, it wouldn't matter. Your test results are valid.

If you would like still further reassurance, you could re-contact the ID doc for his opinion, which I'm sure would the pretty much the same as mine; or have an HIV antibody test. But really, it isn't necessary except to the extent you would find it reassuring. Assuming no further exposures, you definitely don't have HIV.

I hope this has been helpful. Best wishes and stay safe--  HHH, MD