[Question #1367] Scared HIV Risk- Severe Anxiety Cannot Sleep

47 months ago
Scared Student- Debilitating Anxiety- Please Help Shed Knowledge

Hi Dr. Handsfield- I am ashamed of myself because I got drunk and early Sunday (11/6) morning and a stripper with unknown status inserted my unprotected penis into her for a short time maybe 2-5 minutes max with no ejaculation. After I asked her she said she was tested 3 months ago and was clean and said she never does what she did with me she is usually very safe (took that with a grain of salt). However, I just learned she is a former heroin addict and I am petrified. I went to my doctor and told him I was concerned about being exposed to something so we did a Chlamydia and GC test Tuesday (11/8) (results Friday 11/11) and in three weeks (11/29) we will run a blood test. I never told him it was a stripper or her past drug history I was too ashamed of myself. I have been having night sweats and nausea, is this likely from anxiety or HIV? Please let me know my risk for contracting HIV because I am unable to sleep and cannot live 3 weeks like this. Will the blood test in 3-weeks be conclusive. Please please shed some light. This is the worst feeling ever.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Welcome to our Forum.  Dr. Handsfield and I answer questions interchangeably and I happened to pick up your question.  As an FYI, I over 35 years of working together, despite our different verbal styles, we have never disagreed an our assessments or management advice.

The interaction you had did put you at risk for acquiring an STI, including HIV, although the risk is low.  Most commercial sex workers, including CSWs who do or did inject drugs do not have HIV or other STIs.  Further, no single exposure to an infected partner is likely to result in infection.  In fact, most exposures do not.  Despite that, testing is appropriate.  Testing for Gonorrhea and Chlamydia 2 days after exposure will provide reliable results and no further testing for these STIs is needed.  As for HIV, rather than test at 3 weeks, I would suggest you do so at 4 weeks and be sure that the specimen is tested with a4th generation, combination HIV antigen/antibody test.  At 4 weeks using this test your test results will be conclusive and will not need to be repeated.  I would put your risk at having gotten HIV from the single exposure you describe at less than 1 in 50,000.

Your current symptoms are not suggestive of any STI but are quite suggestive of anxiety.  

I urge you not to worry too much about this exposure.  Your testing plan is the correct one and your risk for infection is quite low.  I hope these comments are helpful.  EWH
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47 months ago
Thank you Dr Hook that makes me feel instantly better. I tend to go straight to worst case scenario so my question now is if she were infected and carried HIV how likely would I have contracted it? I am a college student and have gotten 1-2 hours of sleep a night since and have big interviews coming up and just want this behind me. Also if I test positive for GC or Chlamydia would that indicate increased risk for HIV? Thank you again. You are all doing a great service.  My doctor said "You can't negotiate with an erect penis."  If I am lucky and test neg I would argue this is quick lesson in how to negotiate! 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
I think your anxiety may have led you to ISS my response to your question.  As I said, IF she had HIV and was not on treatment, you risk of infection following a single unprotected vaginal exposure would be between 1 in 1000 and 1 in 2000.mmif you had Gonorrhea and/or Chlamydia, your risk would increase to about 1 in 500.  Still not something to spend a lot of time worrying about.  EWH---
47 months ago
Thank you Dr Hook. I did not have any STIs before this event so my question about GC & Chlamydia was if I acquired from her, which I will find out Friday, if that test would indicate any increased risk?  I guess I am trying to use this shorter period test to determine the longer term result of the 4 week blood test. I realh do appreciate all your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
As you know, only three replies are permitted per question.  After that further anxiety-driven questions will be told that this is the case and closed.

Your anxiety is getting the better of you and "what if" mental masturbation will not be helpful. If your tests are positive for Gonorrhea or Chlamydia, you will be at somewhat increased risk for HIV as described above but more testing or testing more quickly will be mostly a waste of your time and money.  Take a deep breath, relax and work to move forward.  Your risk is low.

This ends this thread which will be closed shortly.  EWH
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