[Question #14152] Unprotected Vaginal Sex - Contact with genital entrance precum
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2 hours ago
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Hi Dr. Hunter, I am reaching out for assurance to help ease my anxious mind. Ashamed as I am and a married man, after bout of drinking, I made a stupid decision to drop the woman I was drinking with. I have known her in the past. She asked me to come in see her apartment which I went in and one thing let to the other. We started with foreplay and at some point she got herself undressed. I had no condom, she also didn't and I started rubbing my penis with my underwear on against her vagina area when she pulled out my penis and in attempt to insert in it, I immediately resisted and mentioned to her it wasn't safe. It was already too late as my penis touched the entry of her vagina which was very wet. I later on ejaculated outside. There was no penetration and thrusting however my penis tip very much touched her vagina entrance. Prior the event. I had played soccer with my son in the yard. As soon i started driving home, i started feeling extremely worried which has lasted for the past 4 weeks. Following 3 days later, I have a constellation of symptoms which has kept me severely worried including fatigue, joint pains, lack of energy, swollen lymph nodes in neck and jaw area, pain in chest area and most concerning burning sensation on my body which happens intermittently. At 9 days exposure, 4th gen test was negative, 16 days exposure at er, 4th gen test was negative and also negative for syphilis, gonorrhea, chlamydia. At 19 days hiv rna via health labs/ lab core was negative and at 27 days additional 4th gen test was negative for hiv. Considering my exposure, symptoms and tests what are my chances of staying negative. I fear I may have infected my spouse. Please your expert advice would help me while I wait for more subsequent tests. Thanks
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H. Hunter Handsfield, MD
1 hours ago
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Welcome to the forum. FYI, it's only by chance I am answering your question; users don't have the option of selecting the moderator who responds -- I happened to be assigned at this time.
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You are overreacting to a very low risk situation. I'd bet not one person in a million in your situation would be at risk for HIV -- and little risk of other STIs either. First, there are aspects about your partner that suggest she is at low risk for STIs and especially HIV. (HIV remains very rare in sexually active women in the US, except for some exceptions like injection drug users, some commercial sex workers, etc.) Second the exposure itself was low risk even if she were infected -- such superficial contact of the penis with the vaginal opening or fluids carries little or no risk. Third, your symptoms do not fit with HIV or any other STI. On the other hand they are perfectly typical for the physical manifestations of anxiety. Finally, your test results are highly reliable.
"Considering my exposure, symptoms and tests what are the chances of my staying negative?" Close to 100%. There is little chance you have infected your wife.
You don't say what gonorrhea/chlamydia test you had, but assuming it was a urine or urethral swab test, for sure you do not have either of these. Your negative HIV AgAb (4th generation) tests at 9 and 16 days proved your symptoms were not due to HIV, and the negative result at 27 days is nearly 100% conclusive you were not infected. If somehow I were in your situation, I would not have been tested at all for anything. But since you have started down that path, I suggest you have truly conclusive syphilis and HIV blood tests 6 weeks after the event. This doesn't mean I believe there is any chance you are infected with either one; I do not. They would strictly be for reassurance.
One final fact that might help reassure you: In the 21 years of this and our preceding forum, with thousands of questions from persons worried about HIV after a possible exposure, nobody has yet tested positive. You won't be the first. If or when it finally happens, it will not be from a near zero risk exposure like yours, but from a genuinely high risk event; think unprotected anal between two men, for example.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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