[Question #1630] HIV infection help please?

44 months ago
I'm very scared because last December 08 I had sex with a transvestite.
I did passive (receptive).
I did oral sex for a few seconds without a condom to the transvestite.
The transvestite used condom at the time of penetration.
At 12 days I did a 4th generation vih test with negative result.
At 19 days I had a p24 antigen test with negative result.
At 23 days I did a 4th generation vih test with non-reactive result value 0 25, range <0.9 non-reactive.
At 29 days I did a hiv 4th generation test with negative result, I need more tests ?, thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome to our Forum.  The encounter that you describe was low risk for HIV and other STIs.  Most people, including most transvestites do not have HIV and even when a partner does have HIV, most exposures do not result in infection.  In your case, the risk for acquiring HIV from performing oral sex on your partner is less than 1 infection in 10,000 encounters, IF your partner was infected and it is unlikely that she was.  With regard to your receptive rectal sex, it was condom protected and as long as your condom did not fail, this was safe sex.  (when condoms fail, they break wide open and it is obvious that they have broken so if you did not see that the condom was broken after sex, the condom did its job.

Finally, your test results prove that you did not get HIV.  4th generation, combination HIV antigen/antibody tests provide definitive test results at any time more than 4 weeks (28 days) after infection.  Thus the result of your 29 day test proves that you were not infected. There is no need for additional testing, you can be confident that you did not get HIV from the exposure you described. 

I hope this response to your questions is helpful.  EWH

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44 months ago
Thank you for your answer doctor, are you sure that my exams are conclusive ?, my doctor told me that I have to wait 3 months to have a definitive result and not 28 days, please your comment because I want to continue my life with my wife without fear of Contagiarla, I'm thinking of doing a test more at 6 weeks, consider that I need this test ?, thank you

I commented that at 3 weeks I had a blood test for hepatitis b (Australian antigen), herpes II (igg, igm), syphilis (rpr), chlamydia (igg, igm), with negative results.

Thank you very much
44 months ago
Thank you for your answer, I did not check if the condom did not break, taking this into account, are you sure that my tests are conclusive ?, my doctor told me that I have to wait 3 months to have a definitive result and not 28 days , Please your comment because I want to continue my life with my wife without fear of Contagiarla, I am thinking of doing another test at 6 weeks, I consider that I may need this test ?, thank you

At 3 weeks I had a blood test for hepatitis B (Australian antigen), herpes II (IgG, IgM), syphilis (RPR), chlamydia (IgG, IgM) with negative results.

Thank you very much
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Your doctor told you conservative advice which reflect the "official" recommendations which are approved by regulatory bodies such as the U.S. FDA.  these results are overly conservative and do not completely reflect the research data.  The research conducted on these tests however prove that current 4th generation, combination antigen/antibody tests provide completely reliable results at 4 weeks after exposure.  You should have confidence in your test results.  

There is no medical need for additional testing.  EWH
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44 months ago

Thank you for your response, do you consider that I can continue having sex with my wife without protection ?, I am afraid to infect her. A question at 3 weeks are reliable results I had for hepatitis B (Australian antigen), herpes II (IgG, IgM), syphilis (RPR), chlamydia (IgG, IgM)? Thank you very much.
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Yes, there is no reason for you to worry that you acquired HIV and could give it to your wife through unprotected sex. 

Three weeks is a little early for tests for hepatitis B or syphilis to become positive if you had acquired one of those infections; typically testing at 30 days is preferred as the time for testing although some experts would recommend that your results were not conclusive for these two infections until three months after your exposure.  We do not recommend blood tests for diagnosis of either herpes or chlamydia, particular not IgM tests which can frequently be falsely positive.  For the diagnosis of chlamydia, a PCR-type test taken from the site of exposure (in your case, your rectum) is the recommended test. In the case of herpes, if you have not developed lesions consistent with herpes (sores) by know, you can be confident that you did not acquire herpes from the exposure that you have described. 

At this point your overall risk for infection is rather low. I would not be worried further if I were you

This is my third response to your questions.  Therefore, as outlined on instructions for our Forum, this thread will be closed later today.  EWH

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