[Question #1844] HiV Asymptomatic

42 months ago
Hello Sir,
I am from INDIA.I have involved in a penetrative vaginal sex with a CSW in 2 occasions and it was protected in 2011 march but I dont remember it was broke or not. After the following years  I have stayed very healthy and gained weight also but just a fever once in a year and never had a chronic heache or fatigue or serious illnesses. After 6 years I have done a CBC and it is normal with WBC-7.5 and lymphs-30%. As I know HIV attacks cd4 cells and cd4 cells are half the composition of lymphocytes.There should be decline in lymphs and abnormalities in CBC right? I know it will be dormant on the outside..While it is active inside it should show a abnormality on CBC right?
Is there any way I have contracted HIV and doesnt know it, considering the prevalence in INDIA.
Please help me with my odds so that I can get some courage to take the test.
Please answer my question and help me out of the psychological predicament.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome to the forum. Thanks for your question, which arrived while I was logged in. Most users should not expect nearly real-time replies!

Although HIV is more common in India than some countries, I believe that on average fewer than 1% of female sex workers is infected. And HIV is transmitted an average of only once for every 2,000 unprotected vaginal sex exposures, if the female partner has HIV -- and your exposures were condom protected. Broken condoms are obvious; you would have known. But even if it broke during one of those exposures, the possibility you have HIV is extremely low, probably no higher than 1 chance in a million.

However, you are partly mistaken about blood counts. While longstanding or advanced HIV often causes abnormal results, including low lymphocyte counts, most persons with HIV under a few years duration have normal CBCs and lymphocytes.

As you suggest yourself, the answer to your worries is to have an HIV test. If these were your only possible exposures, almost certainly the result will be negative. As for your "psychological predicament", there really isn't one -- or should not be. It isn't the test that gives someone HIV. You have it or you don't. And if you do, you have to know in order to get care and save your life. Also, research shows that when people delay testing for fear of a positive result, stress declines after testing -- even if the result is positive. In other words, having the answer is almost always less stressful than the worry about it.

So just do it. It is nonsense to wait.

I hope these comments have been helpful. Best wishes--  HHH, MD

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42 months ago
hello Sir.
Thank you Sir for your reply
"While longstanding or advanced HIV often causes abnormal results, including low lymphocyte counts, most persons with HIV under a few years duration have normal CBCs and lymphocyte counts."
My doubt is HIV with 6 years considered a few years or long duration??
I heard with 6 years it probably would have showed with some of the opportunistic infections right?
Thanks in advance
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Some people with HIV for 6 years might have CBC abnormalities and some would have had opportunistic infections, but most would not have either of these. Your normal CBC and lymphocyte counts say nothing whatever about the likelihood you do or do not have HIV.

But these are the wrong questions. I gave you the main reasons that it is unlikely you have HIV. It is now your responsibility to be tested to know for sure. Just do it. As a reminder, forum policy is that two follow-up comments and replies are included with each question, so you have one more coming. I suggest you get tested and use the remaining follow-up opportunity to let me know the result. There is no point in any other discussion before then:  there is nothing you might think of that is likely change the opinion and advice I have already given you.

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