[Question #1895] Possible HIV Exposure

80 months ago
Hello im a 30 year old male and currently live in Malaysia (Kuala Lumpur). I made a huge  mistake and had unprotected sex with a sex worker 5 weeks ago. I went to get tested 2 weeks after exposure for all STI's and came out negative BUT HIV is one of the sti where the results are not accurate enough at that time. I just did another HIV antibody blood test last week ( at the 4 and half week mark) havent received the results. I have been very anxious lately and been doing a lot of HIV research in google an now I cant tell if my mind is playing tricks on me and what is what as far as symptoms go. I noticed a week ago my left side of my neck the lymph nods are swollen but doctor said it was due to ear infection. Also couple days after the encounter my groin was red and very itchy. What are my chances of getting HIV from this one time exposure (Havent had any other after this one and I know before this exposure I was HIV free as I get tested regularly). I am freaking out.
H. Hunter Handsfield, MD
80 months ago
Welcome to the forum. Thanks for your question.

First, the odds you caught HIV from this exposure are very much in your favor. A single episode of vaginal sex with an infected woman carries an average of one chance of infection for every 2,000 events. And staistically it is unlikely your partner had HIV, under a 5% chance in most of east Asia. Second, your first test is partly reassuring. Even at 2 weeks, 50-90% of newly infected people have positive results, depending on the specific test done (antibody versis antigen-antibody test).

And perhaps most important to you at this time, the symptoms you describe really don't worry me. If acute HIV causes symptoms at all, they are generally not so subtle. The lymph node enlargements would be body-wide, not localized to one side of the neck; and itching, in the groin or anywhere else, doesn't suggest HIV. And the timing of your symptoms is also against HIV, which usually causes symptom onset 10-15 days after exposure.

So I am very coinfident your repeat HIV test will also turn out negative. If it is a 4th generation (antigen-antibody) test, the negative result will be conclusive. Please return with a follow-up comment to let me know the result. But stay mellow in the meantime. As I said above, the odds are very strongly in your favor.