[Question #217] Confused and Struggling with marriage

36 months ago
So I stepped out side my marriage and met with a korean escort.  she could barely speak english, so she never told me her status.  We were both naked and I had unprotected vaginal penetration with my penis for about 10 seconds.  It was mainly rubbing her vaginal area, but I may have penetrated her an inch at most.  I freaked out after that and left, but had a complete test at 6 weeks and 12 weeks.  All negative for hiv using antibody blood test, syphilis, and chlamydia. No signs of herpes, but I did do blood work at 16 weeks for herpes type II .  So my questions are , 1) was there a risk for HIV transmission, if so what are the chances I did acquire HIV? 2) the gum clinic in the DC metro area said they recommended 12 to 16 weeks for an accurate results, does that sound correct 3) what are the chances of false negative results, i read that its 99.3 percent accurate, if thats the case then after 10,000 people test ; 700 would be given false negative. doesn't that seem like a lot of missed results?  
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome to our Forum.  I will do my best to help.  Starting with the "punch line" I want to assure you that you no longer have any reason to worry about having acquired HIV from the exposure you describe.  Having said that, let me provide you with the reasons I say this with confidence.

First, your exposure was low risk.  Most commercial sex workers (CSWs) do not have HIV or other STIs.  Even when they do however, the risk from any single exposure is low-in the case of HIV the average risk for HIV acquisition from a single exposure is less than 1 infection per 1000 exposures and this average is probably a high estimate for you given the brief duration of your exposure.

Second, you have negative HIV antibody tests more than 8 weeks after your exposure.  Whomever told you that results are not conclusive until 12-16 weeks was being overly conservative and was probably based on old, out of date information.  At this time with currently available antibody tests, results are conclusive at 8 weeks and no further testing is needed beyond that time.

Finally, and parenthetically, with regard to your question about false negative tests not only is the false negative rate you mention far too high but, in addition, your math is off by a factor of 10.  If tests were only 99.3% accurate (and they are far higher), there would be 70, not 700 missed infections.

Thus, again to state the bottom line.  Based on the information you provide, you can be completely sure you did not get HIV from the exposure you describe, you do not need further testing, and there is no reason to worry about unprotected sex with your wife related to the exposure you describe.  I hope these comments are helpful to you.  EWH
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36 months ago
So the chances of false negative after 12 weeks is still going to have 70 false negatives . Seems high 
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago

Perhaps by pointing out your math errors I caused you to miss all of the rest I said. 

The 99.3% sensitivity figure (i.e. 0.7% false negatives) is far too low.  The real figure is more like 99.9+%.  Further, as I also said, that is to detect infection if you were exposed.  The probability that you were exposed and infected is also less than average.  Your chance of getting struck by a meteor from space is higher than your chance of having gotten HIV.  I urge you to believe your test results and move forward without concern.  EWH

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36 months ago
Sounds Great! I will move on with my conclusive test and forget about the possibility of acquiring hiv.  One last question, then you can close this out.  Does the entire country still using 3rd generation test because they drew my blood from my arm, (not the finger prick) and use it for HIV testing, but I'm assuming they took that sample to do syphillis test as well.  So I don't have to worry about a clinic using a 2nd generation test or older?  do you think they used a 3rd generation test at the clinic when I got my blood drawn because I asked the nurse and she had no idea.  
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Great.  Glad you can now be comfortable that you were not infected.

I would not worry that you were tested with an older, second generation test.  They are no longer sold.

Time for this thread to end and for you to move on.  If there are more questions you will need to start a new thread.  EWH
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