[Question #2628] Worried about HIV, condom broke, please help for mental stability?

44 months ago
About 4.5 weeks ago I g ot drunk and hired a prostitute. We had sex with protection but the condom broke, and I didn't notice til about 3-4 minutes later.

Then we fell asleep and I wake up with her shooting Heroin in my bathroom.

I have been absolutely freaking since and completely on edge.


I have had extreme fatigue, headaches, feeling sick a bit, and some muscle aches. Mainly though fatigue and headaches.
However, I have been very  very very stressed out and depressed.

After all this my ex calls and says she wants to get back together, and I never thought that would happen. This has made me even more petrified cause I have wanted her back so bad.

I took oqrauick at home at 14, 21, 28, and 30 days, all negative. Are these any indication at all I might stay negative? I just need hope.

Please and thanks. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question. I logged in soon after you posted it:  most users should not expect such rapid replies!

First, congratulations for your attempt at safe sex. Too bad the condom broke, but it happens sometimes. But despite that, you can be very confident you don't have HIV. Here's why:  Even though your partner likely is at high risk, it isn't necessarily so:  the elevated risk in injection drug users is because of needle sharing, but not all injection drug users share injection equipment. And sexually, she may be at very low risk:  if she expected or requested condom use with you, likely she does so with others as well. And even if we assume she has HIV, the large majority of unprotected sexual exposures don't result in transmission -- average once in every 2,500 exposures for vaginal sex. (Yes, it's really that low.) Further, your symptoms are very nonspeciific and are most consistent with your obvious stress, anxiety, etc and not a new HIV infection. And finally, your test results so far are very reassuring. The oral fluids test is the least reliable in this situation, i.e. until 3+ months after exposure -- a lab-based blood test is much better. But still, over 90% of infected persons would have positive oral fluids results by 1 month.

Here's a mathematical calculation you may find reassuring:  chance your partner had HIV, let's say about 1%; transmission risk if she had it, 1 in 2,500 (equivalent to 4 in 10,000); and 90% reliability of your tests to date. With these assumptions, the chance you have HIV is 0.01 x 0.0004 x 0.1 = 0.0000004. That's 4 in 10 million, or 1 chance in 2.5 million. In other words, there is not only "hope" you don't have HIV; it is almost 100% certain you do not.

My advice is that you have a lab-based 4th generation (antigen-antibody) HIV test. Wait until 6 weeks after the exposure, when the negative result will be 100% conclusive. You also need testing for other STDs, especially a urine test for gonorrhea and chlamydia and a blood test for syphilis. The urine test can be done at any time; the syphilis test should be at 6 weeks. Having had no symptoms of these STDs, you can expect these tests to also be negative -- but don't take the chance.

Finally, I also recommend you see a doctor for personal evaluation and for the tests recommended, rather than self testing e.g. through an online lab service. You'll probably find personal examination to be normal and reassuring.

I hope this information is helpful and reassuring. Let me know if anything isn't clear.

HHH, MD

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44 months ago
Thanks for your answer Dr. It really helped with my anxiety. I have 1 more week to wait for my 6 week test which I will do at lab.

In the meantime I took another at home Oraquick at 5 week mark. Still negative.....I have been praying and crying to tell you the truth. 

Does this help my chances more? Thanks in advance. My symptoms are still here but so is my anxiety, stress, depression.....
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Your chances already were almost 100% you didn't catch HIV. The latest Oraquick confirms that it is extremely unlikely you are infected. I remain confident your 6 week lab based test will also be negative.

You may be interested to know that in the 12 years Dr. Hook and I have been moderating this forum and our previous one (MedHelp.org), with thousands of questions like yours, not one person turned out to have caught HIV. You won't be the first. When that finally happens, almost certainly it will be someone with a truly high risk exposure, which you did not have.

As for your anxiety, stress and depression:  do your best to separate your reactions to a sexual decision you regret from the infection consequence of that event. They aren't the same. And don't beat yourself up over a very human decision and mistake. But do consider counseling if these feelings continue despite the reasoned, science based reassurance I have tried to give you.
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44 months ago
Well Just checking in I have an appt to get a lab test this Thursday.

I did an oraquick home test  today at 6 weeks 1 day and it was neagative. This result has really called down my fears. 

I just want to ask when you say 6 weeks and 13 weeks is oraquick home test  an ok indicator being a 2nd generation test?

Thanks again for everything......You are a life saver.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Oraquick is not conclusive until 3 months (12-13 weeks). If you want 100% reliability before then, have a 3rd or 4th generation test, as advised above. But in the meantime, re-read my comments above:  even without testing, you can be confident you didn't catch HIV.

That concludes the two follow-up comments and replies included with each question, and so ends this thread. Whatever test you do, if any and no matter when, stay relaxed in the meantime:  based on the exposure, you can count on a negative result.

Thanks for your kind comments about our services. Best wishes and stay safe.
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