[Question #2691] Please Help

41 months ago
Hello

I have not had sex with men much and I had a sexual encounter last night and am very worried. I had drank too much which was stupid and the guy I met told me he was negative but I'm concerned he was lying.  We kissed a lot and he talked me into to sucking him. I did it for about 5 seconds and stopped. He did not ejaculate but could have had some precum. I have some sores in my mouth and my gums bleed sometimes. I also had anal sex with him and while I did wear a condom it may have slipped off at one time I can't be certain. We had sex twice and I wore comdom both times but we had no lube so we used conditioner as lube. He tried to convince me to take it off and I said No. When we finished the second time he ejaculated on my chest and there was some blood in his semen that was on my chest. Should I get Pep?  Is it too late? Can I get tested with HIV RNA at 14 days and if so would it be conclusive? You guys say that a 4th generation test at 6 weeks is conclusive. Is that right? Please help me 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to the Forum.  I sense a high level of concern and hope that my comments will help you to overcome at least some of your worried.  Your questions are presented in a rather "rapid fire" fashion so if I miss one, please feel free to follow-up.  Up to 2 additional follow-up posts are allowed per questions.  Addressing your questions as they appear.

Your partner said he was negative when asked.  the fact is, most people do tellthe truth and indeed, most men who have other male sexual partners do not have HIV. If he said he was negative, he probably was.

there is no risk for HIV or other STI from kissing and the risk of acquiring HIV if he did have HIV is less than 1 infection per 10,000 sex acts.  Mouth sores and bleeding gums do not change this. 

Really, if the condom had slipped off, there would be no questions!

There is no risk for HIV from his ejaculation on your chest.  Blood in the semen is not a sign of infection and does not change things

I see not need for PEP from what you describe. 

HIV RNA tests are expensive and have a higher rate of false positives than other HIV tests.  My suggestions would be to try to relax and ride out things until you can have a 4th generation test.  If you REALLY need to know sooner- see if he will test.  If his test is negative, you are in the clear. 

Yes 4th generation tests are highly reliable at 4 weeks and conclusive at 6 weeks.

Take a deep breath, try to relax.  You will be fine.  This was a VERY low, if not no risk exposure.  EWH
---
41 months ago
Thank you for your reassuring words. I cannot communicate with the guy so getting him to test is not an option. 

I assume when you mention the 1 in 10,000 risk you are talking about oral sex. 

I am a young guy and have a girlfriend. I am new to the bisexual life and I feel very guilty now. So my girlfriend will want sex at some point soon which is another reason I mentioned the RNA test at 14 days. If it is negative at that time does that rule out an infection? Or would I have to re test later?  I just want to be sure I'm ok and I don't put anyone at risk if I'm not.  Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Correct, the calculated risk for getting HIV from performing oral sex on an infected partner is 1 in 10,000 sex acts. 

Yes, a negative RNA at 14 days would rule out infection and there would be no need for further testing.  EWH
---
41 months ago
Hello Dr Hook

I went and had an HIV RNA test on Monday which was 14 days after my incident.  The test was done by Labcorp and came back negative.  Is Labcorp a reliable lab?  Does this rule out any possibility that I contracted HIV?  Should I still go back at 6 weeks to do a 4th generation test to be sure?  Am I ok to have sex with my girlfriend now or should I wait?   Thank you so much for your help and advice. 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
As I mentioned in my original reply, your exposure was virtually no risk for HIV.  From a medical (vs psychological) perspective, you really did not need testing.  Your HIV RNA test now PROVES that you were not infected. There is no reason for further HIV testing.

And yes. LabCorp is a highly reliable laboratory.  You can have confidence in their tests and test results. 

And yes, you can have unprotected sex with your GF.  There is no reason to wait related to the exposure you have described.  EWH
---