[Question #2901] HIV exposure, terrible anxiety

40 months ago
Pleaas, I beg for an answer from the dr. Handsfield. 
Exactly 13 days ago. I met a Japanese guy (from Tokyo) we kissed and he used his fingers to stimulate inside of my vagina. He was rough. So I could feel something raw down there. He wanted to have sex, so he opened a condom, I was sure so I asked him to wait.  So he left the condom out of its package for about 10 mins.. after that he put it on and started the intercourse even when I didn't want to do it. It lasted about 30 sec - 1 min. And asked him to stop cause didn't want to do it. He said the condom was properly used, I am not sure since It was from my back and since it stayed out of the package for some mins. When I say his penis the condom didn't look on place ... There wasn't ejaculation.
I don't think he's a IV drug user, but I know nothing about his sexual life. I don't know if he does MSM. 
I saw something that looked to me like a rash on his chest and his face looked a little red. I don't know.  Maybe he was infected and was going actually actually through ARS?
He said he got tested before and everything was negative. 
I am really scared, can you please tell me what's my risk?  Should I test? If so, when? How probably  (statistically) is that he's HIV+? Do you think I caught HIV from this exposure? I am having what I'd say looks to me ARS symptoms . my throat burns... it doesn't hurt but it feels dry and burns... please help. I feel like I am gonna get sick.
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Welcome to our Forum.  Clients are not permitted to choose which of us answer their questions and I happened to pick up your question.  For your information, Dr. Handsfield and I have worked together for over 35 years and always agree on the facts of our recommendations although our verbal styles may vary.  The sexual encounter you describe was a sexual assault and I am sorry that you have been victimized.  In terms of STD (including HIV) risks however, providing that the condom covered your sex partner's penis, this was a virtually no risk event, even if the condom had slipped down on the penis.  For your information, Japan has one of the lowest rates of HIV among developed nations.

Whether he had a rash on his chest or not is irrelevant to whether his sexual assault put you at risk for any STI.  An isolated sore throat is not the ARS although it, along with high fever and severe muscle or joint aches is one part of the ARS syndrome. 

Your risk for infection is low.  Nonetheless, I would encourage you to be tested for the peace of mind that negative tests will provide.  Tests for gonorrhea, chlamydia and trichamonas will be entirely reliable at this time.  If you have a combination HIV antigen/antibody test at this time, a negative test result will prove that your sore throat is not due to ARS.  If it were the ARS, the test would be positive.  As for definitive proof that you were not infected, a combination HIV antigen/antibody test performed 4 weeks after your exposure will detect over 98% of recent infections and a test performed at any time more than 6 weeks after exposure will be definitive.

I hope these comments are helpful.  Feel free to ask up to two follow-up questions if any part of this is unclear.  EWH
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40 months ago
Please, if you don't mind I have some more questions for you...

Since the intercourse lasted for just around 30 sec - 1 min. How big is my risk of catching HIV from this exposure ?? 

Also, the fact that the condom stayed out of its package for about 10 mins , does it make any different with the protection that a condon should provide?

I already got tested for chlamydia, ghonorrea.. they came back negative. But what makes me really worried is the fact that I might've gotten infected with HIV. 

Can you please give me some numbers about how my risk are? (Just hiv)
How probably is the fact that he could have given me HIV?

Please, i need some reassurance. I can't sleep, I can't eat, work study ... this is killing me.

Does the fact that he didn't ejaculate reduce the risk for hiv transmission? Or the fact that it was short ?? 

Please, help me...  I need some reassurance 
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Your questions seem to ignore what I said about condoms.  Please re-read my original reply and think about them.  In this context, your questions are theoretical and it is from that perspective that I will answer them.

Since the intercourse lasted for just around 30 sec - 1 min. How big is my risk of catching HIV from this exposure ?? 
There are no data on the how the duration of intercourse impacts risk for HIV.  Common sense says that shorter exposures are less risky but how much is hard to say.

Also, the fact that the condom stayed out of its package for about 10 mins , does it make any different with the protection that a condon should provide?
No, that the condom was out of its package should have no effect on  your risk for HIV.

I already got tested for chlamydia, ghonorrea.. they came back negative. But what makes me really worried is the fact that I might've gotten infected with HIV. 
Great, you have proved that you do not have those STIs.  As I said above (twice) your risk for HIV is quite low.  Even if he had HIV (very unlikely) and even if he had not worn a condom, your risk for acquiring HIV would be less than 1 infection in 2000 exposures. 

Can you please give me some numbers about how my risk are? (Just hiv)
How probably is the fact that he could have given me HIV?
Repetitive question.  See above.

Does the fact that he didn't ejaculate reduce the risk for hiv transmission? Or the fact that it was short ??
If he did not ejaculate your risk of infection is lower.  I have already answered your 2nd question.  In my opinion you are worrying entirely too much.  EWH
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40 months ago
Thank you, for your second answer... I am sorry for being annoying. But I just have a few more questions for you.

You mentioned that Japan has very low rate of HIV. Do you know how low is it? Or you know how probable is that this man was infected? 

Also, I know both of you guys are very experienced physicians. Have you seen a case of a woman getting infected through such a short and only exposure? 

I begged for nPEP, doctors totally denied it. Would you agree with that decision?..

And, do you think that extreme anxiety can cause my symptoms? 

If I decided to test with a 4th generation Elisa at 16 days post exposure, do you think the result would be a good indicator of my status ?

I've read ARS occurs with coexisting symptoms. Can you please describe the symptoms for me.. ??

Do you think I am overreacting?
I know it might seem like that but once a person goes through an experience like mine, and feel  traumatized... it's awful. Totally awful.

Thank you so much again for your time, and sharing your knowledge and experience.  

Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
I have already told you that it is unlikely that this man was infected.  Less than 20,000 cases of HIV have been reported in Japan and, as I already told you, Japan has one of the lowest HIV rates among developed nations.

"have you ever" questions are silly but yes I have seen women become infected after a single exposure.  It is very rare and your partner wore a condom making it very rare.

I would not have given you PEP if I saw you. 

Yes, I suspect your unwarranted and extreme anxiety are heightening your perception of symptoms.

I have already answered your question about testing.  Please see my original answer.

Yes, I do think you are over reacting.  I understand that you have been traumatized and I urge you to seek counseling with regard to having been sexually assaulted but I do not think you are at risk for HIV from your description.

This is my third reply to your questions.  This will end this thread and it will be closed shortly.  My recommendation is to seek counseling related to your sexual assault and to test for your peace of mind but to do your best to intellectually understand that what you describe does not suggest you are at meaningful risk for HIV.   I hope that you will not feel the need to return to our Forum unless new problems arise.  The answers will not change.  I wish you the best.  EWH
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