[Question #3513] Unprotected vaginal sex, hiv risks

34 months ago
am a healthy female in my early 30s. 7 days ago I had two occasions of unprotected vaginal sex where he ejaculated inside me both times. He is in his early 60s upper class white male and I am not sure of his sexual history but does seem promiscuous. I usually suffer from anxiety and depression and have had serious feelings of guilt as I am in a loving relationship and shame since. I also have kids so I am extremely scared that I could have done something to compromise my care care for them. I also recently went of my antidepressants (4 weeks ago) and I self ceased. I have been so worried for last 7 days that I cought HIV. The symptoms I've had overall was on day 3-4 chills and lethargy and muscle pain, day 5 fever of 38 at which I saw my GP and she put me on penicillin and back on antidepressants as she said I was fighting an infection. Other symptoms were mild diarrhoea, white spots on my tongue and no sore throat but tender. Usually if I have a flu and cold I experience some upper respiratory symptom but this time just occasional cough. Day 6- I got tested and bloods taken for all STIs I also developed cold sore, fever went down from 38 to 37ish but still extremely stressed and tired with a headache and some pain under my left armpit. I took myself to the emergency hospital as I felt extremely anxious. Doctor said I need therapy and that I am very low risk for STI. Day 7- today I woke up with somewhat enlarged jaw glands tight but not painful, worried sick as my symptoms could mean it is all related to acute hiv. I have a temperature of 37.5. Still no usual symptoms of flu other than the specified. The male is white living and born in Australia. Please could someone tell me how bad my risk is and if the anxiety is playing big part in those symptoms. Thanks a lot and I really appreciate everything you do and the immense value you bring to everyone with your skills.
34 months ago
Dear doctors, 

Just to add new symptoms my left arm is getting numb however the fever and fatigue are improving, down to 37.3 and starting to get my appetite back and more energy. 
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Welcome to the Forum.  I'll try to provide some information and suggestions regarding a way forward from your misstep.  The characteristics of the man you describe make him unlikely to have HIV.  Even if he did, the risk for any single episode of vaginal intercourse following unprotected sex with an HIV infected person who is not on therapy (people on effective therapy are, for all practical purposes, non-infectious to sex partners) is less than one new infection, on average, for every 1000 acts of unprotected intercourse.  Thus even if he was infected (again this is unlikely), your mathematical risk of infection is less than one in 500  and when you consider his low likelihood of being HIV infected, is far, far less. 

We cannot attribute your symptoms to anxiety or depression although your anxiety may make your symptoms more prominent than they might be otherwise.  Nonetheless, it is unlikely that your symptoms represent HIV as these symptoms (fever, sore throat, swollen glands, run down feeling, and perhaps a little diarrhea) are far, far more likely to be due to a common, every day viral infection of the sort most people get from time to time than due to HIV.  They occurred earlier than would be expected from HIV as well. 

My advice going forward is as follows:
1.  If you are still in contact with this many, ask him to be tested for HIV (and other STIs).  If he is negative, you cannot be infected.
2.  You should test for other, far more common STIs, particularly chlamydia, gonorrhea and perhaps trichamonas.
3.  HIV testing about a week after the onset of your current symptoms will tell you if your symptoms were due to HIV, which I doubt.  While current HIV tests are about 99% accurate 4 weeks after an exposure and completely accurate at 6 weeks, in persons with symptoms due to HIV, the tests are positive within a few days of the onset of symptoms.

I hope these comments are helpful.  Please don't worry - your risk for HIV or, for that matter, any other STI, are quite low.  EWH
---
34 months ago
Thank you Dr.Hook, 

Your comment has logically made everything much clearer. Internet can be a very scary place.  And I agree with the onset of my symptoms and no other missteps recently, I believe that my risk for HIV is very low as the GP at the hospital said as well. 

I am not in contact with the man, and he is a very clean forgot to add, but I am sure due to the low risk that I am highly unlikely to get HVI so I understand that your suggestion to test was For my piece of mind. Already got tested for other STI but I will try to stop stressing now and perhaps not even stress my self out with other HIV testing and observe any other symptoms and test if my health and current symptoms get worse.  As you said it is quite highly unlikely. 

Thanks again for helping out and helping me keep my sanity and go back to my normal life. I think my googling for symptoms is over.  


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Thanks for your thanks.  I applaud your testing for STIs and urge you not to worry about HIV.  Take care and do not let this misstep haunt you.  EWH
---