[Question #356] Scared to death

35 months ago
Hi Doctors, first thank you for taking the time to read and address my concerns. I am a 32 year old white female from US.
- ten+ years ago had an on and off relationship with a white male who identifies as heterosexual. Had unprotected vaginal sex several times up until approximately 8- 9 years ago. He did at one point say he tested for STDs at my request but told me they said he didn't need an HIV test which raises concern. He has since married. I regularly get routine tests only for std during pap.recently had stubborn hpv that took nearly 2 years to clear. I know people go many years asymptotic for HIV and it scares me to death. Can you please assess my risk after all these years.
- more recently approximately 2+ years ago had unprotected sex 3 times with a white middle class male without ejaculation if that is pertinent info. I knew him only about a month prior. He too identifies as heterosexual. But, who really knows as I assume most women that get infected from bisexuals probably don't. I have no reason to suspect though. 
I have been very healthy. Once had tonsillitis many years ago but I can't remember if it was around the time of my first risk. Also have tiny red dots on my chest. Read many things that it could be. Including the sports bras I wear regularly. But it does raise concerns as they don't go away. Lastly I have a lump inside my tongue for a while. My dentist said it could just be my tongue and im not sure how long it was there. At least a year. 
I have to schedule my annual pap and will test then but am thinking to put this to rest asap with the or a quick home test. Is it reliable? I need this to be over and am imagining the worst and how I will tell my friends and family. Thanks again.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

Welcome to the Forum.  I will try to help but the real answer to your question is for you to be tested for HIV.  In a person like yourself, based on what you describe, your risk of being HIV infected is far lower than 1/10th of 1%.  In the U.S. less than 1% of sexually active males have HIV and that figure includes men who have sex with other men and drug users, neither of which sounds like your partners.  Further in the unlikely chance that one of your past partners had HIV, only 1 in 1000 sexual exposures leads to infection, thus after 10 exposures to an HIV infected person your risk of infection would still be only 1%.  Having provided these assurances however, if you have not been tested in the past, I would suggest that you do so, both for the peace of mind that a negative test will provide you and because the CDC recommends that EVERY adult American should have been tested for HIV.  I am confident from what you say that your test will be negative.

The symptoms you describe are not suggestive of HIV.  Neither the red spots (most likely benign angiomas which occur in most people as they age) or lump in your tongue are suggestive of HIV. 

Either a home test or a laboratory test obtained at your doctors' office will provide reliable results. 

I hope my comments are helpful to you.  Get tested and put these concerns behind you.  EWH

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34 months ago
Thank you Doctor Hook for your response. You have immensely lowered my anxiety! Just a couple of things... Would someone likely have symptoms after 9 years? Does the area I live in the US make a difference? And if unprotected heterosexual sex from the partners I describe is low risk, is it thought that women with HIV knowingly had high risk partners? My partners were white, def not drug users and identify as heterosexual.  Obviously still slightly anxious. Plan on testing right after the holiday.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

I understand your anxiety.  If you had HIV for 9 years, by now you most likely would have gotten sick with full blown HIV by this time.

some parts of the county have higher HIV rates among heterosexual women than others but in all areas, the rates of infection among heterosexual women is less than 1%.

Many women with HIV are infected by partners who have other partners, as opposed those with known high risk behaviors.   White heterosexual women are among those with the lowest risk as a group.

Again, your risk is miniscule at most.  Please don't worry.  When you test I am confident your test will be negative for HIV.  EWH

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34 months ago
Thank you so very much Doctor Hook. Your words are very reassuring! I pray that you are right as I prepare myself for the big test! Happy holidays!
34 months ago
Dr. Hook, thanks again for your responses. I am now close to test time and in full on panic mode. You mention I would most likely be sick after 9 years... Would this be an obvious sickness? I have never been sick beside the tonsillitis many years ago. Also in regard to the more recent 2+ years ago encounter (3 times) would the absence of ejaculation lower the risk? I apologize for all of the questions and greatly appreciate your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

Had you been infected over 9 years ago, you would be REALLY sick, not just with usual sorts of illnesses, tonsillitis, etc.  The absence of ejaculation would also be associated with somewhat lower risk but, as I said earlier, based on all that you said, your risk of a positive test is VERY, VERY low.  Please don't worry.  Test and your negative result will allow you to move forward without further concern.  I am confident your test will be negative.

Our forum guidelines call for a total of three interactions, max, per question.  This is our third.  thus there will be no responses to further questions.  You would need to open a new question if there are more questions although, from what you say, there should be little reason for this.  Take care.  EWH

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