[Question #3762] HIV Woman risk

87 months ago

From Mexico. 34 female with 36 male mex professor I became sexually active last year he has been my only partner so this is my first year facing testing: Jan/Mar STI/HIV Ab Negative. We broke up in Nov, but agreed a last encounter on March 30 cause test results, badly I didnt ask him for current status. We had mutual oral sex unprotected and vaginal sex protected 3 condoms, about 40 min, ejaculation outside. According with the forum low risk. However, I got concerned and asked him for his status. He claims last test neg Jan but he told me he has been with other girls since then, so status might have changed. Perhaps my lack of experience has made me anxious, especially because one condom did not fit properly and slip, penis head was cover, but the rest of the penis was not, so Im afraid I was exposed to precum several min. I tested again after exposure, 25 days Gono/Clam vaginal swab negative, 4/6 wks VDRL/ HIV Ag/Ab negative. The forum has been helpful but most concerns are from man and I would like to ask woman risks. Giving oral sex riskier than receiving? Condom fail, with man as long as the penis head is covered is fine, but woman and a wide vaginal mucous what are the risk and precautions to take after? Precum less infectious than semen, but my naive understanding is that a couple of precum drops with high viral load can be potentially infectious. Should I have an oral swab for gono and test for Hep AB I believe im not vaccinate? Window period, Im ashamed that I didnt know anything about HIV, and my first resources has been official sites with 3-month wp, getting HIV with one exposure only, and few information about the tech of Ag/Ab test in Spanish, and this has caused me and strong fear that my test are not accurate, especially when they said that Ab develop in 2-12 wks, understanding is that enough detectable Ab can be present until 9-10 wks. And even with an Ag/Ab test neg they still say that is necessary repeat the test 12 wks to have a conclusive result (because a real change of result or merely a formality?) so what will be the benefit of having early test with option of the Ag is it may not detect it and have to wait for enough Ab to make it conclusive? Thanks 4 ur time, sorry for my English

H. Hunter Handsfield, MD

87 months ago

Welcome to the forum.

There'a a lot to unpack here, but the bottom line is that there is little chance you have any STD. The one exception may be HPV, which is so common that every sexually active person is at risk. But fortunately the large majority of HPV infections cause no health problem and are cleared by the immune system. Aside from having regular pap smears, you need do nothing more about HPV.

I see no risk for any other STD. Statistically, you understand your partner is not at high risk, and you describe your final sexual exposure with him as safe (because condoms work and oral sex carries little risk for all STDs and zero risk for some). And you also have the negative tests 25 days to 6 weeks later: all those tests are 100% conclusive by the times you were tested. Any agency or doctor who recommends a final HIV AgAb (4th generation) test beyond 6 weeks is either behind the times or being ultra conservative. Do not get hung up on statistics about when p24 antigen or antibody appear the in the blood. The point is that it is the antibody that clears antigen from the blood. Therefore, after 6 weeks, either antibody or p24 antigen is ALWAYS present (sometimes both); therefore the test is ALWAYS positive in EVERY person with HIV of 6+ weeks duration. There are no exceptions.

So all is well and I do not recommend any further STD/HIV testing. I wish you well in your life, including romantically. Let me know if anything isn't clear.

HHH, MD

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87 months ago

Thank you for your answer.

I will do a pap smear and an appoitment with my gyn to close this. I'm sorry for the overthinking, my biggets concern was the HIV, because there is plenty of confusing information about the window period, the late sereoconversion and the reliability of the tests and all this can play hard with your mind and feed your anxiety. But you have provided me clarifications about this based and science and experience, I promise to stay away of the internet and believe my tests as conclusives and ALWAYS practice safe sex.

And many thanks for your kind words in your last sentence. I'm glad to have found this forum you provide a wonderful service for confuse people like me. I wish you well in your life too!

H. Hunter Handsfield, MD

87 months ago

Having a pap smear is fine, if you are due for routine testing. However, the results won't mean anything in regard to your recent partnership. The only STD diagnosed (indirectly) by pap smear is HPV, but new HPV often doesn't cause abnormal paps for months or years after exposure, so a negative result won't prove you don't have HPV. And a positive result would more likely be from a more distant past partnership. If you remain in doubt about it, discuss with your gyn or whatever doctor/clinic is doing the pap.

You are of course right that "there is plenty of confusing information about the window period" for HIV testing online. However, you can greatly reduce any possible confusion by emphasizing scientifically valid or moderated websites, such as those run by public health agencies and academic resources; and avoid those run by and for people with HIV or at risk. Also be clear on the differences in window period depending on the type of test (antigen, antibody, or both; or RNA testing) and combinations of tests that are done. You won't find many differences between scientifically knowledgeable and/or moderated sites.

Thanks very much for your kind words about the forum and our services. I'm glad to have helped. Best wishes to you as well.

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