[Question #4142] Follow Question #3971 Unprotected Vaginal

32 months ago
Dear doctors,

After following the advice of Dr.Hook in July, I did a test for HIV with a 4th generation test (laboratory test with blood) and a test for chlamydia and gonorrhea in a Urgent Care facility on August 12th. This was 4 weeks and 5 days (Close to 5 Weeks) after the unprotected vaginal intercourse with the girl. She is 23 years white/hispanic white and studies here in Miami, Florida. I'm 32 years old, white. As already explained in the initial question in July, she asked for a condom before the act and we did it first with the condom, only later we had unprotected vaginal sex for up to 10-25 min. (It was the only  one night stand outside my permanent partnership ). I've been scared the last month and I could barely sleep and eat. 

The STD test came back with the following result. I was tested for HIV 1 and 2 NEGATIVE, gonorrhea NEGATIVE and chlamydia NEGATIVE.  ( 4 weeks and 5 days after sexual intercourse) . Just as Dr. Hook said, he said it will be all Negative.

Since I am in a partnership and want to have unprotected vaginal intercourse with my wife, my question is whether the results are safe and I am really negative? Or am I worried too much? I want to end this thing and go on living my life.

I would also like to thank you once again for your efforts. You use your valuable time to help people in this forum. I have the utmost respect for you and your life's work.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome back to the forum. I'll be answering this time, but I have reviewed the discussion you had with Dr. Hook last month.

Your gonorrhea and chlamydia results are definitely conclusive. The HIV test is nearly conclusive as well, although in rare cases it requires 6 weeks for the standard antigen-antibody test to become positive. So it could be considered you tested a little early. On the other hand, the chance your partner had HIV was very low (probably under 1 in a thousand women like your partner has HIV), and if she did have it, the risk for any single episode of unprotected vaginal sex is 1 in 2,500. (That's why many spouses of HIV infected persons never catch HIV, which maybe you didn't know.) So even before you were tested, the odds you had acquired HIV can be calculated as 0.001 x 0.0004 = 0.0000004. That's one chance in 2.5 million. If we now consider a negative blood test that is around 99% reliable at 5 weeks, the chance you have HIV is now 1 in 25 million. I certainly hope you will agree that's zero for all practical purposes! You can safely continue sex with your wife, even if you also would like the additional (unnecessary?) reassurance of another blood test at 6+ weeks after the event.

You don't mention syphilis testing. The chance is almost as low as for HIV, so testing is optional. But if you would like that additional reassurance, have a syphilis blood test at 6+ weeks.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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32 months ago
Thank You for your answer Sir. So i can have unprotected sex with my wife?  And do you think i need another test? 

Best
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
As described above, the chance you have HIV is zero for all practical purposes, and if I were in your situation I would not have any further testing and would have been having sex with my wife most of the past few weeks -- and certainly would resume it now. But you'll have to make the final decision, I can't make it for you. If the odds I have estimated in your favor (24,999,999 out of 25,000,000) aren't quite good enough for you, have another test at 6 weeks.---