[Question #4719] To shed some lights on my exposure of HIV risk

26 months ago
Hello Doctor,

I am 50 years old, circumcised, heterosexual man who has never had STD except few HPV pumps.

I have had two risky sexual encounters back 8 weeks and 4 weeks ago. The first one was an unprotected vaginal sex with a white lady whom I met on a dating site. The second one was an protected anal sex, but condoms has broken and I withdraw as soon as condoms broke. Whole act was less then a minute and lady claimed she was clean. Since she and her partner are in the swinging scene regardless i got very worried.

After 45 days of the first sexual act and at 18th date of second sexual act I bought a OralQuick test it came negative and then went to a STD clinic got Insti antibody test and at the same date i had a combo hiv test from blood spasm and came negative as all.

However, at the 25th the second sexual act, since last two days, I am having intense cough, some low grade fever, and uneasiness do to anxiety.  I don't have sore throat, any rashes or swollen glands.

I will go to the clinic and test again at 5th or 6th weeks of second sexual act.

I need your kind assessment about accuracy of the test have taken and those cold like symptoms I am having...
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome to the fourm. Thanks for your confidence in our services.

Your sexual lifestyle is extremely low risk for HIV. Heterosexual transmission of the virus is a lot less frequent than you might assume from media coverage. The likelihood any particular woman met on a dating website (or anywhere else) has HIV is well under 1 in a thousand, probalby more like one in 10 to 100 thousand. Second, HIV transmission by vaginal sex happens only once in 1,000 to 2,000 exposures, when one partner is infected. So although I would certainly recommend routine condom use for sexual encounters of this sort, the actual risk of condoms fail is very, very low. While your partner's participation in multiple partner sex (swinging) undoubtedly raises the risk, your actual risk remains very low.

As for your symptoms, acute HIV doesn't cause symptoms sooner than 8-10 days after exposure; and those symptoms do not include cough. You caught a cold, not HIV.

Oraquick isn't the best test in this situation. It takes longest of all standard HIV tests to give conclusive results, up to 3 months after the last exposure. Your negative result at 45 days is very reassuring, but not conclusive. You could have a lab-based antigen-antibody (duo, 4th generation) blood test at any time, which would be definitiive. But in the meantime, stay mellow. The chance you have HIV is nearly zero.

That said, you might want to be tested for other STDs, i.e. a urine test for gonorrhea and chlamydia and a blood test for syphilis. These risks also are low in this situation, but higher than for HIV.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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26 months ago
Dear Dr. Handsfield,

Just to be clear I had 4 Genetation HIV test for all STDs at 45th days of my sexual act and 18th days of me second sexual acts and all are negative. 

Secondary, my cold like symptoms appeared after 25th day of my last sexual act.

Just want to make clear and thank you for your great help.

Sincerely yours 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
I understood the timing of your tests. People get colds all the time, and every cold (or any other illness) starts wihtin 25 days of some event you can think of it you put your mind to it. This clearly is just a coincidence. This information doesn't change my opinion or advice.

Thanks for the thanks. I'm glad to have helped.
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26 months ago
Thank you Dr. Handsfield.

I re-tested with 4th Generation Combo Essay from blood plasma at a lab about 5 weeks of exposure and all came negative again.

Regards 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
That's good to hear -- congratulations!

That completes the two follow-up comments and replies included with each question and so concludes this thread. I hope the discussion has been helpful. Happy new year!

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