[Question #5048] Do I have to get tested?

25 months ago

I had a sexual encounter with a guy I know on a friend basis. He plays for the D1 football team at my university. He is very good athlete and claims he gets tested all the time and that he got tested for HIV 2 weeks ago and his last encounter was 4 weeks ago. 

(So he had sex then 2 weeks later got tested.)

Young Half black male. He only has sex with women and does not do any drugs.

I was giving him a hand job when I felt pressure from him to lick his unprotected penis which I did. Only 3 times. His dick was covered with both of our saliva combined with his pre cum. He came on my breasts. 

That night after I was brushing my teeth and realized I had formed a small canker sore through the day. And thus became worried. 

I called the university health center. Explained my concern and she said that I should would not be worried and that I don’t have to get tested. However if I wanted to I could get free rapid testing done that day with pretty accurate results. 


I understand that this is a very low risk. However I have extremely abnormal fears around STDs, please calm them with your expertise. 


However 3 weeks after exposure I got a stuffy nose, sneezing, mild sore throat, light cough, and on and off mild headache.

No fever. no swollen lymph nodes. no rash. No muscle aches.

It feels very much like a cold. But made me nervous at the 3 week mark. 

I was prepared to forget about the whole thing at the four week mark. Until this happened. 

I’m officially on the 4 week mark. 

Questions 

1. Am I required to get tested after this encounter alone? 

2. How could they have accurate results after one day after potential exposure?

3. Even after the symptoms I described am I still not required to get tested?

4. At what point after exposure would someone get symptoms? Am I in the clear at the 4 week mark?

5. How much pre cum or HIV is required to pass the virus? 

6. How long does HIV in pre cum last once exposed in the air?


P.S. I really don’t want to get tested as I am scared of false positives. Which the nurse told me could happen.

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome to our Forum and thanks for your question.  I will provide more detail below but his was a virtually no risk and I see no need for you to pursue testing unless you are having trouble moving forward and a negative test will help you to do so. Before I answer your specific questions, since his penis did not enter your mouth and the only contact was licking his penis and having him ejaculate on your breast does not pose a risk for any STI including HIV.  To provide more detail:
 

1. Am I required to get tested after this encounter alone? 

No, your partner described his recent contacts and testing history.  Further, there was no penetration.  I would not be worried. 

 

2. How could they have accurate results after one day after potential exposure?

Test results for the most common STIs, (gonorrhea, chlamydia) would be reliable at 3 or more days after exposure.  The reliability of earlier testing is unclear.


3. Even after the symptoms I described am I still not required to get tested?

Correct. The symptoms you describe do not raise any concern for STIs, or HIV.  It is more likely than not that you coincidentally got a cold.


4. At what point after exposure would someone get symptoms? Am I in the clear at the 4 week mark?

The onset of your symptoms are within the range of symptoms for the onset of recently acquired HIV. Having said that, as I note above, your symptoms do not suggest HIV.  I would not worry.


5. How much pre cum or HIV is required to pass the virus?

The virus is present in pre-ejaculatory fluids,.  Despite that, nothing about the exposure you describe suggests any risk.  

 

6. How long does HIV in pre cum last once exposed in the air

See above. Any HIV present becomes non-infectious almost immediately on exposure to the environment. 


I hope these comments are helpful. Please don't worry.  EWH

 
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25 months ago
Thank you so much, Dr. Hook! You have definitely calmed my nerves! 

However, being the anxiety-ridden person than I am. (I probably need counseling)


A thought came to me in the middle of the night about how two years ago I had reason to believe that I had contracted oral HSV 2 from a different encounter. My Dr., however, saw no need for testing as it could very well have been HSV 1. 


My symptoms for this potential HSV 2 were ugly sores and inflammation on tongue that I experience frequently after the encounter however not at all during the time on this current encounter.


As you can see I don’t have many sexual encounters due to the fact that I am petrified of STDs. 

And when I do have any mild sexual encounters I get abnormally and ridiculously so scared.


Does this new information change your original opinion in any way? 


*crossing fingers* desperately hoping not. 


Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
I'm glad that my comments were helpful.  

I'm confident that the sores you describe on your tongue were not HSV-2.  For reasons that are not totally clear, HSV-2 only very rarely causes infection in the oral cavity.  OTOH, HSV-1 is extraordinarily common- about 60% of American adults acquire HSV-1 at some time in their life.  For most people these infections are acquired during childhood although adults can certainly cause the,

From what you describe, are you sure  the lesions you noted (and which apparently recur from time to time are HSV-1?  HSV-1 typically causes cold sores and only rarely causes sores on the tongue.  On the other hand, canker sores, which are of unknown cause, typically cause lesions on the tongue, gums or inside of the mouth.  Could you describe the sores that you get a bit more- they may not even be hsv-1.  

Irrespective, I would not worry that the lesions on your tongue that you describe were HSV-2.  please don't worry about this. EWH
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25 months ago

I have had canker sores on my tongue before and these are not it. They are very hard to explain.  


However regardless if I am correct or not on if it is in fact oral HSV 2, what impact does that particular fear have?


Considering this is my last available question:


  1. What is the incubation period for HIV symptoms? Is it 4 weeks after exposure?
  2. What are the symptoms to look out for?
  3. Does having oral HSV 2 in my situation make any difference on your original opinion on whether or not I  am requirement to get tested?
  4. I am now 32 days after exposure,  if I take the rapid antigen antibody hiv test will my test be conclusive? 
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Thanks for the additional information.  The only way to really know if lesions are due to HSV-2 would be to have a viral test ( a PCR or culture) taken directly from an active sore.  Blood tests will not help at all.  If this is HSV-2, you will be the first heterosexual person I have seen with oral HSV-2 in over 35 years of dedicated STI-focused provision of health care and research.  Even if this is HSV-2, it does not change my original assessment or recommendations other than testing a lesion if present.  I see no other indication for testing.  In answer to your specific questions:

  1. What is the incubation period for HIV symptoms? Is it 4 weeks after exposure?
Only about half of persons who acquire HIV develop symptoms- the so-called "acute retroviral syndrome".  The ARS is a sever, flu-like illness with high fever, sore throat (not sores), muscle and joint aches - all occurring at about the same time.  in most persons who experience the ARS symptoms begin at 2-3 weeks after exposure.  Among at risk persons who experience ARS-like symptoms, 99% are due to illnesses other than HIV such as influenza.  

2. What are the symptoms to look out for?
See above

3.  Does having oral HSV 2 in my situation make any difference on your original opinion on whether or not I  am requirement to get tested?
No, other than testing of a lesion, if present as mentioned above. Otherwise no need for testing of any sort.

4.  I am now 32 days after exposure,  if I take the rapid antigen antibody hiv test will my test be conclusive? 
At 32 days a combination HIV antigen/antibody test of the sort almost universally used would detect over 99% of recent infections.  The remaining fraction of 1% of infections would be detected by 42 days (6 weeks) after exposure.  

I hope that these comments are helpful.  As you point out, with this 3rd response this thread is now complete and will be closed without further replies shortly.  Please don't worry.  EWH

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