[Question #5455] Risk of HIV ??

74 months ago

Hello doctors,

Using a tool I found on google which calculates the risk of HIV for insertive anal sex with a HIV+ person I got the numbers as 4 per 10000 exposures with a condom and 11 per 10000 without. What is your opinion on this.

My case: I had insertive anal sex with a sexworker(unknown status) the oral in the beginning was unprotected, sex was protected although I think my condom broke towards the end and was unprotected for about 1-2min. After this it was unprotected oral and I came in her mouth. Shortly after, I had a burning sensation in my penis although this was gone by the morning.I had an HIV combo test at 27 days and came back negative. Some people say that this can be considered conclusive. Could you please advise?

The tool used is the first result on google for ‘hiv risk calculator’ by the CDC.

74 months ago

Also doctor, after the incident below, I was invovled in 2 incidents, one 1 week later and another just before the test however both of these were protected start to finish and im sure of it. Currently I am displaying a throat infection, weight loss, muscle pain in left shoulder and neck,slight chest pain. have had no fever that i can think of till date. I have already crossed the 3 month stage and will be getting a test tomorrow in my home country.

H. Hunter Handsfield, MD

74 months ago

Welcome to the forum. Thanks for your question.

Estimates of HIV risk for particular kinds of exposure are very rough. They mostly are useful to understand relative not absolute risks. In other words, they are valid to conclude that condoms provide a lot of protection, that receptive anal sex with an infected partner is the highest risk, that vaginal is high but lower, and that insertive sex (vaginal or anal to penis) lower still -- with oral sex lowest risk of all. But the absolute numbers are soft. On this forum, we also use figures published by CDC, apparently the basis for the google tool you found. But remember that the numbers apply only to sex with infected partners. With a female sex worker, there's probably under 1% chance she had HIV; in that case, your risk is a hundred-fold lower than the tool may show. Finally, the CDC estimates are over a decade old, when most HIV infected people were not being treated. That's no longer the case -- and sex with an infected but treated HIV infected person generally is entirely risk free.

Far and away the most likely cause of symptoms like yours is a garden variety respiratory virus infection causing pharyngitis (sore throat) -- and 3 months is much too late for onset of symptoms of HIV. Probably your symptoms are entirely unrelated to your sexual exposures. But if you remain nervous about it, have another AgAb (combo) test. Your negative result at 4 weeks is highly reliable, but in rare cases these tests take 6 weeks for conclusive results. But don't lose a lot of sleep over it. You definitely can expect another negative result.

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

HHH, MD

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74 months ago

thank you dr handsfield, If you wouldn't mind, i would like to request that you keep this open until tomorrow and would like to update once the results are in. In your professional experience have you ever seen or heard of a case that changed from 4 weeks negative to positive? I ask this cause im extremely tensed out and stressed, and making up all sorts of scenarios in mind and researching anything and everything related to HIV on the net.

74 months ago

Dear Doctor, I have been experiencing higher temperature than usual today specifically.Orally, my temperature is 37/37.1c although in the last 4 months since exposure I have not to the best of my knowledge had this temp before. I am also having panic attacks due to this. I have also noticed that I am experincing drastic weight loss, no desire to eat. My test tomorrow and i feel the world is crashing around me!!Please advice

H. Hunter Handsfield, MD

74 months ago

The minimal temperature changes you report are unimportant and have no health implications for HIV or anything else. And no, I have never had a patient who had HIV test positivity delayed more than 4 weeks. There also has never been a user on this or my previous forum (14 years and thousands of questions) who turned out to actually have caught HIV. You will not be the first. As for "panic attacks" that's obviously irrational anxiety, especially after the reasoned, science-based reassurance you have had here and perhaps from your own doctor or laboratory. I recommend counseling if you cannot shake it.

This thread is open for one more brief follow-up comment -- but do keep it brief and do not ask anything whose answer is obvious from my replies above. I'm not going to repeat myself. OK?

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74 months ago

Hi Doc,

Just got my results back from my test, came back negative. method used was ELISA COMBO by Abbott. Does the value on the test mean anything? I guess this means i am well and truly negative. Thank you doc for your responses. I guess now the only thing is to tackle the condition that caused all these symptoms,but thankfully its not HIV.

Thanks a ton Doctor!

H. Hunter Handsfield, MD

74 months ago

You're welcome. I'm glad to have helped.---