[Question #6257] Hiv question

17 months ago
Hello Dr,
Roughy a week ago  I had protected and unprotected sex with  a woman I met at a bar randomly. She mentioned to me she just started her period after we had unprotected  sex and I noticed a bit of blood on my genitals not any on my penis. Is it possible for a woman to transmit HiV with menstrual blood in this manner and do you recommend testing? Also to note she is originally from a carribean country (Barbados) which seems to have a higher hiv rate than the US. Appreciate your input 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Welcome back to the Forum.  I note that it is now more than a year since your last post.  I'll try to help.  Several comments:

1. Exposure to menstrual blood.  IF your partner was infected with HIV (statistically unlikely, even in Barbados), potential exposure to menstrual blood does not increase your risk of infection over unprotected exposure without blood exposure.  The amount of HIV in menstrual blood does not differ from the amount present in normal vaginal secretions.

2.  Sex with a casual partner  certainly increases your risk for STI acquisition including HIV although that risk, in general, is low.  Most persons do not have STIs and most exposures to infected partners do not result in infection.  My advice is to test for gonorrhea, chlamydia and if available, trichomonas at this time.  At 4-6 weeks, I would suggest testing for syphilis and HIV.  Unless you develop symptoms in the interval however, over all, your risk for infection is low and  would not worry.

I hope this information is helpful.  EWH 

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17 months ago
Yes thank you  I also was wondering how often you see hiv transmission from female to male. It seems this is extremely rare and have seen some articles  and videos that rate this nearly impossible in the US with very few heterosexual men being infected. Your thoughts ?
17 months ago
As far as symptoms as you stated I did have a nagging cough, sore throat, chills that has lasted 3-4 days after exposure  does this qualify as symptoms ?
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
 There is no question that HIV is occasionally transmitted through heterosexual intercourse from women to men. However when considering your risks, remember that most women do not have HIV (even in Barbados), and when they do, transmission from infected women who are not  taking therapy occurs in less than one out of every 2000 acts of unprotected intercourse.   The odds are very much in your favor. 

 Cough is not a sign of recently acquired HIV infection. The ARS syndrome consists of severe sore throat, high fever, and diffuse muscle or joint aches. Typically it occurs within 2 to 3 weeks of exposure. Your symptoms do not suggest the ARS.

I hope this information is helpful to you. Please don't worry. EWH
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