[Question #6487] STI Exposure Evaluation and Testing

13 months ago
Good Morning, I Would like your evaluation about a regrettable event  I had back in June.  One June 12th, I was out drinking with a 33yo married female coworker and we starting kissing and fondling each other.  I ended up fingering her vagina for 30 seconds and licked my finger when I was done.  We stopped there realizing we were making a mistake.  I decided to get a 10-panel STI check done at LabCorp which include the HIV RNA test at 15 days (All negative).  I was content to stop there until I got symptoms at the 4 week mark  (sore throat which included a severe cough lasting over two weeks long).  My spouse also got the same symptoms in addition to muscle aches and fatigue at the 5-1/2 week mark.  Now my mind was thinking the worst, is this ARS? Did I get HIV and give it to her?  I went in for another round of HIV testing (4th Gen and RNA) at 6 weeks, all negative.  Then I completed another 10-panel test at 8 weeks which included 4th gen test, all negative.  Have I done my due diligence in regards to testing? Should the timing of the symptoms give concern and warrant additional tests?  The only lingering symptom I am dealing with is canker sores on my tongue but not sure if it is related to stress or the event in question.   Your evaluation of this event would be greatly appreciated. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Welcome to the forum. Thanks for your confidence in our services. I'm happy to help.

The bottom line is good news:  for sure you don't have HIV. You needn't worry at all and do not need any further testing. Here are the details.

First, you had an exposure that was entirely risk free. There has never been an HIV transmission from kissing, genital or anal fingering, hand-genital contact, or even oral sex on women -- i.e. no risk even if you had performed oral sex on your partner, and certinaly not from the small amount of vaginal secretions that would have been transferred to your mouth after you fingered your partner. This would be true even if your partner was known to have HIV -- which is unlikely, since HIV is present in under 1 in a thousand of even the most sexually active women in the US. 

Second, your symptoms are not suggestive of a new HIV infection, which doesn't cause cough. It sounds like you and your wife are sharing a cold -- nothing related to the event last June.

Third and most important, your test results are conclusive. There has never been an HIV infection in which the antigen-antiobdy (AgAb, 4th generation) blood test was negative at 6 weeks (not counting persons who have taken anti-HIV drugs as pre- or post-exposure prophylaxis); and you also had an RNA test, which itself is conclusive as well. These are among the most reliable tests ever developed for any medical condition, and the results overrule all other considerations. Regardless of risk at the time (yours was zero for all practical purposes) and regardless of how typical someone's symptoms may be for acute HIV infection (as noted, yours were not typical), the test results rule.

So all is well -- no worries at all. I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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13 months ago
Dr. Handsfield, thank you for your evaluation.  I will do my best move on with my life and not give it another thought.  Your service to this community is greatly appreciated. Feel free to close this thread. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Thanks for the thanks. That's why we're here!---