[Question #6488] HIV Risk and Testing Advice Please

13 months ago

Hello Dr's,  I know there have been numerous questions like mine but do to my anxiety and it not being my exact situation I felt the need to ask my own, so thank you for answering. So I made an insanely stupid decision to meet a women that I met online. We ended up going back to her place. I am 43 and she is in her late 40's, both white upper middle class. Sadly I must admit I'm married and she was until recently, although she has said she has had a long term boyfriend for a while that ended a while before we met (we both stated that we were 100% safe clean but no actual proof). So we ended up mostly kissing and me just being frank fingering her for a while( i don't know if this is of any impact but she got very vert wet) I also performed oral on her for a while and her on me as well. When it came around to having actual sex my better judgement kicked in as well as nerves and I was not in any position to actually do it nor did I want to especially unprotected. I cannot say honestly 100% for sure that my penis did not come into contact with her vagina(she was on top of me) and if it did it was only seconds as I stopped everything at this point She later told me that there was never any penetration but I'm still not 100% sure I know that sounds weird but I was trying to stop everything so I wasn't paying attention just trying to get out of the situation so if we did it was very briefly at most. I've never been in the position to worry about std's or hiv since I have only ever been with my wife so you can imagine my fear once it all got to me.  Anyway my fear and guilt got the best of me and I had a full STD test and HIV 4th Gen test at 21 days, all negative but my anxiety and mind are still getting the best of me because I have to go back in 3 months. And I really can’t determine how reliable this first set of tests are. My anxiety is through the roof that I got HIV even though I’m pretty sure rationally I shouldn't. Should I go back and get tested again before the 3 months to ease my fears and if so how many days? Its been 33 days as of today Scared to death about this and with my anxiety I keep looking for symptoms. Sorry if I sound crazy I just don’t know enough to know. 

Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Welcome to the Forum.  I'll do my best to help.  I suspect that as you have already looked at similar posts on our site, that my responses will come as no surprise to you- this was a very, very low risk event for all STIs (more below). 

First- risk assessment- most persons do not have STIs and when they do, most exposures do not lead to infection.  In your specific case, there is a very low risk for abstaining gonorrhea or chlamydia from performing cunnilingus on her.  Similarly syphilis and HIV are virtually never acquired from performing oral sex on a female partner.  With respect to your masturbation (fingering) of her and your frottage (rubbing without penetration, even in the presence of vaginal secretions) there is no meaningful risk for gonorrhea or chlamydia (and both you and she WOULD know if penetration had occurred). Such contact might lead to herpes or syphilis but if you had acquired either of these, you would have developed penile lesions by now and would know it.  There is no HIV risk from any of the activities you describe.

As far are your tests are concerned, were you tested in the throat for gonorrhea or chlamydia?  Following throat/oral exposure, testing of the throat is needed.  Any urine or penile tests you had would serve to validate that there was no risk for STIs from your genital/genital contact. Blood tests for syphilis or HIV at 21 days are strong but not entirely conclusive evidence that you were not infected with these infections.  Syphilis testing should be conclusive at this time and is unlikely since no lesion has been noted.  As already mentioned, nothing you describe puts you at risk for HIV but if you wish to prove it with laboratory testing, results will not be conclusive until 6 weeks after the event.  We strongly recommend against testing against herpes following exposures such as these since the tests are unreliable in terms of falsely positive results and do not provide information about how long infection has been present if truly positive.

I hope that this information is helpful.  If anything is unclear, please feel free to use your up to two follow-up questions. EWH

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13 months ago
Dr EWH, 
  Thank you so much for your response. 
I was not throat tested only gave a urine sample and blood. So I should ask for that? Would I have any symptoms at this point that I should be looking for? 
And it sounds like for my peace of mind a test at 6 weeks will be done waiting until the 3 month mark would have been extremely hard  on me.  I really appreciate your help and and truly thank you for helping to ease my anxiety. I know its similar to other cases but sometimes it just helps when you know it specifically addressing you. And when all can keep thinking about is whether you might have gotten HIV .. it’s scary. 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Thanks for the additional information.

To test for peace of mind (I am confident the tests will be negative), you should have a throat swab for gonorrhea and chlamydia (most STI throat infections are asymptomatic) and follow-up blood tests.  At 4 weeks the HIV blood test in 99.9% conclusive but it is not completely conclusive until 6 weeks.  There is no good reason in your situation why a 3 month test is needed- that is out of date thinking. 

Take care, please don't worry.  EWH

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13 months ago
Thank you again very much! I appreciate your time and this truly valuable service you are providing allowing us to ask questions and get answers from experts like yourself. Thanks again for easing my  fears. Will do all that you advised. 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
I'm pleased that my suggestions were helpful. Take care.  Please don't worry.  This thread will be closed later today. EWH
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