[Question #6505] Hiv scare from exposure

13 months ago
Hello Doctors, 
Straight Male , 35 India my sexual history
1. Protected vaginal sex in frankfurt with 3 CSW in 2007.
2.Protected vaginal sex with college girl in 2008.
3. Protected vaginal sex with CSW in 2011.
4.Got married in 2014 and have child in 2016 ...wife get tested for hiv and she is negative.

5. Got massage from female on 8th Nov. 2018 she sits on my thighs....she is wearing denim shorts and i feel very sharp pain in my thigh for few seconds but when she get off no pain....feel like pin or needle prick but i remember no blood on my thigh.

6. Got unprotected oral sex on 2nd december 2018 from very high end massage therapist (female)for 2-3 minutes ..she only provide massage & oral sex to customers (no vaginal sex).
These are only exposures in my life. Last exposure( recieving blowjob from female )  make me anxious and i got tested after 28 days on 30 dec 2018 with hiv combo test (4th generation) from reputed lab in delhi and result is negative ( my first Hiv test) And syphilis test on 16th jan 2019 ( 46 days after last exposure)

1. Am i safe (hiv)? I think recieving oral sex is no hiv risk for reciever as i read in other threads.
2.My result are conclusive with respect to blowjob( 28 days before test) and possible needle prick ( 52 days before test)?
3. 56 deanstreet london clinic ( biggest in europe ) says on website that 4 week is conclusive .Is this correct?
4. Do i need more test (medical risk).

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

Welcome to our Forum and thanks for your question..  I'll be glad to address your questions.  Before I respond to your specific questions, let me provide some background information.  First, it is statistically unlikely that any of the exposures that you describe ere to persons who had HIV.  In addition, the exposures you describe are safe, virtually no risk events- condom protected sex is safe sex with no risk for HIV as long as the condom is worn throughout sex and does not break (when condoms break, they typically break wide open, leaving no doubt that breakage has occurred).  Similarly, receipt of unprotected oral sex is also a no risk event for HIV- no one has ever acquired HIV from receipt of oral sex.  Finally, while neither you nor I can know what the pricking sensation you experienced was, the fact that it did not puncture your skin to draw blood makes it also a virtually no risk event.  I would not be the least bit worried about HIV in your situation, even without testing.  Your testing verifies that you did not acquired HIV (or syphilis).

As for your specific questions:

1. You are correct.  As I explained above, your exposures did not put you at risk.

2.  4th generation tests are absolutely conclusive at any time more than 6 weeks (42 days) after an exposure of any sort.  In the past we considered results of 4th generation tests at 4 weeks (28 days) conclusive but colleagues at the U.S. CDC state that they are aware of a very few cases in which tests became positive between 4 and 6 weeks.  These results have, to my knowledge, never been published and occur rarely, less that 1/10th of 1% of the time at most.

3.  See my comment above.  For all practical purposes, a 4 week 4th generation test is conclusive.

4.  No more testing is needed.

I hope that this information is helpful.  EWH

13 months ago
Thank you very much Doctor . It relieved my anxiety very much .I am thinking about these 2 exposures after 1 year because my wife is pregnant and this worries me  and i start focussing on these 2 exposures.

1. I am 99 % certain that this is not needle prick ...may be my anxiety .Why a therapist try to infect me by sitting on my thighs with needle in his pocket  ....may be my hair pulls or pinched nerve . I have not seen any blood . But as you said for any sort of exposure 42 days is conclusive test for combo test and my test is on 52 day.so i am completley safe in regards to this exposure whether there is blood or not  ?

2. Regarding 2nd exposure recieving oral sex ( no risk for hiv ) and my test covers 99.9% at 28 days so no chance ?

3.  Regarding old protective exposures they are 8.5 and 12.5 years old and i am completly healthy ...my health and hiv test says i m not infected due to those exposures ...correct ?

4. Finally doctor i have not tested for gonnohorea and chlymdia ...but dont have any symptoms after 1 year and in between i have taken 5 days course of Augmentin 625mg for throat sensation after 2.5 month of last exposure in feb 2019.

5. Also doctor the massage girl( needle prick one ) has ringworm in  her thigh though look like cured ....i think no risk for hiv if my penis rubbed with ringworm fir 4-5 sec...though i have try not to touch ringworm .
I know my questions are repetitive but i think i am getting best advice in the world from best doctor and i dont want to miss that chance .
Thanks again doctor.

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

Thank you for the follow-up.  Your wife's pregnancy does not change my reply.  These were no risk events and you have proven that you did not get HIV (or syphilis) from them.  In follow-up:

1.  I agree with your assessment.  You are in the clear and have proved you were not infected by the event you described.

2.  Correct.  No chance.

3.  Correct.

4.  I see no reason for testing for gonorrhea or chlamydia. 

5.  Contact with this person's ringworm lesions would not change my assessment.  Still no risk.

Take care. EWH

13 months ago
Thank you Doctor ,
1. Only last 2 questions then i will move on .....sir if my needle prick experience is real one from the pocket of massage therapist and blood comes out of my skin which make it a potential exposure ........then also my 52 days combo test cover this exposure 100 % for hiv 1 and hiv 2 though in north India hiv 2 is not present  according to my research....

2.  Inspite of high risk even i have risk of hiv infected blood transfusion single test after 6 week is enough  because test overrules...I am worried because i have seen people are testing many times . My rational mind says after window period of 6 weeks it doesnt matter whether you take one test or two or more . My single test is enough ( 100%) ( I dont have any exposure after my last test on 30 dec 2018).

Sorry doctor asking repetitive questions but i am very anxious person ....i decide i take ur advice and move on ....thank you for your wonderful forum . It is really helpul.

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

1.  Correct.  If you really did experience a needle prick, and if the masseuse had HIV (both are unlikely from what you say), your 54 day results will be conclusive.  you need to believe them and move forward without concern.

2.  You are correct again.  At 6 weeks a single test is conclusive and sufficient.  Repeating the test would serve no meaning scientific or medical purpose.

This is my 3rd reply to your questions.  As per Forum guidelines this thread will soon be closed without further replies.  Take care.  Please don't worry.  EWH