[Question #6847] Anxiety over this

10 months ago
Dear Doctors, 5 weeks ago, was making out with a fren. Then he inserted the tip of the head slightly 1cm into the vagina for less than 10secs. 
Went for 20 & 28 days 4th gen with negative results. Wasnt planning to at 6 weeks. But been getting random pains in body here & there & it comes & goes for a week. Is this ars? I have to say I do have ocd anxiety issues. Thank you! 
10 months ago
The random pains appeared just this week. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
Welcome to the forum. Thanks for your question.

Your negative antigen-antibody (AgAb) tests are nearly conclusive; it's the rare new HIV infection (1-2%) that require a full 6 weeks for a conclusive result. However, although your results are not quite conclusive in regard to infection, they are 100% conclusive about your symptoms:  they prove that your various aches and pains are not due to HIV. It is not possible to have symptoms of acute retroviral syndrome (ARS, initial HIV infection) with a negative AgAb test.

In addition, if your partner doesn't have sex with men or an injection drug user, the chance he has HIV is very low; and even if he did, the possibility of transmission after such a brief exposure is zero or close to it. (Even with ejaculation in the vagina by an HIV infected male,the average risk for the female partner is only 1 in a thousand.) As for your symptoms, they aren't suggestive of HIV anyway. I've never heard of someone with new HIV whose only symptoms were body aching that comes and goes.

So at this point, you can be 100% certain your symptoms are not HIV. All things considered, I would put the chance you have HIV at under 1 in a billion. (That's right, billion: even one in a million would be far too high an estimate.) If I were advising my own patient or say someone personally close to me, I would say that HIV testing wasn't even necessary, and that no further testing is necessary -- to go forward with confidence she wasn't infected. However, if you feel you won't completely relax until you have had a conclusive test, have another AgAb test 6+ weeks after the event. Alternatively, have a discussion with your partner. If he is willing to be tested, a negative result would show you were not exposed and could not have been infected.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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10 months ago
Appreciate your reply! 
But the pains came after the 28days. That's why I'm worried. Thinking it could be ars. Can it happen after 4 weeks? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
ARS symptoms don't start that late. Onset almost always is about 1-2 weeks after virus acquistion, rarely maybe 3 weeks. 4+ weeks rules out ARS as the cause.---
10 months ago
Thank you Dr HHH! I will go with confident that I'm negative. Since the risk is close to zero. :) 
10 months ago
Sorry.. 2 last questions. 
The fact that he did thrust a few times. Is the risk is still negligible? & in conclusion I dont need a test again? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
This doesn't change my opinion or advice. If you think it through, the answer is obvious. If the risk is 1 in a thousand for unprotected sex for several minutes, with ejaculation in the vagina, what can it be from such a brief exposure?

Do you "need" a test? No, not from a medical or risk perspective. However, you wouldn't still be asking this question unless you're still worried, and my guess is that won't change with this last reply. Some people, especially those who are particularly anxious,  are more reassured by negative test results than by professional opinion, no matter how expert. (I don't take it personally!) If a negative test result at 6+ weeks will remove all worry, by all means do it. This doesn't mean I believe there is any chance you have it; I do not. Strictly for reassurance. If you decide to do it, stay relaxed until then. It will be negative.

That completes the two follow-up exchanges included wiht each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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