[Question #6889] Risk assessment and testing

10 months ago
Dear Drs.


I recently had couple of encounters, unfortunately due to stress,  and would like your advise:

1) Protected Anal with a female CSW  
2) Protected Anal with a female CSW
3) Protected Anal with a Male CSW ( I was insertive).

I used condoms with lube and as I recall the condoms didn't fail.

I tested 32,35,41 days 4th generation lab test ( negative results)  following the last encounter with the male CSW, and 6+ weeks following the encounter with the female CSWs. I contacted the male CSW, he since traveled to Thailand, and he agreed and tested 35 days after our encounter with negative result through the Thia Red Cross and shared with me the result, I talked to them and they said its a 4th generation test. today is 41 days following the encounter and he agreed to test tomorrow. 


Would appreciate your assesment  , and if he doesn't test at the 42 day mark should I do further testings? 




10 months ago
I tested 47 days following the last encounter with the female CSWs
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
10 months ago
Welcome to the forum. Thanks for your confidence in our services.

Two aspects of your question are most important. First, the exposures were condom protected. Statistically, it is unliely your female CSW partners had HIV; under 1% of sex workers (usually less than 1 in a thousand) have HIV anyway. There is probably a higher chance your male partner had it, but still not very likely. But even if one or more had HIV, the condoms protected you. Second, Your test results are conclusive and prove you don't have HIV. The 32 and 35 day tests were nearly conclusive, and the 41 day result definitely was. (There is no signficnat difference in test performance between 41 and 42 days.) And if your partner tests negative, it will show you definitely weren't exposed.

So based on what is known now, you can be confident you don't have HIV. That will be conclusively confirmed if your most recent partner tests negative.

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

HHH, MD
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10 months ago
Thank you Dr. Handsfield for your advise.

Will keep you posted once I receive his results, and for any follow-up questions.




9 months ago
Hi Dr.Handsfield,

How confident can I be in my results so far, as his testing is getting delayed a little bit. Noting that he tested 35 days after the encounter.  Can I be confident I didn’t catch anything. As I recall the condoms were always there and didn’t fail. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Your partner's negative test at 35 days is nearly conclusive -- around 99% reliable.  So it is extremely unlikely he has HIV, but he should have a final test when 6 weeks have passed. I already told you it is certain you didn't catch HIV. There is less certainty about certain other STDs, for which condoms do not provide complete protection, such as herpes and HPV. However, the risks for these also were low and I don't recommend testing for them.

You have one more comment or follow-up question on this forum; I suggest waiting until all testing is complete, assuming you would like to tell me the results. Threads are closed after 28 days.
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9 months ago
Hi Dr.Handsfield,
Apparently the MSW is still not tested due to the Covid-19 situation. I hope you don't count this as a follow-up question, but I raised this concern in my initial thread that if he doesn't test following the 42 day mark, should I seek additional testing myself?
Also I am starting to approach the other FSW for testing. Am I doing the right thing or am I moving in the wrong direction? I know the first CSW tested negative 4 months before our encounter, not sure about the second CSW. Appreciate your response Doctor and hopefully you will keep the thread open and not count it as a follow-up.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
My initial advice said nothing about anyone needing any more testing. Your last test was done long enough after all exposures to be conclusive and no more testing is needed, either for you or your partners. But if you want still more reassurance, it seems most reasonable for you to be be tested again and not rely on any of your partners to do so. I'll leave this thread open for one more exchange; with that, or at 28 days (whichever comes first) it will be closed. But really, you definitely don't have HIV. It's time to stop worrying.---
9 months ago
Hi Dr Handsfield.


The MSW is positive, he just confirmed that to me. The result he shared with me wasn't entilgable to me at first but indeed he is positive.

Today is 47 day since encounter and I did another 4th generation test, it is negative. Pls advise me as I am really terrified now and not sure what todo or if I can even trust my results. should I test more now?
9 months ago
The encounter was brief and condom protected. No oral.
9 months ago
He is not on medication as he told me he just found out he is positive. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Even with an HIV positive partner, you had only safe sex and your test results so far are conclusive. Given this development, you might wish to have one more test, if another negative result will improve your confidence you aren't infected.

That concludes this thread. Please don't start another about these exposures and HIV testing. And for sure no need to return to tell us if you are tested again and once more have a negative result. Thanks. I hope the discussion has been helpful.
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