[Question #7042] Unprotected exposure.

8 months ago
I wish I would have learned from my previous experiences but now I am back. 

I recently had a 20 minute unprotected vaginal sex with an old partner. I have been recently tested for all stds and I am negative. I am unsure of my hsv 2 status I am on valtrex due to my frequent oral hsv 1 outbreaks. It’s been 20 weeks from my previous encounter with a hsv 2 positive person. I am continuing to test negative. However with the new partner he also tested positive for hsv2 in the past and doesn’t have symptoms.... I am now scared that he could have had other stds and now I am at risk again. Possibly for HIV I am struggling mentally yet again. 

1. Am I at a huge risk for getting HIV amongst other sexually transmitted diseases? 

2. What risk percentages am I at for a one time exposure for HIV, syphillis, and herpes ? 

3. I am very disappointed in myself for putting myself this situation again. What are my chances of my hsv2 becoming positive after 20 weeks. I have been on valtrex for a long time... I have read different information on its affects on testing. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago
Jessica, I am going to refer your questions about HIV to my colleagues, but I"ll answer the herpes part.  Valtrex most definitely impacts antibody testing for HSV 2 and I would say that it isn't possible to know what's going on with HSV 2 infection while taking daily Valtrex.  The University of Washington warms about Valtrex use when interpreting the western blot results so it's not just me that has this concern.  it might be worth talking about his index value on his herpes test, since he has had no symptoms, just to rule out the possibility of a false positive on his blood test.  If his IgG results fell between 1.1 and 3.5, he needs a confirmatory test.  However, if he has had outbreaks of herpes, this is not necessary. 

Terri
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Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Good day. Teri asked me to weigh in on your questions regarding risk for HIV and syphilis.   I will provide a brief answer for you.  I do not know much about your partner however I suspect that he is a heterosexual male who does not have sex with other men.  If so, this was a Very low risk event.  Part of estimating that risk relates to how likely or not it is that your partner had HIV or syphilis.  HIV and syphilis are currently relatively uncommon infections amongst heterosexual men and women. Both are far, far more common in men who have sex with other men.  Only a small fraction of 1% of heterosexual men in the United States have HIV or syphilis. 

In addition, in the unlikely circumstance that your partner had either HIV or Syphilis, it is still unlikely that you were infected. Most exposures to infected partners do not lead to transmission of the year infection to sexual partners.  HIV is transmitted to an infected persons through heterosexual sex on average less than once in every 1200 sexual encounters. For Syphilis, transmission is more common but Syphilis is a rare infection. For Syphilis about one in 4 sexual encounters would lead to transmission of infection.  Assuming that your encounter was with a heterosexual male who did not have sex with other men, I would estimate that you were risk of acquiring either HIV or Syphilis is a small fraction of one percent. Put another way chances are greater than 99% that you did not acquire HIV or syphilis from the encounter you described. If you remain concerned, you could certainly test for both of these infections about six weeks following your exposure (earlier testing would be less conclusive).  At that time results will be conclusive.  I am confident that if you choose to test that your tests will be negative, proving that you were not infected by the encounter you describe.

I hope this information is helpful to you. Take care. Please don’t worry. EWH
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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago
Thanks so much, Dr. Hook, you are amazing source of information about HIV and syphilis (and other things too). 

Terri
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