[Question #7535] Exposure Worry

3 months ago
Hello Doctors,

I had asked a question about a lower risk exposure on here almost 2 years ago. I hate to be back worrying but I have a different exposure I am quite worried about.

I had heterosexual intercourse twice(unprotected) with a female friend/acquaintance that I have known for years but more recently reconnected with. The first was about 5 months ago.. had my normal blood work done I think exactly 28 days post that exposure. I'm pretty sure HIV was tested for then as I saw it on the form and obviously negative as my doctor has said nothing(I'll will confirm it was actually tested so then). The second and most recent exposure was pretty much exactly 3 months ago, in early-mid October.  Without going into too much detail, my worry is I believe her sexual partners to have increased in between the two exposures and I had been in touch with her up until mid December when she has suddenly and oddly begun to ignore my communication and drop me from social media (which is odd for the history of our friendship). Anyway I know it's not a confirmed exposure or why my mind has gone to the idea she is worried to tell me something big.. but it has.  I'm freaking out wondering my real risks are? I have blood work scheduled mid next week, so in 5 days for something missed on my last test(unrelated) so I will have HIV and syphilis tested again. But thinking every little sore throat or potential markings on my skin is a rash related to say HIV will be hell for the next week.  Am I right to assume any fevers, sore throats, rash or swollen lymph nodes related to these infections would be obvious? Are there symptoms of either in the 2-3 month post exposure range that I should be aware of? As an example, about a week ago I felt shitty one night with body sweating(no actual fever), chills, and the hint that my throat might get sore. I just thought I was about to get sick(Covid worries) etc. But when I woke up the next day I felt fine and pretty much have since. Didn't worry 

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
Welcome back to the forum.

You're overthinking everything in regard to HIV. First, it is unlikely either of your partners had it -- under one chance in a thousand, if you're in the US and if they're not sex workers or injection drug users. And when a woman has HIV, the average HIV transmission rate by unprotected vaginal is once for every 2,500 exposures. So the chance you caught HIV calculates to something like 1 in 2.5 million for each event -- zero for practical purposes.

No, symptoms of acute HIV infection often are not obvious:  half of all new infections cause no symptoms. And don't assume that any skin abnormality you might see (or think you see, affected by anxiety) might be HIV. Feeling "shitty" from time to time is part of being human, not evicence of HIV.

The way to know you don't have HIV is to be tested. I have no way of knowing whether HIV testing was done along with the other tests you had, but all you have to do is make a phone call to find out! If not tested yet or uncertain, have an AgAb ("duo", 4th generation) test now. The negative result will be conclusive, and far more reliable that trying to judge symptoms or the risk at the time of exposure. STay mellow in the meantime:  absolutely nothing you describe about your partners, exposures, or symptoms suggests HIV. And maybe you'd also like to know that in the 15 years of this and a preceding similar forum, with thousands of questions about HIV risk, not one person has turned out to have caught HIV. You certainly won't be the first, given the low risk nature of the exposurs you describe.

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

HHH, MD
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3 months ago
Hey Doctor,

Yes those stats and reassurance certainly do help, thank you and I sure hope I'm not the unfortunate one to be the first in 15 years. 

I am in Canada btw and it was the same girl both exposures, not two different. I'm also quite sure I was tested 1 month after the first exposure, which I get is now only about 95% accurate, but basically we are most likely dealing with the one exposure. Either way I had blood taken for both HIV and syphilis first thing Friday morning so we will see, it will be a stressful next few days. I do totally understand that symptoms are hard to judge on this and fully aware that the feelings I'm having now of maybe a slight fever starting or the little bit itchy neck irritation is probably just anxiety related. 

I will ask about one thing I have been experiencing in the last 6-8 weeks and that is the redness of the veins on the inside of my eyeball being exaggerated.. mainly one eye. Odd thing is though that it varries in severity from average noticable to not.. and seems to come and go consistently throughout the 8 weeks.  Looking online they mention could be bacterial or viral.. I'm doubting bacterial based on the above comments and that I took a 10- day 2 pill a day Doxy regiment for an unrelated issue and this issue persisted through and since that.  Would Doxy have killed a bacterial eye infection ? and have you heard of that being a HIV viral symptom?

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
The epidemiology and risks for HIV in Canada are pretty much the same as in the US. Your negative test one month after potential exposure is 98-99% conclusive, not 95%. You can be sure your next test will also be negative.

The variable appearance of blood vessels in your eye is meaningless; probablly you're just looking too closely and noticing natural variations. In any case, this certainly doesn't hint at HIV. The doxycycline also makes no difference in any of this.

I'll have nothing to say further until and unless you decide to report your next HIV test result. Stay mellow in the meantime:  there is no chance you have HIV.
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