[Question #7583] HIV exposure

3 months ago
Hello I just got an anonymous text message saying I may have been exposed to HIV. My only recent sexual partner that it could’ve been has not answered my texts about it. 

My exposure with him was last Tuesday so about 9 days ago. We made out a lot, masturbated each other (he tapped some precum from his head onto my vagina with his finger), and I gave him some head. He ejaculated on himself. As far as I know we did not have penetrative sex. 

What is my risk and how soon is a RNA test reliable? Thank you.  Sorry if anything is difficult to understand I am freaking out. 
3 months ago
Sorry I’m just checking if this thread works because it says it was updated an hour ago but I don’t see anything. Just ignore this. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
Welcome to the forum. Thanks for your confidence in our services. The update probably was assignment to me as moderator.

This sort of notiice is understaably alarming. However, based on your desciption of hte sexaul event, you were at little risk of HIV. As for whether he actually is infected, that may not be certain:  rather than being infected himself, perhaps he in turn was in contact with someone he learned has HIV. What more do you know about him? Apart from this notice, do you have reason to suspect he's at high risk, e.g. sex with other men? Injection drug use? Past imprisonment? Also, I assume you have no other high risk factors (simply dating male partners doesn't count as high risk) -- i.e. other known contact with infected partners? Drug use? And you're not a sex worker, right?

Obviously, you should continue to try to contact him. Alternatively, if the notice came from a third party -- especially a public health department -- contact them. They probably have more information about his infection status, risk factors, etc. However, if none of this pans out, it remains reasonable tor you to be tested. The best approach is to see a physician experienced in HIV treatment and prevention in person, then follow his or her advice about specific tests and timing. If uncertain about your personal physican's expertise, your local or state health department clinic would be a good option. Otherwise, you can have an RNA test at any time; around 90% of newly infected persons would have a positive result by then, so a negative result would be reassuring, although not conclusive. Then an AgAb (antigen-antibody, "4th generation") blood test at 4 weeks would make it virtually conclusive -- with perhaps a finally conclusive AgAb test at 6 weeks.

Do your best to stay mellow in the meantime. Even with a known infected partner, HIV is rarely if ever transmitted except by unprotected vainal or anal sex. The highest risk component of your exposure was your performance of fellatio -- and even that is very low risk. (If the male partner is infected, the average risk to the oral partner is estimated around 1 chance in 10,000 -- which is equivalent to giving BJs to infected men once daily for 27 years before infection might be likely. And even this assume ejaculation in the mouth, so your risk is lower still.)

The other issue, of course, is risk for STIs other than HIV. That risk also is very low -- and here too, the main risk is for oral infection from performing oral sex. When you seek care for testing, it would be reasonable to have a throat swab to test for gonorrhea and chlamydia.

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

HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
One more thought:  Depending on your sexual ifestyle and past partnerships, perhaps the card didn't come from the partner you think. Even a partner from months or years ago might have leanred recently he is infected and is casting a broad net among his past contacts.

HHH, MD
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3 months ago
Thank you for your response. I asked him and he claims he did not send the text or put in my or his information in any sort of program to receive a text like that at all. He said he still hasn’t tested but after my concerns will go now and keep me updated. I’m not entirely sure I believe he didn’t have anything to do with the text so I will await proof of his results. 

As for our pasts he said I was his newest partner in the past 6 months, before that was his ex of 4 years and before that I’m not sure. We’re both 22 tho. And he is also my newest sexual partner I’ve been tested past the window period for all previous partners. He’s never tested, never been with a man, imprisoned, or done drugs and me neither. 

The program was third party and anonymous unfortunately so I cannot get back to them. 

When you say the rna test would be conclusive at anytime do you mean now that it’s been 9 days it’ll be conclusive from now on? Which day would be better to test RNA 12th, 13th, or 14th after exposure? 

Is the risk from oral sans ejaculation high? Has anybody been infected this way? Would you be worried? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
Sounds like this may have been a scam and that your recent partner isn't infected. At this point, I suggest not having an RNA test. If he has a routine (AgAb) test with negative results, you'll know you could not have been infected. Or perhaps now having triggered his uncertainty, and given his willingness to be tested, probably you should have an AgAb test as well. If both negative, you'll both be assured neither could have infected the other.

If you decide to proceed with RNA testing anyway, wait until 14 days for ~90% conclusive result. (The RNA test is never 100% conclusive by itself -- negative results need to be confirmed with negative antibody test at 4 weeks or more.)

I gave you the statistic for penile to oral HIV transmission. There are no data on which to estimate the risk without ejaculation, but it must be lower than with it (1 in 10,000).
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3 months ago

I don’t know if it could be a scam when I google the phone number some people do say it’s a scam but i don’t know if they’re in denial or confirmed it. The site itself looks legit. (Tellyourpartner.org) I don’t know if I believe him or not either when he says he had nothing to do with the text. He seemed offended by the thought of somebody saying he could have an std and said it’s likely a scam or algorithm that took my phone number. 


But I’ll see if I can convince him to test as soon as possible. And I will take the RNA test on Wednesday then and hopefully won’t be coming back.  


How come some sources say oral isn’t a risk and you guys say it is? And would having gingivitis and brushing my teeth about 4 hours before affect it? And why isn’t the precum to my vagina the biggest risk? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
As best I know, tellyourpartner.org is legitimate. But that doesn't stop misuse or scams. For example, maybe your partner has an enemy (or a ffriend with a bizarre sense of humor) who is sending messgas in his name. In any case, if he gets tested with negative result, you can and should skip your own RNA test.

Whether oral sex is or isn't a risk is entirely semantic. We sometimes also say "no risk" because it's so low it can be considered zero. There has never been a proved case of HIV transmission oral to penis, or by cunnilingus for either the oral or vulvar partner. But that doesn't mean the risk iy zero, just extremely low. Don't get hung hp on such trival differences. I've given youl the reasons your risk is zero for all practical purposes. From a medical or risk standpoint, you don't need testing for HIV -- the only reason is the reassurance you'll likely experience from the negative result.

That completes the two follow-up exchanges included with each question, and so ends this thread. I hope the discussion has been helpful.---
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