[Question #7588] HIV Exposure part 2

3 months ago

So unfortunately I asked him again if he’d go get tested and he said “you’re making me feel uncomfortable because I know my body and I know I don’t have anything” and swearing he wouldn’t even know how to send an anonymous text. I honestly don’t believe him but either way I need to test. 


Would a RNA test at 13 and a half days be pretty accurate? I just want to know if I’m okay as soon as possible and since he refuses to test and show me his results I have to. 


Do you think my test should come back negative? The riskiest thing to my knowledge is him touching my vagina after touching his precum and giving him oral. I’m sort of afraid he might have slipped in his penis into my vagina too without noticing. How risky would this be?


But I am gonna test on Tuesday and hopefully the results will be negative. 


Would you test in my position?

Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago

Welcome back to the Forum.  I'm sorry that you are having to go through this and that your partner is not more appreciative of the reason that you asked for him to test.  As I suspect you may know, Dr. Handsfield and I share the Forum, having worked together for nearly 40 years.  While our verbal styles are somewhat different, we have never disagreed on the fundamentals of our assessment or advice.  On this occasion I happened to pick up your follow-up.  I've read your earlier interaction with Dr. Handsfield and agree with all that he said.  We can't know whether the notification you received was a scam or had some basis.  Irrespective, it's totally understandable why this would raise apprehensions for you.  It's also sad that your recent partner was not more understanding and accommodating.  Finally, before I do answer your question, by way of background, like Dr. Handsfield I would say that the realistic chance that your encounter lead to any meaningful risk for HIV infection is virtually zero, both because the sex acts you took part in fall into the category of virtually no risk exposures and because, based on what you say he says, it is statistically unlikely that he has HIV. 

None of what I've said above however means that testing is not a reasonable plan and it is totally understandable that you would want accurate test results as soon as possible.  The HIV RNA test becomes positive in persons with recent infections earlier than other tests.  Most experts say that test results any time more than 11 days after an exposure provide accurate results although, as Dr. Handsfield did, those same experts do often suggest further testing with a 4th generation, combination HIV antigen/antibody test 6 weeks or more after the exposure.  I should add that I have never seen or heard of a person with a negative HIV RNA test taken more than 11 days after exposure going on to have a positive test related to their exposure of concern. 

Thus, bottom line, I understand your plans for testing and do not disagree.  I hope this perspective is helpful.  EWH

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3 months ago
Thank you, unfortunately I think it is likely he is positive because of his unwillingness to get tested to be able to provide  me test results although I guess there is no way of knowing. The fact that you both agree my test should show up negative after only giving head is reassuring. Would my risk be higher if he had managed to slip his penis inside my vagina? 

And I’ll be getting tested this Monday. So if I got exposed Tuesday January 12th at around 7 pm and tested on Monday January 25th at 12 pm it’ll be about 12 days and some hours testing after exposure. This should surely be a reliable result? (Including testing at 6 weeks after)
3 months ago
Also I want to clarify if my gingivitis and bleeding gums while brushing my teeth hours beforehand would increase the risk involved in oral?
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
If his penis penetrated your vagina, your risk would certainly be higher. Even then however your risk for infection would be less than one infection per 2000 sex sex, on average.  Thus more than 99.9% of penetrative penile-vaginal exposures do not lead to infection. The odds are strongly in your favor.

Once again, we are in agreement that if you’re only exposures were masturbation and performing oral sex on him you were risk for acquiring HIV if he was infected are vanishingly low.  A negative test more than 11 days following the event would certainly support the same conclusion.

The presence of gum disease, recent bleeding at the gums, mouth sores, or recent dental work would not change the negligible risk of infection. Please do your best to not worry. EWH
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3 months ago
Hello I just got my test results back. RNA taken 12 days post exposure came back negative. How reassuring or conclusive are these results if my only risk was oral? 

Also given the chance he might have inserted his penis into my vagina without me noticing, how reassuring would these test results be? 

Either way I will be taking the 4th gen test in a couple weeks but I just want to know if I should feel more relaxed or if I should keep my guard up for a potential different result. 

Thank you for your help. 
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago

These results are highly reliable and should provide you with peace of mind.  As I mentioned above, while some experts would recommend another combination HIV antigen/antibody test at six weeks, I do not particularly see the need and am confident that should you choose to retest, it will provide a negative result at that time.  I have never seen or heard of a person with a negative HIV PCR after 11 days going on to develop a positive test at a later date.  I urge you to relax and remain sorry that you've had to go through this.

As you know, we provide up to three response to each client's question.  Thus this thread will be closed shortly without further responses.  I hope the information and perspective I have provided has been helpful.  EWH

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3 months ago
Would  this suggestion to not need to test again apply in the case of brief penile penetration? I don’t think he did insert his penis into my vagina but in the event he did would this 11 day RNA test cover that as well? 
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
With or without penetration my assessment would be the same.

End of thread. EWH 
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