[Question #7710] Hiv concern

1 months ago
Hello.

So I had unprotected vaginal sex only with a sex worked in a strip club in Mexico.

I was drunk and did the mistake of not wearing a condom.

My question is how likely is it for a straight male to get hiv from one exposure of unprotected vagjnal sex.  I’m uncircumcised and have no open sores or warts.  

I went to a local planned parenthood and tested for stds at 2 weeks and everything came back negative. Chlamydia, gonorrhea, syphilis, and HIV, the hiv test was a rapid alert 4th gen test.

Now I’m at 6 weeks and going to go get tested again for hiv, because I have dizzy spells, stress, random joint pain on my elbow, diarrhea that comes and goes. 

Thank your so much in advance . 


1 months ago
Sorry I forgot to add that I’ve been having no sleep for the last 6 weeks, I wake up in the middle of the night at least 2 times and struggle to fall back to sleep, I think this is stress or anxiety or Coukd that be a symptom of acute hiv?  I had random bumps on both armpits that came out of no where, doctor said that they weren’t lymph nodes . I’ve lost around 10 pounds in this 6 weeks. Could this be symptoms of hiv or more related to stress ?


Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Welcome to the Forum and thanks for your questions.  I’ll be glad to comment.  The likelihood that you acquired HIV from the exposure you describe is very low.  Let me provide the statistics first, then add a further comment.

Statistically your encounter was low risk.  Most exotic dancers/commercial sex workers do not have HIV.  Even if your partner had untreated HIV, your likelihood of acquiring HIV is substantially less than 1 in 1000 ( in other words, there is a more than 99.9% chance of infection IF she had HIV.   

The symptoms you describe are not suggestive of HIV.  Rather the indicate your anxiety and stress over the possibility.  The good news is that your test today, 6 weeks after the event will provide you with conclusive results.  I anticipate that your tests will show that you were not infected.

I hope that this information is helpful.  If there are further questions, please feel free to use your up to two follow up questions for clarification. EWH 
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1 months ago
Thanks dr Edward hook, I was reading your response and you put in the stats part “ Even if your partner had untreated HIV, your likelihood of acquiring HIV is substantially less than 1 in 1000 ( in other words, there is a more than 99.9% chance of infection IF she had HIV.   ” 

Did you mean to say there’s a 99.9 chance of not getting ? Because from what I understand from your response it says there’s a 99.9 chance of infection??



You think all the dizzy spells I’ve been getting for the last 3 -4 weeks are not related to hiv?

Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
I apologize for the typographical error. I left the word NOT out. The phrase you mention was meant to say “...there is a greater than 99.9% chance that you will not be infected.” Please accept my apologies. EWH---
1 months ago
Sorry I made a new question earlier but wanted to ask these questions, especially the ones with being uncircumcised 


1st question. I took pep for 5 days only, I didn’t finish it. Does 5 days affect the window period for testing ? 

2nd. I have a red throat but no soreness or pain at all, joints hurt in my elbows out of no where and pain come and goes.   Dizziness and lightheaded for several weeks! And diarrhea that comes and goes   These started around 2 weeks after and  have been going for 4 -5 weeks.  I have no fever or swollen lymph nodes or rash.  Could those be early hiv symptoms ?

3. I’m uncircumcised and have read that that it’s more likely to catch hiv that way ? Is that true ?  



4. She was a sex worker from a strip club in Mexico and I don’t know if she had and std or anything but I came out negative for gonorrhea chlamydia at 2 weeks is that a good sign that maybe she doesn’t have any std at all ? 

 5. I see that they say that heterosexual men are less likely to get hiv, but what about in parts in Africa that they say that most of hiv + people are hetro males ?


Thank you so much doctors!
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Thank you for the additional information including the fact that you took five days of PEP. I wish that you had said that from the outset.  It is hard to give accurate advice when our clients do not provide us with an accurate set of facts to comment on.  If you had asked me if you needed PEP following the exposure you described, I would’ve said no, that the risk is too low for that to be useful. Further, it is unknown as well how five days of PEP would affect your test results although it is certainly likely that your results will  take longer than six weeks before they can be considered conclusive. Precisely how long is unknown since you did not take the PEP for the recommended 30 day period.

1.  Yes, it is likely that five days of PEP would prolong the window until your results are conclusive. Current scientific data however are for people who take PEP the recommended 30 days. Precisely how long having taken five days of PEP extends your window period is unknown because there are no scientific data on this. Having said that, again I state that your risk of infection from the encounter you described is extraordinarily low.

2.  The symptoms you described could be caused by any number of different processes. Knowing which one is not possible without testing. On the other hand, if you have been tested for HIV with a fourth generation HIV antigen/antibody test during the period you had symptoms, if the test is negative you can be sure that your symptoms are not due to HIV.

3.  Yes, uncircumcised men are at somewhat higher risk for acquisition of HIV, if exposed. The fact that you are uncircumcised however does not overcome the fact that the exposure you describe it was very, very low risk for infection.

4.  The fact that you were tests for gonorrhea and chlamydia are negative is good evidence that your partner did not have STI ‘s, presuming you did not take antibiotics as well as PEP.

5.  You are correct, heterosexual men are at less risk for HIV than men who have sex with other men. The fact that most HIV in Africa is occurring among men who are heterosexual is because the infection is so common there.

You have one further opportunity to seek clarification or ask additional questions. If any part of this message is unclear please feel free to ask for clarification. EWH

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1 months ago
Okay I’m sorry I didn’t give all the details in the beginning. 

So from what your telling me those 5 days of pep could prolong the window period right? 

I’m getting tested tomorrow, tomorrow will be 6 weeks from the last dose of pep that I took in those 5 days. They told me it was going to be a blood lab test idk if it’s going to be 4th gen or just a antibody blood test 



And no I didn’t take any antibiotics for other stds .


Thank you so much for everything you guys tho 
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Thanks for your follow up. This will be the final response to this series of questions.

You are correct that having taken five days of PEP may prolong the window for your test results to be conclusive. However, the fact of the matter remains that the exposure you described was very, very low risk for acquisition of HIV or any other STI.  Further, I repeat that if you’re recent test for HIV are negative, that proves that the symptoms you are experiencing are not due to HIV.

I suspect that the test you will have tomorrow will be a fourth generation test. You should ask. No matter what test is taken however I would recommend did you repeat test at 5-6 weeks to be entirely sure that you were not infected. 

This concludes this thread. I will have a little more to add to further questions. Please resist the temptation to ask repetitive, anxiety-driven questions. 

EWH 
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1 months ago
Okay so even tho tomorrow marks 6 weeks  after pep , test again in 5-6 weeks  is what you Recommend right