[Question #7776] HIV exposure

1 months ago
Hello Doc's,
I appreciate everything you guys do.  This seems to be a great resource.
So I've been having a great deal of anxiety around a recent exposure.  I hope you guys can give me some advice.
Four weeks ago, I had my first experience with another male.  We met at his place, we mutually masturbated and other and both orgasmed onto his stomach.  During he jerked himself and me, then rubbed my anus.  I dont think he penetrated it, if he did not much.  I am afraid he may have gotten precum on his finger, then rubbed it onto my anus.  I dont think I had any fissures at the time but I cant be certain.  I had a decent amount of precum of mine around my genitals, so I may have been exposed through that route too. He stated that he was clean, but I know thats not certain.
Since then I have been having a good deal of symptoms of something, I hope not HIV.  Approximately four day after I got a headache and cough, then about a week after sore throat.  I went to the doc and they prescribed an antibiotic and urine tested for gonorrhea and chlamydia, and came back negative.  Two weeks after exposure I developed oral thrush, swollen lymph nodes (they started to hurt at around 2 and a half weeks), muscle and joint pain, and diarrhea.  Now four and a half weeks after exposure most of my symptoms have gone away.  I still have some thrush and swollen lymph nodes but they dont really hurt anymore.
I got tested with an HIV1/2 Antibody test at 2 weeks, came back negative.  Then a 4th gen HIV test at 26 days after, I just got the results back as negative. 
So my question is should I still be worried about HIV, and get another 4th gen test done at 6 weeks?
Edward W. Hook M.D.
Edward W. Hook M.D.
29 days ago
Welcome to our forum. Thanks for your question. I’ll be happy to comment.

The exposures you describe are very low risk for acquisition of HIV. Where are you now you do not know that your partner had HIV. Mutual masturbation is not a risk factor for HIV and the virus is not transmitted from person to person through transfer of genital secretions on one person’s hands to another’s genitals or rectum.  Further, the symptoms you describe at 4 days, or even a week later, are not suggestive in anyway of HIV and occurred far too early to reflect a recently acquired HIV infection..  Tests performed at the time symptoms are present are useful for determining whether or not symptoms are due to HIV. If the tests are negative, the symptoms such as your thrush and sore throat, are not due to HIV.  Even more importantly, your test results at four weeks confirm just how unlikely it is that you have HIV. At four weeks far nmore than 99% of test results are reliable. Your negative test results are strong evidence that you did not acquire infection through the encounter you described. To be completely sure that you were not infected, repeat testing at six weeks is probably appropriate. That said I am confident that you did not acquire HIV through the low risk Exposure you describe.  

I hope the information I have provided is useful to you. If there are further questions, please do not hesitate to use your up to two follow-up questions for clarification. Take care. EWH
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29 days ago
Thanks for the reply Doc.
 
I forgot to mention in my previous post and I'm really sorry I know this is gross, but I had some small cuts around my anus.  I think they are from when I had diarrhea.  They started about the same time around two weeks after exposure and were ichy and bled a little on toilet paper.  Like I said before I don't think that I had any cuts on my anus at the time of exposure. But if I did and they weren't quit healed yet, would that put me at a higher risk?  Also do you think I'm at any risk of other STD's that may line up with my symptoms from this exposure?  Last question is it worth it for me to test again monday at a little over five weeks or should I just wait for six? The anxiety is killing me.
25 days ago
So Doc I ended up getting another 4th gen test done at 37 days, and it came back negative. What are they odds I still may test positive at 6 weeks?  And thanks again Doc I really do appreciate the advice.
Edward W. Hook M.D.
Edward W. Hook M.D.
24 days ago
Cuts or abrasions around your anus would not meaningfully change your risk.

Your five week (37 day) test result is very, very strong evidence that you do not have HIV. Well over 99% of persons who are going to develop a positive test will do so within four weeks of exposure. Results at 42 days or six weeks are absolutely conclusive. Your testing five days shy of that is very very strong evidence that you did not acquire HIV from the encounter you describe.  

If I were you, I would not feel the need for additional testing. I hope this perspective is helpful to you. Please don’t worry. EWH
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24 days ago
Thank you for getting back to me Doc.  I really appreciate your perspective.  There are so many conflicting view point around the internet when it comes to testing and symptoms.  The PA at planned parenthood stated that the window period is 3 months after exposure, but she didn't seem to up to date on HIV or the fourth gen test.  Is there information dated?
Edward W. Hook M.D.
Edward W. Hook M.D.
23 days ago
It saddens me to hear that a medical professional working at Planned Parenthood provided you with such out of date information. It is been more than a decade since a three month interval was recommended as being necessary until HIV blood tests were definitive.  Today Third generation, antibody only tests provide conclusive results eight weeks following exposure and using fourth generation combination HIV antigen/antibody tests, results are conclusive at six weeks. In fact with the fourth generation tests, at four weeks results are more than 99% conclusive.

We urge all of our clients to not seek information from the Internet. Statements made on the Internet are not filtered at all and many of them while probably well intentioned, are out of date, taken out of context, or represent urban myths which are untrue. Further it is difficult to discern which statements on the Internet are accurate and which are not. I hope that the information 

I have provided is helpful to you.  As you know, we provide up to three responses to each client’s questions. This is my third response to your questions. Therefore this thread will be closed shortly without further responses. Take care. EWH 
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23 days ago
Thanks Doc. You have answered my questions thoroughly.  This is a great resource, and I really appreciate the quick responses.  Thanks again for all you guys do. 
Edward W. Hook M.D.
Edward W. Hook M.D.
23 days ago
Thanks for your thanks.   EWH ---