[Question #8452] HIV Transmission Information

44 months ago

Background: 24 y/o male from Mumbai, I was in a relationship with a girl for 4-5 months in 2017 where we had unprotected vaginal sex. She has been tested 4 times for HIV, once during our relationship, then 6 mo after last exposure, then 10 mo & finally after 4 years of our last exposure. I have tested twice, once 9 mo, then 11 mo after last exposure. We tested from well reputed labs (NABL accredited), had blood drawn from veins.

I did some research, as per latest govt estimates, HIV incidence has reduced in Mumbai (~ 2-3 cases / 10,000 unifected per year, prevalance of ~0.5%)

a) Tests were 4th gen, both of our reports have an index value mentioned, methodology in my report says ELISA and ELFA. Since our reports have index value mentioned, as well as ELISA & ELFA, these should be lab-based tests and not the rapid ones, correct? I enquired with one lab and they said they do on a machine. I understand lab-based tests are gold standards

b) Hypothetical scneario - I understand girl is HIV -ve, suppose she had sex with someone who is HIV+ who ejaculated inside her, if I have sex with this girl say after half an hour, can I be infected by the sperms of other infected male? Is this even possible?

c) I am with a new partner, we only had intense genital rubbing many times, she has given me oral 2-3 times, in light of above test results as well as low risk activities, there should be no harm to her, correct?

Many Thanks.

Edward W. Hook M.D.

44 months ago

Welcome to our Forum and thanks for your questions. I’ll be glad to comment. Although the prevalence of HIV in Mumbai is relatively high, you have reliably proven that neither you nor your partner at the time had HIV. There is no need for a continuing concern regarding your exposures with the partner you mention or for further testing related to the encounters which occurred in 2017. In response to your specific questions:

1. Yes it sounds as though the tests that you had were performed in a laboratory and the results obtained anytime more than six weeks following an exposure are conclusive and reliable. It is time to believe those test results.

2. While in science you can never say never, this would be a most unusual means of acquiring HIV. I have never heard of a person acquiring HIV and the man are you described.

3. There is no risk of transmission of any STI, including HIV, from genital rubbing of the sort you describe. As long as you are not infected with HIV or other STI‘s there is no risk to her from performing oral sex on you. Conversely, even in the unlikely circumstance that she had HIV, there is no risk to you of acquiring HIV through receipt of oral sex. There has never been a case of HIV proven to have been acquired from receiving oral sex.

I hope this information is helpful to you. EWH

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44 months ago

Really grateful for your reply which have addressed my concerns and proven that I am conclusively HIV negative. My current partner is a virgin, so no issues there. I would like to ask few follow-ups with your permission.

a) I and my ex were tested for syphilis too. I got tested with Treponema EIA, TPHA and VDRL (RPR) - 1 year after my last exposure

She was tested with VDRL (RPR) and TPHA - during relationship, then 6 mo, 10 mo & 4 years after our last exposure

As per my research, I believe RPR and TPHA are lab-based tests, correct? Also, these results are conclusive, correct?

Also, my current virgin partner does not need a test, correct? (she just had kisses and hand-genital contact before me with someone else)

b) If a female does naked genital rubbing and performs oral sex on a man, these two are not known transmission routes for Hep B and Hep C, correct? (I understand Hep C is rarely transmitted in heterosexuals from reading this forum)

Again, thanks a lot. I have got a lot of important information from this great platform. Sending lots of wishes from my side to you.

Edward W. Hook M.D.

44 months ago

I’m glad my responses were helpful. Straight to your follow-up questions:

1. Yes, your syphilis results are entirely conclusive and there is no need for further testing. Your new partner need not test if she is a virgin.

2. Correct, there is no risk for hepatitis B or C from the activities you described. As you correctly point out, hepatitis A is virtually never sexually transmitted through heterosexual encounters.

EWH

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44 months ago

Thanks Dr Hook. That addresses all my concerns. I do not have any follow-up. I would just like to confirm if I am interpreting the following typos correctly:

1) First follow-up response (statement no 2) - "I have never heard of a person acquiring HIV and the man are you described"

This should be "I have never heard of a person acquiring HIV in the manner you described"

2) Second follow-up response (statement no 2) - "As you correctly point out, hepatitis A is virtually never sexually transmitted through heterosexual encounters"

This should be "As you correctly point out, hepatitis C is virtually never sexually transmitted through heterosexual encounters"

Thanks a lot. Merry Chrismas and Happy New Year in advance.

Edward W. Hook M.D.

44 months ago

1. Correct. Sorry for the typo.

2. Also correct. Sorry.

This completes this thread. Take care. EWH

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