[Question #8581] Down and out
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42 months ago
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Had 2 encounters with CSW's. First encounter involved protected vaginal and brief unprotected oral. What was disturbing was blood stains on the bed sheets. Second episode involved unprotected oral sex performed on me. Have experienced a sore throat and lack of appetite and esphogal irritation which began about a week after the encounters and have lasted about 10 days.
20 days post encounter, I had a PCR and 4th gen test and am awaiting results.
Can you estimate risk and the need for further confirmatory testing.
No fever or rash involved. Thanks
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H. Hunter Handsfield, MD
42 months ago
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Welcome back to the forum. Your main concern this time appears to be HIV, and that's the focus of my replies.
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First, most CSWs do not have HIV: depending on where you are (US, developing countries, etc) probably the chance either of your partners had HIV is no higher than 1%, maybe under one chance in a thousand. Second, sex during menstruation, or other blood contact during sex, does not increase the risk of HIV. The amount of virus in blood is no higher than in vaginal fluids. Third, your symptoms are not highly suggestive of a new HIV infection.
For those reasons, I expect your blood test results to be negative. If they are, it will be conclusive that your symptoms are not due to HIV. (You cannot have HIV symptoms more than a few days and still have a negative antibody or 4th generation HIV blood test.) And negative results on both tests will be nearly 100% conclusive against infection itself. For truly conclusive results, if these are negative, you might want to also have another AgAb (4th generation) blood test at six weeks.
I hope these comments are helpful and reassuring. Let me know if anything isn't clear.
HHH, MD
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42 months ago
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Thankyou. I will await the results. Percentage wise, if both tests are negative?
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42 months ago
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For what it is worth, can you also provide a risk percentage for each act. Would you personally be concerned if you found yourself in this situation?
Would anxiety possibly contribute to finding food unappealing, coupled with the throat and esophageal issues?
Cheers..
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H. Hunter Handsfield, MD
42 months ago
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"risk percentage for each act": If a partner has untreated HIV, each episode of unprotected vaginal sex carries an average HIV transmission chance of 1 in 2,500. With condom, therefore probably 1 in 250,000. Assuming a one percent chance your partner had HIV, the risk is 100-fold lower still, i.e. 1 in 25 million. Unprotected oral probably zero risk -- CDC estimate of 1 chance in 20,000 if the oral partner has HIV. That's equivalent to getting BJs by infected partners once daily for 55 years before infection might be likely. And no, I would not be personally concerned or be tested (or alter my sexual practices with my regular partner) if somehow I were in your situation.
The symptoms you list certainly could be related to anxiety.
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42 months ago
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Thankyou for your guidance. Was told I would receive the test results by Feb 23, so I am hopeful this thread can remain open until then, in the event I have a query.
Thanks again.
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42 months ago
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Well received results of PCR and duo 4th Gen tests and thankfully they were both non reactive. My math was skewed and the tests were taken 18 days post exposure. Based on this result, what would be the percentage of accuracy? And finally, confirmatory testing required? Thank you very much for your guidance and your straight up non judgemental comments.
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H. Hunter Handsfield, MD
42 months ago
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This combination of tests probably would detect around 95% of new HIV infections, and is 100% proof your symptoms aren't due to HIV. If you feel you need 100% conclusive testing, have another AgAb (4th gen) test at 6 weeks.
That concludes this thread. Thanks for the thanks -- I'm glad to have helped.
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