[Question #8602] Test?
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42 months ago
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Hello Doctor,
I am a middle-aged male that had unprotected vaginal sex and performed cunnilingus on a female, middle age woman that was a one night stand.
It has been 8 days, I have no symptoms and feel fine so far. Giving the statistics that I have read is there a reason for me to get tested for STIs sans any symptoms?
If I were to get a panel screening at nine days with HIV RNA and other STDs and they produce negative results, would that be conclusive enough considering the one encounter with an unknown individual? (Bearing in mind the STI tests that can produce results in that time frame)
From what I understand that the chance of contracting HIV in this scenario is rather low. I would assume that 9 days and an RNA test would be fairly conclusive.
Thank you
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Edward W. Hook M.D.
42 months ago
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Welcome to our forum and thanks for your implied confidence in our service. I'll be glad to comment. You don't say much about your "middle aged" partner (definitions of middle age vary) but overall the encounter was relatively low risk- STIs are more common among younger (than 25 years) person and even then most persons do not have STIs. Further, even following unprotected exposure to an infected partner, most single exposures do not lead to infection. Finally, the absence of symptoms at 8 days makes it still less likely that you were infected although certainly STIs, can occasionally be asymptomatic. Thus I would certainly endorse your plans for testing, both as a matter of good sexual health practice and for the peace of mind that negative tests will provide.
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At this time tests for the most common STIs (gonorrhea and chlamydia) will be conclusive and reliable. Although the risk for infection is lower following cunnilingus than following vaginal sex, for completeness sake, I would suggest a throat swab as well as a urine test for gonorrhea and chlamydia. An HIV PCR test at 11 days is felt to be nearly conclusive (9 days might be just a little early) and although many experts recommend follow-up with a conventional combination HIV antigen/antibody test at 6 weeks, it would be extraordinary for a person with a negative PCR at 11 days or beyond to go on and develop a positive test. As I already mentioned, the likelihood that your partner was HIV infected is very, very low. Finally, syphilis screening is typically performed as part of STI testing although results are not terribly reliable until at least a month after the encounter. As for HIV, the risk of syphilis in a middle aged woman is very, very low.
when you pursue testing I would specifically recommend against blood tests for herpes (too many false positives and confusing results) or other less common pathogens in the absence of symptoms. All tooo often broad STI "screening tests" include tests for non-pathogens such as mycoplasma hominis or ureaplasma and just lead to confusion.
I hope this information is helpful. EWH
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41 months ago
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I did as you mentioned and checked for the time appropriate STIs within their windows, urine and throat swab. All negative, as I imagined.
Today is day 11 - statistically speaking do you still think it be a good idea to test for RNA HIV?
Thank you, Doctor
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Edward W. Hook M.D.
41 months ago
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The answer to that question depends on your level of concern. The partner you described was low risk, as was your exposure. Personally, I would be comfortable waiting until 4 to 6 weeks following the encounter and then having a routine fourth generation HIV test as well as syphilis testing simply to be thorough rather than the more expensive HIVPCR test. Of course, if you were feeling particularly worried about this, the PCR test would provide some degree of assurance but I really am comfortable that your risk is close to zero. I hope this perspective is helpful. EWH---
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41 months ago
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I’ve looked at the statistics and done the math. It seems highly improbable to me at this point as well.
I’ll do a routine wellness check and panel at the 6 week mark to assure I pose no risk to anyone going forward.
Thank you for your information.
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Edward W. Hook M.D.
41 months ago
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Glad I could help. This thread will be closed shortly. Take care, stay safe. EWH ---