[Question #8670] Unprotected sexual

41 months ago

Iam male , I was drunk and had sexual from the vagina with girl from a moroccan in Dubai on on 06/March /2022 by the money and i didn't know any thing about her health history , the sesxual was without condom for 5 minutes and when i noticed that istopped immediately and i finshed without completing

Today on 16/March/2022 i did hiv combo test , the result is nonreactive and i know it's early test but i did that because iam scare .

My quetions is :

1- iam very very scare , What is the probability of pass Hiv to me from her if she have it , and is this sexual is very dangerous ?

2- what is the probability of pass hepatitis B and Gonorrhea or other diseases to me ?

3- when do symptoms of a Gonorrhea appear?

4- i had sex with my wife after 2 days from that sexual and we both have suffer from pain and burning in the urin and i did normal urin analysis for me the result came back good did you think we have Gonorrhea ?

5- is my hiv test combo 4th generation on 11 day after the sexual are reassuring ?

Thank you doctor

H. Hunter Handsfield, MD

41 months ago

Welcome back to the forum.

There are similarities to the question you asked two years ago, and my thoughts now are similar to those you had that time from Dr. Hook. HIV is quite rare among sexually active women in Dubai, even in sex workers. This probably especially true for women from Islamic countries like Morocco. And as Dr. Hook advised, the chance of HIV transmission is low even if she were infected. For a single episode of unprotected vqginal sex with an infected female partner, the average risk is around once for every 2,500 exposures. Risks of gonorrhea and chlamydia are higher, but still the large majority of men in your situation are not infected. Syphilis is always possible, but very low -- maybe almost as low risk as HIV.

It's hard to know what to make about your and your wife's symptoms. In males, painful urination alone is rarely due to gonorrhea, chlamydia or any other STI; discharge is the main symptom. And your normal urinalysis is reassuring, although it doesn't totally rule out an STI. An STI could explain your wife's symptoms -- but more detail is needed. Does she also have vaginal discharge? Do either of you have urinary frequency or urgency.

Those comments partly address some of your questions, but to be explicit:

1,5) For the reasons above, HIV is extremely unlikely in this situation. However, your test was done too soon to have any meaning. You could have another AgAb (combo, 4th generation) test at about 3 weeks, for a 90% reliable negative result, but conclusive testing will have to wait until 6 weeks.

2,3) With no discharge of mucus or pus from your penis, it is very unlikely you have gonorrhea. Gonorrhea symptoms almost always begin 3-5 days after exposure. Chlamydia is a greater risk, and symptoms come on later than for gonorrhea, typically 1-2 weeks after exposure. Most likely you don't have chlamydia, but it is a possibility that could explain both your and your wife's urinary discomfort.

4) With these symptoms, both you and your wife should be tested for gonorrhea and chlamydia. You could be tested yourself to start -- but regardless of your results, it may be necessary to arrange for your wife to be examined and tested. Another option, however, is to contact your March 6 partner and ask her to be tested for HIV and other STIs, especially gonorrhea, chlamydia and syphilis. If she has negative results (and has not been treated in the meantime), you can be more certain you were not infected. But even then, at least you should be tested now.

You might consider visiting one of Dubai's STI clinics; the one I am aware of is this http://www.zackmd.com; there may be others. Best to be professionally evaluated in person. Do not take any antibiotics or other medications of any kind before being evaluated and tested.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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41 months ago

Hi doctor ,

my results of my tests came out

1- Molecular Detection of Neisseria gonorrhoeae DNA by Real-Time PCR

( not detected )

2- Molecular Detection of Chlamydia trachomatis DNA by Real-Time PCR ( not detected )

3- Molecular Detection of Trichomonas vaginalis DNA by Real-Time PCR ( not detected)

4- Molecular Detection of Mycoplasma genitalium DNA by Real-Time PCR ( not detected)

5- Molecular Detection of Ureaplasma urealyticum DNA by Real-Time PCR ( not detected)

6- Molecular Detection of Ureaplasma Parvum by Real Time PCR ( not detected )

7- Molecular Detection of Mycoplasma Hominis by Real Time PCR ( not detected )

All these analyzes were through urine and took place on the 11th day after sexual intercourse.

1- Is it considered definitive and does not need to be repeated? Although it wasn't a morning urine sample?

2- Is that results considered in my favor in term of not being infected with hiv, Knowing that I am circumcised and from an Arab country ?

I couldn't go about my normal life because of thinking about HIV , and I apologize for the length and thank you very much for answering my question and trying to reassure me .

Very thanks doctor .

H. Hunter Handsfield, MD

41 months ago

All those tests are conclusive. You definitely do not have gonorrhea, chlamydia, trichomnonas or Mycoplasma genitalium. (The three other tests were unnecessary: U. urealyticum, U. parvum and M. hominis are normal bacteria that never need treatment.) The negative results are equally accurate regardless of being uncircumcised and in an Arab country.---

40 months ago

hello doctor

‏I would like to inform you that I did hiv combo test in the laboratory on the fourteenth day of sexual intercourse and the result was negative, and I did the analysis today, which is the twenty-third day of sexual intercourse, for all sexually transmitted diseases in the laboratory hiv combo, hepatitis B virus and hepatitis C virus, RPR , and the result is negative.

‏1- Are these tests a good indicator enough to rule out infection HIV and hepatitis B infection?

‏2- Have you seen, doctor, a patient whose result was negative on the 23rd day of the hiv combo analysis and changed to positive?

‏Thank you for your help and for answering questions.

‏Thanks alot.

H. Hunter Handsfield, MD

40 months ago

1. Your negative HIV combo test is 90% reliable at 2 weeks; 6 weeks is necessary for a conclusive test (although a test at 4 weeks will be almost conclusive, around 95-98%). There are several kinds of tests for hepatitis B -- a negative antigen test (HBsAg) at 23 days is would modestly reassuring, but for conclusive results you also need HBsAb and hepatitis C antibody tests at 6 weeks.

2. No, I have not seen this -- but rare thing happen, even if I haven't had such a case myself. (I've never cared for a patient struck by lightning. Does that change your risk of being struck?)

For the reasons in my original reply, it is very unlikely you have any STI. If I were in your situation, I would continue unprotected sex with my wife without worry of infecting her. But you need repeat blood tests at 6 weeks to be completely certain. But also be aware that in the 15 years of this and our preceding forum, with thousands of questions like yours, not one person later reported they had in fact acquired HIV or any other positive blood test. You are not likely to be the first!

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Please accept this reasoned, science-based reassurance and try not to worry!

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