[Question #8736] HIV Seroconversion

40 months ago

Hello all:

I had a sexual encounter with a woman who had protected intercourse with a previous man who used heroin before I came along. I assume he used needles.

Hearing this got me a little ramped up with her being possibly being at risk for HIV.

I never had sexual intercourse with this woman. I just open mouth kissed her, (w/ tongue) stuck my fingers in her vagina sucked on her breasts (nipples) also. She also gave me oral sex. I do have genital herpes but didn’t notice any outbreaks.

I got tested for HIV, ab/ag 4th generation via lab on Day 36 (5 weeks). It was negative.

On day 34, three days prior to being tested I started to have post nasal drip, low grade fever of 99.2 (on day 37), some congestion and my neck glands feel swollen etc. I tested negative for Covid as well and I’m vaccinated and boosted.

1) if it was HIV seroconversion, when do symptoms usually develop?

2) what are the symptoms usually like? what I have?

3) in prior threads you’ve said you can’t test negative with symptoms. Would this be true even after only 3 days of symptoms and then get HIV tested?

4) how accurate is a test in day 36?

5) Should I be tested again?

I love your science based answers as the details helps me understand things. Thank you and good day!

H. Hunter Handsfield, MD

40 months ago

Welcome back. This is your twenty-first question on the forum, if I counted correctly; I'm pretty sure that's the record. Scanning them briefly, these questions or similar ones have been addressed. The answers haven't changed.

You describe a zero risk exposure for HIV, even if your partner has the virus, which she probably does not. I would guess that under one in a thousand femailes with her sexual history have HIV; it isn't transmitted by kissing or fingering, and there has never been a proved case of transmission oral to penis; and your negative AgAb test at 5 weeks is at least 98% conclusive. Your symptoms started too late for ARS from the exposure described, and acute retroviral syndrome (ARS, i.e. HIV seroconversion symptoms) doesn't cause nasal congestion or post nasal drip. You caught a cold.

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

1) ARS starts 1-2 weeks after infection, never later than 3 weeks.

2) See above.

3) Yes, correct. The symptoms of ARS are caused by the immune response to the virus, not HIV itself. Antibody has to be present when symptoms are caused by HIV.

4) As noted above, somewhere around 98-99%.

5) Since you weren't at risk anyway, I would not have recommended testing at all. But if the scientific evidence I have discussed doesn't convince you and you remain worried, have another test 6 weeks or more after the sexual event.

Thanks for the thanks. I'm glad to have helped. But when new questions or concerns arise, I would encourage you to think carefully about whether you have raised the same issues previously and review your many previous threads. Most likely the answers are there!

HHH, MD

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39 months ago

Thank you dr for your reply and I apologize but I really value this service.

I do want to point out and see if your answer would change.

I did kiss someone else and this time I did have a sore on the inside of my bottom lip. I noticed it on a Sunday. It was a red dot (like it bled at one point) and wasn’t actively bleeding. Maybe bc I bit my lip or from salt on food. It hurt if I bit down on it.

The next night Monday night I kissed this women and it was a slight open mouth kiss. I don’t think my sore was bleeding but definitely wasn’t fully healed. She flosses her teeth a lot and did so earlier that night. I didn’t see anything on her lips.

Would that be a risk for HIV? I’ve heard competing theories on whether it is or not. My stress level is high bc of the sore on my inside lip.

Sorry to take up your time but I value your input for my quest of inner peace.

39 months ago

I should add I’m not seeing her anymore but she was in an abusive relationship before and wanted to go slow physically with me. But we aren’t seeing each other anymore. In my past I’ve noticed people that want to move slow have had something such as HSV-2 which is what I have. I do disclose that.

H. Hunter Handsfield, MD

39 months ago

As per my reply above, HIV isn't transmitted by kissing, or so rarely the risk can be ignored. Any "competing theories" on it are just that, theories, not proved fact; or the opinions of uninformed persons. And if you think about it, there must have been billions of kisses between HIV infected and uninfected partners in the presence of various sores in the mouth, and still no known cases of HIV transmission. So this information doesn't change anything. No risk at all, even if your partner has HIV -- which probably she does not. There really is no cause for worry here. You need not be tested for HIV on account of the events described here.---

H. Hunter Handsfield, MD

39 months ago

Your last comment had not come in when I replied. I'll just add that I of course cannot judge the mood or intentions of your partners, but I am skeptical that "going slow" in a new relationship is a sign someone might have an undisclosed STI.---