[Question #8803] HIV transmission

39 months ago

Hello Dr. Hunter and Dr. Edward

I had unprotected sex on 1 January 2022 with a woman and I insert my penis in her vagina for almost 2 seconds by mistake. Then, without penetration, I rubbed my penis on her vagina for 3 minutes. Also, I did oral sex for her, likewise, she did the same for me. The sex was including French kissing and breast sucking.

However, I was worried about HIV infection. I did a combo test after the sex relation on 17, 28, 31, 43, 67, 96, 118 all came back as non-reactive. Though, I have the following questions that I need your kind support to answer:

1-Do I need to perform other tests (like Nat) to confirm my result and get a conclusive answer?

2-I have a scrotum shrinking at all day and continuous movement of my testicle for the past 3 months. Is that considered as an early-stage infection of HIV?

3-I have genital chilling feelings for the past 3 months. Is that considered as an early-stage infection of HIV?

4-Is there any previous cases for anyone who was negative at 3 months and turned positive after that?

5-In case of contracting both HIV and hepatitis C at the same time, could that affect the window period of the combo test?

6-I have been using antibiotics for 3 weeks, could that affect the window period of the combo test?

7-Are the antidepressant and anxiolytics drugs like (Olanzapine, Amitriptyline, and Effexor) could affect the window period of the combo test?

8-Is there a relation between prostate inflammation and early-stage infection of HIV?

Finally, are my symptoms related to HIV infection?

Thanks

H. Hunter Handsfield, MD

39 months ago

Welcome to the forum. Thank you for your confidence in our services.

Here's the take-home message: no worries! This exposure was very nearly zero risk for HIV, and your test results prove without doubt you were not infected and therefore that something other than HIV explains all your symptoms. No more testing is needed.

Those comments answer all your questions, but to be explicit to assure no misunderstanding:

1) The HIV antigen-antibody (AgAb, "combo", 4th generation) HIV blood tests are 100% conclusive within 6 weeks of infection. Your negative result at 43 days was conclusive, and all other tests after that one were unnecessary. No more testing is needed.

2,3) HIV doesn't cause such symptoms. I suspect they are the result of your concerns about HIV, or perhaps anxiety over a sexual decision you regret; as a result, you are noticing trivial symptoms or even normal body sensations that otherwise you would ignore or not even notice.

4) No, this never happens except in people who take anti-HIV drugs after exposure.

5) The internet meme about hepatitis C virus (HCV) interfering with HIV testing is mostly an urban myth. This is a rare problem if it occurs at all. In any case, you were at zero risk of HCV. The internet is full of mistaken information about HCV as an STD, which is almost never heterosexually transmitted, i.e. between men and women. Sexual transmission of HCV occurs almost entirely among HIV-positive MSM who have potentially traumatic anal sex with other men.

7) No drugs or medications of any kind interfere with the accuracy or timing of the AgAb HIV blood tests. (As mentioned above, the only exception is with anti-HIV drugs themselves.)

8) No, prostate inflammation is unrelated to HIV. However, nongonococcal urethritis (NGU) is an STD that is easily confused with prostatitis. If you have been diagnosed with a prostate problem, double check with your doctor or clinic about the diagnosis, This won't have anything to do with HIV, but conceivably could be due to another STD from the sexual exposure you have described (depending on your symptoms, when they started, etc).

I hope this response is helpful. Let me know if anything isn't clear.

HHH, MD

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39 months ago

Thank you Dr. Hunter for your kind reply.

You don't know how much I was relieved while reading your answers.

I know that we should not extract some answers from the web for our different questions. I have been browsing some of the website regarding the window period for HIV (This was before I contacted you) and there is one individual calming the following:

He was involved in unprotected sex with a women on 25/03/2016. And he did combo test on 15/04/2016, 15/5/2016, and 28/06/2016 all came back as non-reactive (95 days after the exposure).

After that, he did PCR on 20/08/2016 and the result was positive (148 days after the exposure).

Again, he did combo and rapid test on the second day and the result was non-reactive (148 days after the exposure).

Then, on 07/01/2017 he did combo test and the result was reactive (298 days after the exposure).

This is really frustrated me and I'm afraid that my result might be changed as the above individual.

I'm not sure if I can return to my sextual life with my wife or I should wait for 10 months to confirm my result.

I'm also considering to do PCR test.

What your thoughts Dr. Hunter, I'm really in dilemma situation.

Thanks

H. Hunter Handsfield, MD

39 months ago

I cannot comment on the case you cite, having not seen the website or a scientific report about it. There has never been a scientifically proved case of delayed HIV test positivity of the sort you describe, except perhaps in a few cases in which the exposed person took anti-HIV drugs. A single claim by one person of course cannot necessarily be believed, and I'm sure you have not seen the complete story on that person.

Perhaps it will also help you to know that in the 18 years of this and our preceding MedHelp forum, with thousands of questions from people concerned about possible HIV infection, not one has turned out to be infected. You will not be the first. If and when that happens, I expect it to be from a truly high risk exposure, not the extremely low risk sort of event you describe.

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39 months ago

Thank you Dr. Hunter for your clarification. As you have mentioned, we don't know the full story behind this guy!

Your kind support was really appreciated. God bless you.

Please accept my warmest regards.

H. Hunter Handsfield, MD

39 months ago

Thanks for the thanks and your other kind words. I'm glad to have been of help. Best wishes and stay safe.---