[Question #945] Risk Analysis

50 months ago
Hello Doctor 

I'm a 32 year old heterosexual male (circumcised) (banker by trade). I was away on business in Western Europe attending a conference and met a female lawyer (38), a speaker at that conference. She is unhappily married with 3 kids. One thing led to another and we ended up in bed together on the third night of the conference. I did not have any protection with me as I was not anticipating this would happen and held back as much as possible until I gave in and had unprotected vaginal intercourse until my conscience caught up with me and I pulled out. Must have been roughly 3-5 minutes of exposure at best. 

I am confirmed HIV/STD free (prior to this exposure) as I even tested for all STDs 3 months post my last "exposure" which was protected in all cases. As for her, she told me that she had only had intercourse with another person (other than her husband) a year back and, roughly 2 weeks after our encounter, she did a full STD/HIV panel test and came back negative (we had remained in touch and she decided to test and inform me).

I am now 6-weeks post exposure. Feeling great physically, bar what seems to be a very mild cold/sinusitis as well as some anxiety from having been foolish and given in to temptation. I know that not all infected people suffer ARS symptoms and the chances of infection may be low for me but obviously not zero. Her negative test is of course reassuring however, that only really means that she was "conclusively" negative 3 months before taking the test. I also don't know what her husband has been up to in the meantime and if he was unsafe with another, could have infected her! 

Questions: 
(1) Will an ELISA HIV test today (at 6-weeks) give a definitive result? 
(2) Do I really need to bother taking one? Or other STD tests? 
(3) Have you come across a positive result based on an experience like mine in your years of practice? 

Thank You! Tim
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Welcome to the Forum.  The encounter you describe was very low risk for HIV or for other STIs.  You partner is not in a traditional risk group and told you about her past history as well as choosing to get tested after three weeks after the encounter.  All of this makes your encounter very low risk.  Most people do tell the truth, particularly AFTER the event. That she voluntarily chose to get tested three weeks after virtually assures you that you are not at risk for other  STIs and makes it most unlikely that you could have gotten HIV.  Current ELISA HIV tests now are reliable positive at 6 and certainly by 8 weeks.  This if she was tested three weeks after the encounter, there is very little chance that she was infected in the three weeks before your encounter and you have little reason to worry  If you do choose to test, you could now get the readily available 4th generation, combination HIV antigen/antibody test which provides conclusive results at 4 weeks after infection.

In answer to your specific questions:

1.  See above

2.  I would not be worried.,  If you choose to test for your own peace of mind, I would understand and would be confident that the result would be negative.

3.  No I have no.

Summary, if I were you, I would not be worried.  I hope these comments are helpful to you. EWH

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50 months ago
Thank you very much Dr. Hook for your informative response. This was my gut as well, but I preferred to hear it from a medical professional. This has was most helpful. Have a great day ahead. Tim
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
You bet, glad you found my comments helpful.  EWH
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50 months ago
Dear Dr Hook

Further to our correspondence above, I wanted to update the thread with my 7-week results (ELISA HIV test and STI panel). All results came back negative.

In my view this should be conclusive (unless you see otherwise). Thank you again Dr for your support and guidance.

Best wishes. Tim

Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
Yes, your results from testing at seven weeks are absolutely definitive.  it is time for you to put these concerns aside and move forward.  EWH
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