Health Chats
HIV Prevention and Safe Sex
Tuesday Apr 07, 2009, 03:00PM - 04:00PM (EST)
H. Hunter Handsfield, M.D.Blank
University of Washington
, Seattle, WA
If you've ever had a condom break or had unprotected sex, you've probably wondered about your risk of contracting HIV. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, join Dr. H. Hunter Handsfield in this hour-long chat and get answers to your questions.<br><br> As the Director of the STD Control Program for Public Health and on the Board of Directors of the International Union against Sexually Transmitted Infections and American Social Health Association, Dr. Handsfield is a renowned expert in the study of infectious disease. In this live health chat, Dr. Handsfield will answer your questions about sexual activity with low risk exposure to HIV, such as oral sex, condom-protected intercourse, hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids, as well as symptoms of early HIV infection.<br><br> Note: Questions about the treatment of HIV/AIDS or its complications, viral load or similar topics will not be addressed in this chat. Questions about STDs other than HIV will also not be permitted. If you have a question about STDs, please join Dr. Handsfield on March 31st for the <a href="/health_chats/register/6">Living with STDs Health Chat</a>.
MedHelp:
Hi, Thank you for joining. This chat will begin in 10 more minutes. In the meantime, feel free to submit your questions in advance
H. Hunter Handsfield, MD:
Greetings, everyone.  Welcome to the HIV Prevention and Safe Sex online chat.  There are a lot of you and it is unlikely we we get to all questions.  We also will be selective, to assure overage of the widest possible range of questions and types of advice.  Also, please do not use this chat to re-ask questions that have been addressed in the forum, including follow-up questions.  Please accept my apologies in advance if we don't get to your question.
inocent:
i have a risk on November 28, my last test was taken on April 02, come back negative. The person who i was having sex was a female (i am a male) and she was HIV +. It was only one time exposure with a broken condom. Do i need to restest? since i had my last test after four mounths. The people in the lab they use the DUO TEST VIDAS ULTRA. Thank you doc.
H. Hunter Handsfield, MD:
Testing is always reliable 3 or more months after exposure, usually after 6-8 weeks.  The level of risk during the exposure doesn't matter.  You were not infected and do not need further testing.
ravana:
Dear doctor,I am a student in china poor economic(no credit card)to ask you question by paying..plz help waiting for this day.Had sex with CSW 2 mth ago,used condom. But before sex fingered her vagina about 20 secs(my nailbed skin was peeled off can see the red part of my inner layer(no bleeding).i also didn’t felt vaginal secretion may be due to before sex..Am I at risk???About the symptoms:1)4th week after exposure headache for 2 days.2)6 ½ weeks af ter exposure fever for 1 day,sorethroat and malaise for 3 days.(took Tylenol)3)since from 4 ½ week muscle started to ache (very mild),its been more than 1 month,as well as nowdays sometime my phalanges,carpels, also ache(joint ache)… pain is mild.  Could these be  symptoms? how common is muscle and joint ache In early hiv??
H. Hunter Handsfield, MD:
That's much too detailed for this format and available time.  Fingering carries no risk and your symptoms do not suggest HIV.  Get tested.  You can expect negative results.
veryworryperson:
Mutual Masturbation. A sex worker touched her vagina and then instantly touched my penis (including penis head), can this action cause HIV transmission?                               No oral/vaginal/anal sex. Tested 2 times, 33 days and 39 days, both negative using Abbott Determine I/II. Do I need further HIV testing for medical reason (not mental reason)?

Symptoms: Ringworm on face, lasted for 3 days only after I applied lotion, itchy. Serious back pain (back bone pain, I think) at week 7, lasted for a week. No fever, no diarrhea. Are they symptoms of HIV?

What is enlarged lymph nodes? I feel two nodes behind my neck, cannot be seen visibly. But When I press my skin, I can feel them, they are here from week 1 - week 10(now), the size remain unchanged. Or I simply didn't realise them before this mutual masturbation incident.
H. Hunter Handsfield, MD:
OK, everybody, listen up:  So far the questions, including a couple I am ignoring, are describing zero risk situations and also are too detailed for careful responses. Also, the information requested is readily available by scanning the forum, using the search link.
H. Hunter Handsfield, MD:
Mutual masturbation carries no risk whatsoever, and as described many times on the forum, symptoms never are useful indicators of new HIV infection.  Almost every symptom that humans can experience can be caused by HIV.  Most such symptoms are due to other, much more common things.  That applies here.
yourhelp:
Dear Doctor ,i worked with a NGO in India and we had blood donation camp and is it here where this incident happend.
what is the risk of a needle stick if the needle was initially used on a hiv positive person and then capped and after 1 hour i opened the cap and accidentally pricked myself deeply with it(a person came and banged on me by mistake).Please note that as we were volunteering outside  we didnt have a proper place to throw the needles so we kept it in a bag so that it could be thrown later.
H. Hunter Handsfield, MD:
That is a high risk exposure, especialy if there was visible blood on the needle.  If this happened less than 72 hours ago, speak with a health care provider -- preferably an infectious diseases or HIV/AIDS specialist -- about the possibility of post-exposure prophylaxis (PEP) with antiretroviral drugs.
depeche:
Why are the CDC guidelines so different in comparison to the european ones? France says 6 weeks for a DUO test is conclusive, UK says 28 days
H. Hunter Handsfield, MD:
This has been discussed on the forum.  The data on seroconversion time (the interval from exposure to positive test if infection occurs) are not very precise.  The lack of precision means that different experts have different advice, depending on several issues.  Among others, governmental agencies, especially in the US -- where medicolegal issues figure prominently in policy decisions -- tend to take very conservative positions, which translates to advice about longer window periods.  As forum regulars know, in my opinion the availalbe scientific evidents supports shorter intervals, like what you describe for France or the UK.
MagicHands:
Hey Doc. I did something stupid and gave/ received oral sex with a girl of unknown status. I got tested 12 weeks after, and it was negative. This is 1 week short of 3 months; is that okay? The nurse also said to come back in an additional 3 months. Is it really necessary? How confident can I be that i do not have HIV?  I admire what your doing. thanks.
H. Hunter Handsfield, MD:
Thanks for the thanks and admiration.  Oral sex is very low risk, probably zero in most circumstances; and test results are always reliable 12+ weeks.  There is nothing magic about 12 versus 13 weeks.  As suggested in the question immediately above, 6 weeks would have been sufficient.  You don't have it.
someone12341:
Hi Dr. HHH, 4 weeks ago, I made a mistake and masturbated with another guy. He touched himself and had precum on his finger. He rubbed around his urethra with his thumb with precum for 5 - 10 seconds and then used the same finger to rub on my urethra for 3 - 5 seconds. I pushed his hand off, but when his finger was fondling with my urethra, he had precum and he opened my urethra a little bit. This is the exposure. Yesterday at 30 days, I took an EIA test and the results came back negative. My question is how risky is this and how accurate the test was. When will a test be conclusive for my risk?
H. Hunter Handsfield, MD:
HIV is not transmitted by mutual masturbation.  You didn't need testing at all.  
shknnbtz:
About eight months ago I received unprotected oral sex from a CSW. I am uncircumcised. I got a negative 35 and 72 day test using Uni-Gold rapid finger stick test. For about the last 2 months I have felt a minor throbbing pain under my left ribcage. Should I retest or move on?
H. Hunter Handsfield, MD:
No measurable risk, no need for testing,a nd your test results prove you weren't infected.  Stop it.
number15:
Hi Dr. I have a question about tests…About 11 months ago I had a very high risk exposure. I started developing symptoms in my mouth about 4 days later and they still have not gone away. I have tested negative 3 times; at 2 months, 5 ½ months, and 8 ½ months post-exposure. I have been to several doctors, including ENT’s, and no one has been able to help me. Should I be tested again at some point or do you think I am conclusively negative?
H. Hunter Handsfield, MD:
How high risk the exposure was doesn't matter. Your test results prove you didn't catch HIV.  You do not need further HIV testing. Continue to work with your doctor(s) to learn the real cause of your symptoms.
inocent:
Sorry, can the doctors clarify what this sentence means...(taken from the UK guidelines, i ve downloaded the file from the website). ....."" PAGE 11 The need for a repeat HIV test if still within the window period after a specific exposure should be
discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test
at three months is still recommended to definitively exclude HIV infection""
H. Hunter Handsfield, MD:
The time to stop testing is a matter of probabilities.  If someone has only 1 chance in a 1000 of having caught HIV, a negative test with "only" 99% assurance reduces that person's risk of actually being infected to 1 in 100,000 (0.001 x 0.01).  In such a circumstance, a test at something like 6 weeks is fine.  But if the risk started out at something like 1 in 100, then later testing would be a good idea.  For these reasons, the "need" for testing beyond 4-6 weeks varies with the circumstances. One size does not fit all.  However, most health agencies have difficulty expressing this in brief statements, so this nuance often is missing. But not on this forum!
supermomma531:
I have a 10 year old girl who I want to be able to talk to about safe sex. I don't know where to start. Are there any books or resources that I can access? I have already started to talk with her about puberty stuff that girls tend to go through earlier these days. She can be very emotional. I don;t want her to find out any other way than through me. I can be very blunt and honest, hence the reason I am asking how to talk to her. I don't want to scare her. Thank you for your help and advice.
H. Hunter Handsfield, MD:
I'm sure there are excellent general safe sex education websites and resources, but my expertise and knowledge are limited to those that are specific to HIV and other STDs.  The main thing you should look for, in my opinion, is balance.  Sites focused only on STD/HIV tend to be frightening and neglect the positive aspects of human sexuality. Always remember that the sexual revoluation was, on balance, a very good thing.  So look for sites that equally stress the positives in healthy sexuality, not just the negatives.  Also, avoid politically driven sites that might overly stress morality, religiosity, and selected personal philosophies.  Sorry I can't be more specific, but I hope this helps.
yourhelp:
is it possible to get HIV from a blood draw?if the person used a used needle on me which was probably used on a hiv positive patient beforee me.reuse of needle have hit india before thats why i am concerned
H. Hunter Handsfield, MD:
No, not possible.  There used to be risks when providers resused needles, especially in resource poor countries.  But it's not an issue today.  Many health care providers have HIV and they are not required to disclose their status to their patients, because there is no risk of transmission.
ezdee:
Dr HHH, i had protected sex with an escort about 8 weeks ago. we french kissed a lot and i had bit the inside of my lower lip a couple of hours ago while eating. the wound was tender but I am not sure if there was any visible blood. I was not too worried until two weeks later I had sore throat for a couple of days and 4 weeks later I had diarrhea for a couple of days. I have also noticed that my tongue is white and there is a whitish coating on the back of my tongue for the past few weeks. What is my risk and do I need to get tested? Thanks!
H. Hunter Handsfield, MD:
The main reason for testing in this circumstance is peace of mind. From a strict risk assessment perspective, testing isn't necessary.  Buf you have to ask the question at all, it probably means this reassurance won't be enough.  If so, feel free to be tested if you'll sleep better with a negative result.
Rapid_Rod:
What is the proper lubricant to use on a condom? Do lubricants help prevent condoms from breaking?
H. Hunter Handsfield, MD:
No oil based lubricants is the only rule. They can weaken latex condoms and result in breakage.
worriedlikecrazy:
Do you think there ever will be a vaccine against HIV?