HIV exposure

[cozinator]

Hello. I have 2 questions. I was exposed to hiv 2 days ago. I had anal sex with another man (me being the bottom). We began using a condom for the first haf. We stopped using it for the conclusion.  He got to the point of cumming then pulled out and came on me (butt crack). Later that night he told me he was positive but he was UNDETECTABLE so he could not spread the virus.  The next day I got tested. I know this dose not clear me from the exposure. I just have a few questions.  1. I used a rapid oral test at the health department I went around my top gums but I forgot to used the other side of it for the bottom gums I used the same side  will the make the result negative if I was already positive.  2.  Him being undetectable give me a better shot of not getting it? Plus him pulling out  3. Is he right in saying he can't spread it? 4. If u could how would u rate the risk.   Thank you

[kirk8]

I think the Dr. said you have a 3% chance of having HIV.  The virus doesn’t spread very easily but receiving anal sex is very risky.  It is the most common way HIV is acquired.

Also, 4 weeks isn’t enough time for an antibody test.  Those tests are only 80-85% at 8 weeks.  97% at 12 weeks, from what I’ve read.

Most people get a flu or mono like illness before antibodies show up.  If you have been feeling ill it may be from this acute infection.  Just get tested again and you will know for sure.  

[cozinator]

What do you mean 3%, is that of me having it or not having it? I heard 85% of people should test positive in 4 weeks on anti body test, is it worth me getting tested at 4 weeks?

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post.
I will answer each of your questions here below:

1. I used a rapid oral test at the health department I went around my top gums but I forgot to used the other side of it for the bottom gums I used the same side  will the make the result negative if I was already positive.  
UNLIKELY AS IT IS A VERY SENSITIVE TEST.  HOWEVER IT IS ONLY AN ANTIBODY TEST AND WOULD NOT BE RELIABLE IN THIS CASE AS IT REQUIRES A WINDOW PERIOD OF AT LEAST 8 WEEKS.

2.  Him being undetectable give me a better shot of not getting it? Plus him pulling out  

THE RISK OF TRANSMISSION WOULD BE LESS, BUT NOT ZERO.  ALSO VIRAL LOADS CAN FLUCTUATE AND HE MIGHT HAVE NOT BEEN UNDETECTABLE ON THAT PARTICULAR DAY.  PRECUM IS INFECTIOUS, THEREFORE PULLING OUT IS NOT COMPLETELY SAFE EITHER.

3. Is he right in saying he can't spread it?

HE IS WRONG.  THE CHANCES OF TRANSMISSION ARE LOWER IF VIRAL LOAD IS UNDETECTABLE, BUT IT IS STILL POSSIBLE TO BE INFECTIOUS.  ALSO HIS VIRAL LOAD MIGHT HAVE BEEN UNDETECTABLE AT THE LAST BLOOD TEST WHENEVER THAT MIGHT HAVE BEEN, AND HE WOULD NOT KNOW HIS EXACT VIRAL LOAD ON THAT PARTICULAR DAY.

4. If u could how would u rate the risk.

I BELIEVE THAT YOUR ESTIMATED RISK IS HIGH AND I WOULD HAVE RECOMMENDED PEP IN YOUR CASE.  THE RISK FROM THIS SEXUAL ENCOUNTER WOULD BE ESTIMATED AT 3%, WHICH IS SIGNIFICANT.

Best wishes,

Dr José