HIV - Prevention Expert Forum
1. Conflicting info, 2.Testing warranted?
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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1. Conflicting info, 2.Testing warranted?

I'm a male who had sex with a woman 3 times over two different weekends. No condom was used. One of the times (as it turned out,) she just started her period. I discovered this when I saw the blood on myself after we finished. The last time I was with her was 2 weeks ago.

Why is there so much conflicting info about risk and HIV? For example, some online information about hiv says that exposure to menstrual blood can double the risk of hiv transmission from a woman to a man. Other places say that menstrual blood poses no higher risk.

What scared me the most is that I found out that this woman used to be a drug user (with needles.) I asked her if she was ever tested for HIV and she told me that she indeed was tested, four times during a two year period, and each of the tests were negative.

* Since I don't know with certainty how trustworthy she really is, should I be getting tested?

* Since there was blood during the sex, should I be getting tested?

* Or, do my 3 unprotected sexual encounters simply mean there's like a 3 in 1,000 chance of hiv transmission, and I should just forget about all this, and simply never have unprotected sex again?

Thank you...
239123_tn?1267651214
Welcome to the forum. Thanks for your question.

As for conflicting information, I suspect you understand there is little regulation on the Internet. Anybody can post more or less whatever they want, without regard to the facts or their understanding of the truth. There is indeed a lot of misinformation about HIV and it's prevention. You can keep it to a minimum if you stick with professionally run websites like those of CDC, public health agencies, academic institutions, or selected NGOs like the American Sexual Health Association (www.ashastd.org).

There are conflicting data and opinions about sexual exposure to menstrual blood. But I would suggest that it really doesn't matter much. If a woman has HIV, the average transmission risk for a single episode of unprotected vaginal sex is around one in 2000. It really doesn't make a lot of difference if the "real" risk is 1 in 1,000.

As for your particular exposures, people rarely lie about their HIV status when asked directly, so it is unlikely your partner is infected; and even if she is, your risk is very low, for the reasons discussed above. Your analysis of your risk Is about right, except it doesn't account for the low chance your partner has HIV. That is, your risk is nowhere near 1 in 1,000; it's probably under 1 in a million.

In general, I recommend against HIV testing after any particular exposure, unless the risk is particularly high, and from a strict risk analysis, you don't need to be tested. However, most people sufficiently nervous to come to an online forum for advice probably should be tested for peace of mind. So it's up to you!  However, the chances of chlamydia, gonorrhea, or other STDs are a lot higher, so you may consider visiting your local STD clinic for routine testing -- with or without an HIV test.

My last suggestion and hope is that you'll use condoms for future adventures of this sort!

I hope these comments have been helpful. Best wishes and stay safe-- HHH, MD
3 Comments
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Thank you. That's helpful. That answers my question.

OH... How long should I wait before getting tested for these other STDs? (Is two weeks after the encounter long enough?) And, is a general doctor's office sufficient for this testing, or should it specifically be at an STD clinic?

Thanks for your answer. It was very helpful. (You always seem far more knowledgeable and authoritative than most other sources I see online, so thank you.)  
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239123_tn?1267651214
Thanks for your kind words.

Gonorrhea and chlamydia testing can be done any time; the tests are valid any time after 2-3 days following exposure.  A syphilis blood test should be delayed until 6 weeks, but it's is low priority anyway; syphilis is almost as unlikely as HIV in this situation.  But I would recommend it if you go ahead with an HIV test.  Your doctor's office should be fine.
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