HIV - Prevention Expert Forum
Can I move on.....
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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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Can I move on.....

Hi dr, on 11th march I send to china ktv and gotten super drunk.. Then I bought the ktv girl back to my hotel room.. As I am super drunk, I cannot get a decent erection.. I vaguely remember her went on top on me.. From my previous experiences I am unable to penetrate a lady when when I got that drunk.. I remember pushing her away after around less than 5 sec.. After which we did oral jobs for each other..

I became very scared of this exposure and went to a doc to take the DUO test at 28 days. The results turn out tone negative.. Phew. At the same day in also took the full STD test.. Which all are negative as well..

My attending doc assured me that I am HIV free and since STD all clean as well... I can continue to have unprotected sex with my wife...

Do you agree totally what my doc has spoken to me or should I go and test it at 3 months? My doc told me there is no need too.. The DUO test at 28days is conclusive...

From your expert opinion, is the DUO test 100% accurate?

I really want to move on and make baby with my wife... Is it safe as well... I am such a prick!!!

Thank you doc

Really appreciate your kind reply and advice..
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

I reviewed your discussion on the community forum.  You had accurate replies there.  You had a zero risk exposure (even if there was penile penetration, the risk from a singloe episode of vaginal sex is very low).  More important, your doctor is exactly right:  the DUO test is conclusive at 28 days.  You don't need any more testing, and you can safely have unprotected sex with your wife.

In case you are interested, here is a thread that discusses HIV test reliability at various times after exposure:

http://www.medhelp.org/posts/show/1704700

So no worries -- all is well!

Best wishes--  HHH, MD
12 Comments
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Avatar_n_tn
Hi Dr,

Thank you very much for your kind comments! May god bless you...

I guess I will stay off Internet reading and believe the experts on my results and move on..

Reading too much from different sources can be misleading at causing uneccesary anxiety at times.am I right Doc?
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239123_tn?1267651214
I think you're exactly right.  It's a consequence of the giant amount of easily accessible information available on the internet.  Here is how I put it in a different thread not long ago.

"Indeed the internet can be dangerous for anxious persons with unexplained symptoms.  Perhaps you're familiar with Nate Silver, who has become rather famous for his political predictions (http://fivethirtyeight.blogs.nytimes.com).  He has written a book about statistical issues in everyday life (The Signal and the Noise, Penguin Press, 2012).  Here is a quote from it:

"'...[consider] what might happen if you put a hypochondriac in a dark room with an Internet connection.  The more time that you give him, the more information he has at his disposal, the more ridiculous the self-diagnosis he'll come up with; before long he'll be mistaking a common cold for the bubonic plague.'

"Anxious people tend to be drawn to information that reinforces the anxiety, and to miss the reassuring bits, even if they're more common."
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Thank you so much doc! I dunno if I have used up my quotas... But if there is still room for a final discussion/question: I would like like to bring a closure to my episode( hopefully!)

1) in your own opinion, is a 28 days duo test as conclusive as a anitbody 90 days? ( I have read, 28 days duo test, 99.89%, 90 days antibody 99.99%, is there 0.1% worth worrying?)
2) I know it is probably senseless to you.. But because we are so scared of the moment of foolish that's why we look to experts like yourself, and I am sure it has been asked many times, have you ever seen a 28 days duo test neg turn positive?

Lastly I must comment that you and the other expert has truly done a marvelous job in taking your time off your hectic schedule in answering our questions...

I will be contented enough even if you do not answer my last questions...

Thank you once again and I wish you success in everything you do...

Warmest regards from A scared soul from the other side of the planet...
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239123_tn?1267651214
1) Read my comments above, and the other thread whose link I provided. Did you think I might have changed my mind?

2) I haven't see this and neither has any other HIV/STD expert.  It doesn't happen.

You have the facts.  Using them to not be scared is your apparent challenge, but not one I can help with.  Good luck.
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Avatar_n_tn
Hi Doc,

I am trying to move on after my last post but I don't seems to be able to let it go completely.. After staying away off Internet for a few days... I come back right into it.. However now I only read the forum on Medhelp.. Hosted by yourself, Dr Edward, Dr Sean Cummings and Dr Garcia..

If your kind heart will allow, I would like to comment and post a 1-2 questions.. I promise you that you will not see me post again.. If I were to post.. I will pay another 22 dollars..

1) I back calculated.. The exact time where I got my exposure and testing is 27 days and 12 hours..  There should be any difference am I right Doc?

2) I have read in some of your posts that AB is the one that clears the P24, and the P24 will be detectable by 10-16 days.. After which AB might be developed to clear the P24.. In this scenario, it is practically impossible to have a false negative isn't it.

3) I know no test can be 100% sensitive and 100% specific.. You want more of each side then you need to scarifies the other. My understanding is that for a good screening, you always want to make sure you try to make sure all negative results are conclusive, allow some false+ve that why they have to western blog to confirm on a +ve testing.. Am I right doc? If I am right, would I mean if the DUO test is 99.89% accurate, the percentage is even higher than that if you have a negative results?

Thank you so much for reading my post..


3)I understand no test are with 100% sensitive and specific.. for a good HIV and STD screening,
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239123_tn?1267651214
1) 27 versus 28 days undoubtedly makes no difference.

2) You correctly understand how the duo test works.

3) By 4 weeks, the duo test comes very close to 100% sensitivity and specificity.  Also remember that test performance also depends on the prior probability of the condition being tested for -- and based on the exposure you have described, the chance you caught HIV was probably no higher than 1 in a million.  Even a test with "only" 99% sensitivty would reduce that chance to 1 in 100 million.  Which of course is zero for practical purposes.

That's all for this thread.  Do your best to accept the reassurance you have had, stop analyzing it, stop searching the web, and move on with your life.
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Avatar_n_tn
Dr, before you close this thread.. I would like to express my heartfelt gratitue to you for all your time and effort in evaluating my case and given me the assurances that I need..

I wish you good health and success in whatever you do!

Best wishes from someone that finally can sleep well in 2 months....
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239123_tn?1267651214
Thanks for the kind words.  I'm glad to have helped.
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Avatar_n_tn
Hi Dr,

Good evening!

I plucked the courage ( which may be silly to you) and went for a AB test today.. At 11 weeks. Exactly like what you have expected it is negative..

Thank you for your valuable time... I will move on...
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Avatar_n_tn
Hi Doc,

I obviously have ran out of quotas.. During my last message to you I promise it will be my last post.. After which I am so shy to write to you again thus I pay again in the international forum..

I am sad to say I feel the expert in international forum are not as informative and supportive..

Thus I am trying my luck to ask you one more question.. I am sure with my both test I should be free of HIV

The problem with me I seems to be unable to shake it off.. I am trying to find a phycriatiris in my country and seek professional help. The problem is that they are v expensive..

Want to seek your opinion if do you think they can really help people like me?

Sorry to have bother you..
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239123_tn?1267651214
I can't help that you are "unable to shake it off". That's an emtional/psychological issue, not a medical one, and nothing I can help with.  Certainly professional counseling often is very helpful.  Perhaps your country has clinical psychologists in addition to psychiatrists, who may be less costly.

That will end this thread.  Good luck with it.
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