HIV - Prevention Expert Forum
HIV Clarification
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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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HIV Clarification

Dear Dr.

First of all I wanted to thank both of you for your help on this forum. I think I have read all the responses both of you have written in the past 5 years. I’m pretty sure I know the answer to these questions but I just wanted to be sure.
I am a gay male and have not tested for 6 years, due to my stupidity. During this time I have engaged in the following:

• Anal sex receptive sex approximately 12 times. I’m pretty sure all of them have been condom protected  sex but it’s difficult to remember things 6 years ago. I think I would remember if the condom broke or if there was ejaculation inside of me and I don’t remember either of these incidents happening.

• Anal sex where I was the top approximately 6 times. I know all of these were condom protected sex.

• Receptive oral sex, not condom protected. I never gave oral sex just received it. This has happened multiple times.

I did not know about “do ask do tell” until I read your responses. I have tried to be as safe as possible and I thought I was doing a good job at it.
My last anal sex was on May 8, 2009 and I received oral sex on June 15th. I have had 15 different HIV test to include a PCR DNA on Oct 10 and an OraQuick test on Oct 5th. The rest of the tests were either Home Access Tests or regular blood tests from June 28th to Dec 15th all of these tests have been negative. I’m pretty sure I am HIV – but I have not had sex since June 15th and I will not ever have sex again because my heart cannot deal with the anxiety. I would just like some professional help concerning the following questions:

• Do I need further testing?
• Am I truly HIV negative and can I put this all behind me?
• If I do not have any further sexual contact can I be HIV+ later on in my life?

I would really appreciate your professional opinion in this matter.
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Welcome to the forum. Thanks for your kind words about it, and for being a loyal "customer".  And congratulations on your responsible approach to sexual safety.

However, you are being far too compulsive about HIV testing, to a point that I am worried about your mental health (OCD, maybe?).  With the level of risk you describe, it would make sense for you to have a standard HIV antibody test once a year -- or every 6 months if you can't stand waiting a full year between tests.  Unless and until you have a definite HIV exposure  -- e.g., condom failure in anal sex with a known infected partner -- I recommend against testing after individual exposures and against any PCR testing.  I hope you have been paying for all the excess tests yourself; it would be unfair for you to be accessing public services (e.g., an STD clinic) and in effect using public resources for all this.

But to the information you really care about:  it is not possible to have HIV in the face of the negative results you have had.  Since your last exposure was in June, a single antibody test in September would have been sufficient to be 100% certain you are free of HIV.  And of course you can't catch HIV "later on in my life" unless you are exposed to it in the future.

Best wishes--  HHH, MD
Of course I paid for them myself I would never expect any one to pay for my mistakes. I appreciate your timely response and I will stop testing and move on with my life. Again, thank you. You don't realize how much help you have been.
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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