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HIV Risk Assessment and Testing Reliability

Hello Dr...I can't put in words the help reading your advice has provided me.  I sincerely appreciate the service you provide.  It is wonderful that we all can receive advice from someone with your experience and credentials.

My situation is as follows:  One night in Las Vegas I was very much intoxicated and made a poor decision.  I recieved (as best as I can remember being intoxicated) oral sex from a streetwalker with a condom followed by intercourse with the same condum.  (I know you say there is 0 risk with condom protected sex; however, since I was intoxicated I have trouble trusting my memory)  The intercourse lasted no more than 5 or 10 minutes.  This was a condom purchased by me in the lobby of the hotel.  Since I was unable to finish we stopped and she suggested I use a more sensitive condom which she had.  She requested to put both condoms on and after putting on the second condom she gave me addtional oral sex.  Again unable to finish I removed the condom and finsihed myself without any lubricants.  29 days after this exposure I had a HIV Proviral DNA by PCR and general antibody screening test through Labcorp.  Both returned negative.  I have a few questions and very much appreciate your expertise and advice.  I have not been able to stop obsessing and need to move on with my life.

1.  Please assess my HIV risk.
2.  Can I rely on the PCR and standard test and resume sexual relations with my wife?
3.  Do you recomend additional testing?

Thanks again for your support.
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Avatar universal
Where did you get that figure from?  Do you have a link?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Information provided by test manufacturers is highly regulated, at least in the US and most western European countries and presumably is reliable, but I do not have independent information about it.
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Avatar universal
Thanks again for your comments.  One last question.  The manufacturer states a Proviral DNA PCR is 99.9% reliable at 28 days.  Do you agree with this statement?
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Putting it all together, the chance you caught HIV probably is less than 1 in a million, or 37 times lower than your lifetime risk of dying by lightning strike.

1) If you used a condom, the risk of HIV was zero.  Without condoms, the average risk of infection if your partner was infected is around 1 in 2,000.  The odds are she wasn't infected.  You are the one to judge whether a condom was used, not me.

2) I never guarantee someone isn't infected, but the odds are greatly in your favor.  You will have to make your own decision about sex with your wife.

3) Four weeks (29 days) is pretty reliable and from a purely risk assessment perspective you don't need further testing.  But a negative antibody test at 6 weeks would be still more reliable.

For further detail use search the function, using search terms such as 'HIV transmission risk', 'time to positive HIV test', and 'HIV anxiety'.

HHH, MD
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