Help ease my sudden worry

[anxious490]

Hello Doctors. Wonder if you could quickly read my situation and let me know I'm OK.

I'm female, (UK) in my 40's and been married for 15 years.  Just under a year ago (11 months) , I had a very brief relationship with someone I used to work with (he is male, married).  I performed unprotected oral sex 3/4 times and there was a brief moment of unprotected sex which I stopped as I couldn't go through with it.
I tested negative for Chlamydia and Gonorreah and put this incident behind me ad have been having unprotected sex with my husband ever since.

However 2 weeks ago whilst watching a medical drama, HIV came up as an STD which sent me into panic mode.  HIV had never entered my mind.  I was instantly scared that I had been infected and in turn infected my husband.  I have read lots of posts and your stats however whilst not reassured enough, this week I had an HIV duo test which was negative. - am I ok, no harm done?

I'm probably one of the many people in middle age who has an over-inflated view of HIV but if you were me, would you be happy with this test (11 months on).  It was only because I have been having sex with my husband that I got scared and went into panic mode.

Or would you suggest another to be sure - it's only as I've read a reply saying that if someone has 2 negative results they can be 100% sure the tests have not missed an infection.

Thank you.  From all these posts, I know you guys are pretty busy here.  

[Edward W Hook, MD]

1.  Correct, the number is not relevant to your result.  Negative is negative.  
2.  If you had an ineterminant result you woul have been told and further testing to address the issue would have been done automatically
3.  Correct.  

Why are you still worrying?  You have a conclusive negative result.  Time for you to let this go an move forward.  EWH

[anxious490]

Doctor, can I just ask one more thing.  When I got my result last week I remembered there was a number alongside the negative result.  I assume this is what is referred to as an index value?

1.   I cant remember what that number was but I assume it's of no concern as I was told the result was negative.

2.  I assume if there was a problem then I would've been informed that my sample was being retested - is this what's called an indeterminate result?

3.  Basically labs don't ignore any samples that could be borderline?

Thank you

[Edward W Hook, MD]

You didn't need a repeat test from a medical perspective.  Your additional negative test confirms that you did not get HIV from the encounter you were concerned about.  EWH

[anxious490]

Hi Doctor, just to let you know that for piece of mind I went and got an antibody only test and it was negative.

combined with my negative Duo last week, that's pretty good news isn't it?

[anxious490]

Thank you. I feel much better.  So I've never been infected nor infected my husband?

That's my last comment. As you say - time to stop worrying

[Edward W Hook, MD]

Yes, in fact any test taken more than 8 weeks after exposure is conclusive. Time to stop worrying. EWH

[anxious490]

Thank you for replying especially on a Saturday.

I have seen replies from both doctors that anything over 3 months is 100% conclusive.

So I can be rest assured that my 11 month neg is concrete evidence that I didn't get HIV?

Thank you

[Edward W Hook, MD]

Not quite.  Before testing your risk for infection was very, very low but there was a single episode of unprotected genital intercourse with a low risk partner which, theoretically, could have lead to infection.  With your negative HIV test however, you can be confident that you did not acquire HIV.   EWH  

[anxious490]

Thank you doctor.  Your comments have been helpful.  

It was only point 3 that made me feel not so confident.  I would've thought the test at 11 months was 100% conclusive that I was never infected?

Unless I have interpreted your comment incorrectly.  Or were you saying that my risk was non-existent before testing?

I just want to be sure that i'm not infected or have infected my husband.  Thank you.

[Edward W Hook, MD]

Welcome to our Forum. The short answer is that you are OK.  A DUO test taken 11 months after exposure provides highly reliable results and shows that you did not get HIV from your exposures.  Several comments to amplify what I've just said:

1.  Your partner.  The likelihood that a heterosexual male in the UK has HIV is very, very low.  Let that a 0.1% chance (i.e. one in a thousand).  When you combine this with the low probability of transmission of infection in the unlikely situation that he might have been infected, you can see that even before testing there was little risk of HIV.
2.  Your exposures.  There is virtually no risk of HIV form oral sex, even if your partner was infected.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  As for the brief vaginal exposure, HIV is transmitted only once in every 1000 exposures so again, the odds are very much in your favor.
3.  Then, when you factor in the results of your recent HIV test, you can combine these numbers and appreciate that your risk if HIV is virtually non-existent.  

There is absolutely no reason for concern that you got HIV from the encounters you describe.  I hope my comments are reassuring.  EWH