Help!

[acctg]

I had unprotected sex about two months ago with a man who did not ejaculate inside of my vagina.  I had an orasure (oral) hiv test approx 30 days later and tested negative.  I again had unprotected sex w/the same man again, except this time he came in me during my period.  He claims he is HIV-, but has never been tested.  Should I be retested?  Do you think that I have anything to be worried about?  I am freaking out!  I have a very bad sore throat and have since two days after the last incident of sexual contact.  HELP!

[Edward W Hook, MD]

You've now had sex with this person twice, on two separate occasions despite being concerned about whether or not he is infected.  I would ask you where the disconnect in this relationship it?   HIV transmission is a "numbers game", the risk of transmission with a single exposure is very, very low.  It goes up with additional exposures.  If you have a partner you have doubts about, there are lots of ways to address the issue.  the best, if this is going to be ongoing is for both of you to go together and get tested- then everyone knows where the other stands (infection-wise) and there is none of the all too common -did he/she tell the truth concern etc.  If it is not a long term relationship, condoms work and are encouraged.  If none of these is possible, then there is HIV testing for you.  An HIV test taken at 4 weeks following exposure will shift the odds very much in your favor since by then 85-90% of tests that are gong to be positive will be.

Taking all of this into consideration- the best and quickest approach if for both of you to get tested.  It will give you the most assurrance.  If that is not possible, then you need to be tested again. Overall, my guess is that you are not at great risk- HIV is really quite uncommon.  Hope this helps.  EWH

p.s.  Your partner has no excuse for not getting tested if he has never been tested before- there is nothing to be gained by not being tested.  EWH

[whatisay]

I am confussed about the odds-

A one time encounter of oral sex has a 1 in 10,000 chance of infection.

The next encounter  has a 1 in 10,000 chance- does that mean now that you have had two encounters the chance is 1 in 5,000?

If I have 10,000 balls in a jar and one is red- If I pull one out, it is not red, I put it back, my next draw still has the same odds 1 in 10,000-  If i keep it out the odds are 1 out of 9999-

Now if I stop taking out balls I am assured I won't get the red ball.  But if I keep playing I always have a 1 in 10,000 chance of getting the red ball.   The longer I play means I have more attempts at getting the red ball.  Eventually I will get it, the issue is you don't know when-if at all-

So if someone has three bouts of oral sex(male insertive with female) they have 3  -  1 out of 10,000 chances to be infected -any one of which could  be an infection but the possibility is low for each

In other words, the first bout of oral sex whiuch does not result in infection does not make me more prone to infection.  

Is that right?

[Edward W Hook, MD]

Let's review the statistics and you will see why I am not concerned for you from a statistical perspective.

1.  First, your partner was probably not infected.  There are about 1 million people in the US with HIV out of a population of 300 million, thus on this basis alone, the chance that your partner had HIV was about 1 out of 300.  That however is an overestimate since he was not a man who had sex with other men or an IV drug user- groups who have higher rates.
2.  If he was infected, the odds of you getting infected after an episode of intercourse is less than 1 in 1,000. Yo had sex with him twice so that makes the odds 1 in 500.  Mathematically that means on a statistical basis your likelihood of infection is about 1 in 15,000.
3. That you were menstruating is taken into account in these numbers.

Get tested.  It will be negative and then you won't have to waste your time needlessly worrying.  EWH

[acctg]

Thank you for your reply.  I am still very concerned about my possible exposure so I am hoping that you will answer this for me.....

Is it probable that having sex unprotected, with semen ejaculated inside me during my period would yield a probable chance of hiv infection?  I am scared to death and am trying to statistically eliminate the possibility that I have been infected with hiv while I am waiting to be able to get a test.


You say that HIV is not very common.  Can you please elaborate a bit on that.  I have read that as few as 1 in 300 people have HIV/Aids.  I am a 32 year old white female living in rural NY.  

Thank you in advance for your reply.