Hiv risk and testing

[surfsider]

Hello,

I am 24 year old white circumcized male. At age 23, about 8 months ago I lost my virginity to a girl who is now a friend. The incident didn't last long, I believe a total of 7 minutes but not continually,  as her parents were about to come home. I also didn't reach climax.  The incident was unprotected which I know always poses some risk. Also she said she was on her period, but I saw absolutely no blood. I've asked her repeatedly if she had been tested. Her response was that she had a test after her last boyfriend who I believe was into drugs but not an IV user. She also said she has no diseases.  She isn't an IV user either, although she has done drugs. I am a college graduate and she is a white female college student.  She has had experience however, having told me she has had 9 partners but only two or three committed boyfriends whom she slept with unprotected. This is the only sexual exposure I've had although i've done other virtually non risk things with other girls. I know it was dumb and I am now somewhat scared to get tested although I know that if I have it, testing won't change anything besides the knowledge of my status. I just wish I could force her to get tested in front of me because if I know her test results for sure there is  really no reason I have to get tested.  I have had no symptoms, although I did have a fever for two days about 7 months after wards. She has also never traveled outside the country, if that matters in terms of demographic risk.

A) How much does a woman menstruation change the risk after one incident?  

B) Do you recommend anonymous or confidential testing and does confidential testing have consequences if i were to turn up positive? Such as ability to get insurance or a job?

C) How long does a conventional test take to get results back? If I go in to a clinic on friday do they perform it over the weekend or wait till business days? Does it matter what day to take the test.

Thank for your time

[Edward W Hook, MD]

No need for further testing .EWH

[surfsider]

Dr. Hook

Thanks. I went in for a test at the health dept today and it was negative using the OraSure method. Should I test for other STD's now even though I've had no symptoms and the encounter was 10 months ago?

[Edward W Hook, MD]

Last answer.  Anonymous testing centers tyically report their results, just not identifying information on who was tested.

Your local clinic would be a fine place to get tested.

The thread is now over. EWH

[surfsider]

Dr. Hook,

Thanks for your prompt responses. The clinic I am thinking of going to offers free anonymous testing but a 10 dollar charge for confidential testing on their website. Should I go somewhere else? If it's an anonymous test, how do you even get your results back? I imagine the CDC would have no knowledge of how many people are infected with HIV in the u.s., if everyone went the anonymous route.

[Edward W Hook, MD]

Policies vary from state to state however I believe you are mistaken about this on several fronts.  there is no data and if fact, it would be illegal for insurers not to insure someone because they had chosen to be tested.  Further, there is plenty of confidential testing available that is free.  

It sounds to me as though you are getting this information from the internet.  If so, I would seek another source such as where the testing is performed.  the internet is a useful source of much information but is also a source of many incorrect and sometimes paranoid statements.  


I would have NO concern about confidential testing whatsoever.  I think you are being a bit  paranoid.  EWH

[surfsider]

I keep reading about the advantages and disadvantages of anonymous vs confidential testing.  Why is anonymous free when confidential has a charge? I've read that if you choose confidential testing companies and insurers can see that you tested and even based on that fact alone would be hesitant to insure you, is that true? If you were to get tested which option would you choose as a young recent graduate? Sorry to bombard you with questions.  

[surfsider]

Thanks for the info.

I know a lot of people have anxiety about contracting HIV and I am no different. No doubt, if I tested positive I would find it hard to deal with but I have to live with the risk I took and learn from it. So do you advocate testing after each unprotected exposure when not in a monogamous relationship? Also of the people affected what percent go undiagnosed until the aids stage?

[Edward W Hook, MD]

Welcome to our forum.  I'll be pleased to help.  The exposure you describe was VERY low risk for HIV. the statistical risk that your partner has HIV is less than 1 in 10,000 and probably lower given what you've told me.  The risk from a single episode of vaginal intercourse is less than 1 in 1000. Thus mathematically your risk is lower than 1 in 10 million- not something to worry about. Having said that, getting tested is a reasonable thing to do, as is testing for other, more common STDs.  Your exposure qualifies you for periodic STD/HIV "screening (testing in the absence of symptoms) because you have had a new partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).

In answer to your specific questions:
1.  There is no medical proof that risk for HIV is any higher with exposure to menstrual blood than to genital secretions.,   See above regarding the risk calculation.

2.  Your test will be negative.  Confidential testing at a public health clinic assures you that the test will be done by professionals.  There is no particular benefit to anonymous testing.  The issue related to having a job or insurance is not the test result but that you cannot lie when asked if you have been tested and what the result is. If you lie, the company has no need to insure you.

3.  The test itself typically takes only a day or two to perform but sometimes takes a while to get back to be reported to you.  In some settings you can be tested by highly reliable, rapid test which will provide an answer as quickly as in 30 minutes.

Hope this helps.  You really have very, very little to worry about. EWH