Aa
I am so worried,
Hi, Here is a bit of a background to why I am so worried. I was married for 30 years and recently started dating again. Well the last date led to sex. It started with a condom on but it wouldnt stay on because my partner was having a problem maintaining an erection so he took it off. He tried for the longest time to get an erection and finally got enough of one that he could insert his penis. No condom. I dont know if he finished HIS JOB or not. There also was alot of oral sex, both ways. and anal fingering. I am freaking out because the condom was not used the whole time. I am clean i was tested last fall and everything was neg and this was the first man i was with since. He told me he was checked before a surgery and he didnt have ANYTHING. I did go to the doctor this week for std testing, no results yet and he even told me because i was freaking out so much he went and gave a urine sample to check him. I didnt ask him he did this on his own. This act took place on jan 5th. My doctor has ordered an HIV PCR for the 27th because I am so frantic and she said this was the earliest. Is this a good test for me to have and is the time frame ok? It would be 3 weeks. I did something so stupid that i am going crazy with worry. What are my risks? This man was a 57 yo man, divorced, retired and told me he has dated 2 girls in the 2 years hes been divorced. He has reassured me he is clean. He has never done any needle drug use and is not gay. Thank you for listening. Oh and one more thing. I need to have a heart ablation soon but i dont want to have it until i know the results which is just adding extra stress.
MEDICAL PROFESSIONAL
As I said above, PCR tests do become positive before antibody tests. Here are your options for the test which I really doubt you need:
1. HIV antibody testing- reliable at 8 weeks
2. A combination HIV p24 antigen/HIV antiboy test- reliable at 4 weeks.
3. A combination of an HIV PCR and HIV antibody test at 4 weeks- equally reliable as number 2 above but with the caveats I mentioned earlier
Best course is to talk with your partner, as I said before.
Nothing more to say. EWH
1. HIV antibody testing- reliable at 8 weeks
2. A combination HIV p24 antigen/HIV antiboy test- reliable at 4 weeks.
3. A combination of an HIV PCR and HIV antibody test at 4 weeks- equally reliable as number 2 above but with the caveats I mentioned earlier
Best course is to talk with your partner, as I said before.
Nothing more to say. EWH
Thank you Doctor for your advice. So now my concern is having the right test as quickly as possible. How long of a period do you have to wait for any other test? I just need to know Im ok as quickly as possible. I dont believe there is any chance the other person will get tested for HIV although this would be much easier. Im confused as to why my doctor has order a PCR test if its not used for detection. Maybe because it can be done quicker. If a PCR test is done and it comes back negative is that a definitive negative and would i still need to take any other blood test? Ive read so many conflicting reports on PCR tests. Thank you very much
MEDICAL PROFESSIONAL
Welcome to our Forum. Please don't worry, this was a low risk exposure. STDs are far less common among older Americans and even in the unlikely circumstance that your partner was infected, most exposures do not lead to transmission. I anticipate that both his tests an yours will be negative and when they are, please accept those results as final.
As far as HIV risk, given your partner's age an the characteristics you mention, his likelihood of having HIV is close to 1 in 100,000. Further, if he did (most unlikely), HIV is spread in the course of heterosexual intercourse, on average, only once in every 1000 acts of vaginal intercourse. Thus your mathematical risk is less than 1 in 100 million. Put another way, you are more than 100 times more likely to get struck by lightning.
In general we do not recommend HIV PCR testing for diagnosis is HIV infection for several reasons an if you were my patient I would iscourage you from getting a PCR test. While the PCR is likely to become positive more quickly than other antibody detection tests (i.e. usual blood tests), at the present time the blood tests are becoming more and more sensitive and detecting infection earlier and earlier so that the time difference in detection between PCR test and antibody detection tests is becoming smaller and smaller and at present is, in general only a week or two. In addition the time course over which the PCR tests become positive is less well described than for the blood tests and, as a result, it is difficult to make a definitive statement on what a negative PCR test means at any time within a few weeks of exposure to a HIV infected or possibly infected partner. PCR tests are also more expensive than regular antibody tests. Finally and most importantly, the false positive rate for PCR tests (i.e. a positive result in persons who do not have HIV) is higher than for blood tests. Each of this on this Forum have seen a number of people who were worried needlessly because of false positive tests. For all of these reasons, we rarely recommend testing for HIV diagnosis using PCR.
It woul be far, far wiser to see if your partner would be willing to get an HIV blood test. He could do this at this time and in a day or two when the results come back as negative, you can be assured that you were not expose and thus have virtually no chance if becoming infected in the encounter you described. EWH
As far as HIV risk, given your partner's age an the characteristics you mention, his likelihood of having HIV is close to 1 in 100,000. Further, if he did (most unlikely), HIV is spread in the course of heterosexual intercourse, on average, only once in every 1000 acts of vaginal intercourse. Thus your mathematical risk is less than 1 in 100 million. Put another way, you are more than 100 times more likely to get struck by lightning.
In general we do not recommend HIV PCR testing for diagnosis is HIV infection for several reasons an if you were my patient I would iscourage you from getting a PCR test. While the PCR is likely to become positive more quickly than other antibody detection tests (i.e. usual blood tests), at the present time the blood tests are becoming more and more sensitive and detecting infection earlier and earlier so that the time difference in detection between PCR test and antibody detection tests is becoming smaller and smaller and at present is, in general only a week or two. In addition the time course over which the PCR tests become positive is less well described than for the blood tests and, as a result, it is difficult to make a definitive statement on what a negative PCR test means at any time within a few weeks of exposure to a HIV infected or possibly infected partner. PCR tests are also more expensive than regular antibody tests. Finally and most importantly, the false positive rate for PCR tests (i.e. a positive result in persons who do not have HIV) is higher than for blood tests. Each of this on this Forum have seen a number of people who were worried needlessly because of false positive tests. For all of these reasons, we rarely recommend testing for HIV diagnosis using PCR.
It woul be far, far wiser to see if your partner would be willing to get an HIV blood test. He could do this at this time and in a day or two when the results come back as negative, you can be assured that you were not expose and thus have virtually no chance if becoming infected in the encounter you described. EWH
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