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Please assess my HIV risk
Hello Doctors,
I am 35, an straight asian male from China. I would like to ask you to reassess my HIV risk again. My exposure was an unprotected virginal sex with a CSW due to condom break on July 10. I got HIV antibodies test on August 09 (30th day post exposure), which came out negative. But since August 08 (the beginning of 5th week post exposure) I got a series of strange symptoms: Oral ulcer for about 3 days, left jaw pain near the ear, feeling odd under my left axillary each for a day, nausea and vomiting for 3 days, dry cough always, diarrhea occasionally, right knee pain since 2 days, fatigue...the symptoms come and gone, some I have had before some I never had before, I simply don't feel fit like before. But until now I didn't get significant fever and swollen lymph nodes since exposure. Since 2 days I also feel a slight burning on top of my urethra when I urinate, but from outside it seems normal. So I came to see doctor today and got a set of STD Tests, Chlamydia came out positive. Other tests including HIV-test (on 36th day post exposure, which is a quick test for HIV antibodies), all came out negative. Since my main concern remains HIV infection, I would like to ask:
1. I knew from your posts statistically the odd is in my favor to not get HIV infected, but does the fact I got Chlamydia change your judgement a little? Because I have read somewhere the risk of HIV-infection becomes higher by existence of other STDs,
2. I didn't know Chlamydia has such a long latency period (5 weeks in my case, or did i not notice the symptoms before?) Does it imply I have a slow reacting immune system and therefore longer window period for HIV? But actually I don't think I have a weak immune system.
3. Which kind of people tend to have longer windows period? Could you answer according to your professional experiences or are there some studies?
4. Do transmission methods have influence on windows period? e.g. sex infected people have longer window period?
Best regards
I am 35, an straight asian male from China. I would like to ask you to reassess my HIV risk again. My exposure was an unprotected virginal sex with a CSW due to condom break on July 10. I got HIV antibodies test on August 09 (30th day post exposure), which came out negative. But since August 08 (the beginning of 5th week post exposure) I got a series of strange symptoms: Oral ulcer for about 3 days, left jaw pain near the ear, feeling odd under my left axillary each for a day, nausea and vomiting for 3 days, dry cough always, diarrhea occasionally, right knee pain since 2 days, fatigue...the symptoms come and gone, some I have had before some I never had before, I simply don't feel fit like before. But until now I didn't get significant fever and swollen lymph nodes since exposure. Since 2 days I also feel a slight burning on top of my urethra when I urinate, but from outside it seems normal. So I came to see doctor today and got a set of STD Tests, Chlamydia came out positive. Other tests including HIV-test (on 36th day post exposure, which is a quick test for HIV antibodies), all came out negative. Since my main concern remains HIV infection, I would like to ask:
1. I knew from your posts statistically the odd is in my favor to not get HIV infected, but does the fact I got Chlamydia change your judgement a little? Because I have read somewhere the risk of HIV-infection becomes higher by existence of other STDs,
2. I didn't know Chlamydia has such a long latency period (5 weeks in my case, or did i not notice the symptoms before?) Does it imply I have a slow reacting immune system and therefore longer window period for HIV? But actually I don't think I have a weak immune system.
3. Which kind of people tend to have longer windows period? Could you answer according to your professional experiences or are there some studies?
4. Do transmission methods have influence on windows period? e.g. sex infected people have longer window period?
Best regards
MEDICAL PROFESSIONAL
1. Yes, the Unigold test is as good as other standard lab tests and my statements about the so-called window period apply to it as well.
2. Your risk was low to start with. I see no need for further testing but whether you feel the need to be 100% "sure" is up to you. EWH
2. Your risk was low to start with. I see no need for further testing but whether you feel the need to be 100% "sure" is up to you. EWH
MEDICAL PROFESSIONAL
Welcome to the HIV Prevention Forum. I will add to the information that you have already received on the International HIV Forum.
I agree with the advice offered on the International Forum. Your risk of HIV from a single exposure is low. It is statistically unlikely that your partner had HIV and even if she did, the chance of transmission in a single act of intercourse is low.
That you had chlamydia is not too surprising. Chlamydia is far more common than HIV and more easily transmitted.
I note that you have a negative HIV blood test 4 weeks after your exposure. At that time about 90% of HIV infections would have been detectable so this too is strong evidence that you did not get HIV.
In answer to your questions:
1. With chlamydia the risk of HIV is slightly higher. This is in large part because persons who get one STD (like chlamydia) are also more likely to get another (like HIV). Even with chlamydia however, your risk of very low, particularly with your negative 4 week test.
2. That your chlamydia was not apparent or detected before 5 weeks is not unusual. The signs and symptoms of chlamydial infection tend to be quite mild and can easily be overlooked. Your chlamydial infection does not in any way suggest that you have a weak immune system or that IF you were to get HIV (which is NOT likely) it would take you longer to develop a positive test.
3. There are no studies of prolonged "window periods" because, except for people who have taken anti-HIV medications, they do not exist. Do not worry about prolonged window periods.
4. No. Route of transmission has no effect on window periods. Over 2/3 of HIV infections result from a single virus entering the body. the window periods are the same no matter how the virus go in.
To summarize. Your risk of HIV is very, very low. My advice is to get another HIV test at 8 weeks. I anticipate that the result will be negative. At that time you should have no further concerns about HIV from the exposure you describe. In addition, I encourage you to continue to use condoms despite your recent unfortunate experience. Take care. EWH
I agree with the advice offered on the International Forum. Your risk of HIV from a single exposure is low. It is statistically unlikely that your partner had HIV and even if she did, the chance of transmission in a single act of intercourse is low.
That you had chlamydia is not too surprising. Chlamydia is far more common than HIV and more easily transmitted.
I note that you have a negative HIV blood test 4 weeks after your exposure. At that time about 90% of HIV infections would have been detectable so this too is strong evidence that you did not get HIV.
In answer to your questions:
1. With chlamydia the risk of HIV is slightly higher. This is in large part because persons who get one STD (like chlamydia) are also more likely to get another (like HIV). Even with chlamydia however, your risk of very low, particularly with your negative 4 week test.
2. That your chlamydia was not apparent or detected before 5 weeks is not unusual. The signs and symptoms of chlamydial infection tend to be quite mild and can easily be overlooked. Your chlamydial infection does not in any way suggest that you have a weak immune system or that IF you were to get HIV (which is NOT likely) it would take you longer to develop a positive test.
3. There are no studies of prolonged "window periods" because, except for people who have taken anti-HIV medications, they do not exist. Do not worry about prolonged window periods.
4. No. Route of transmission has no effect on window periods. Over 2/3 of HIV infections result from a single virus entering the body. the window periods are the same no matter how the virus go in.
To summarize. Your risk of HIV is very, very low. My advice is to get another HIV test at 8 weeks. I anticipate that the result will be negative. At that time you should have no further concerns about HIV from the exposure you describe. In addition, I encourage you to continue to use condoms despite your recent unfortunate experience. Take care. EWH
Dr. Hook,
thank you very much for your reply and help. I feel so relieved now.
Best regards
thank you very much for your reply and help. I feel so relieved now.
Best regards
Hello Dr. Hook,
today (6.5 weeks after my exposure) I took an other hiv antibody test at a local hospital.
I didn't wait till 8+ week to take the test as you suggested in the last post, because I will move to other place to work next week, and due to the high stress these days
I felt I must have taken a test before that for peace of my mind so I did so.
It was a rapid Unigold (blood) test, which came out negative. Although a little early
to be conclusive, I feel so relieved today. Would you please give me some further advices?
1)Does the rapid Unigold antibody (blood) test perform as well as other standard lab tests at this stage (6 weeks+ post exposure)? Do your general statements about window period based on the tests used in USA on this forum also apply to this kind of rapid test used here? (I have read that generally 3 "generation" standard lab test are used in china, someplaces 4th generation lab test, but I donot know which generation the unigold rapid test belongs to, does it matter?)
2)I knew from yours and Dr. Handsfields posts that an antibody test an 6+ weeks should be considered as quite reliable. With the negative test result today, can I just move on and forget this thing or would it still be necessary and better that I take a further test at 8+ week to be 100% conclusive?
Thank you in advance.
today (6.5 weeks after my exposure) I took an other hiv antibody test at a local hospital.
I didn't wait till 8+ week to take the test as you suggested in the last post, because I will move to other place to work next week, and due to the high stress these days
I felt I must have taken a test before that for peace of my mind so I did so.
It was a rapid Unigold (blood) test, which came out negative. Although a little early
to be conclusive, I feel so relieved today. Would you please give me some further advices?
1)Does the rapid Unigold antibody (blood) test perform as well as other standard lab tests at this stage (6 weeks+ post exposure)? Do your general statements about window period based on the tests used in USA on this forum also apply to this kind of rapid test used here? (I have read that generally 3 "generation" standard lab test are used in china, someplaces 4th generation lab test, but I donot know which generation the unigold rapid test belongs to, does it matter?)
2)I knew from yours and Dr. Handsfields posts that an antibody test an 6+ weeks should be considered as quite reliable. With the negative test result today, can I just move on and forget this thing or would it still be necessary and better that I take a further test at 8+ week to be 100% conclusive?
Thank you in advance.
Dr. Edward W Hook,
thank you very much for your swift and professional reply. I really appreciate it.
Best regards
Chen
thank you very much for your swift and professional reply. I really appreciate it.
Best regards
Chen
Actually I asked once on international forum, but today I was found to have Chlamydia, so I would like to ask you to reassess my HIV risk again. I also want to thank you for all your informative and professional replies on this forum, they help me a lot to deal with my stress these days.
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