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Risk and testing
Dear Drs,
I recently (January 1st) split up with my HIV+ girlfriend. In November I tested negative for HIV and since then we engaged in protected vaginal sex once and unprotected oral sex (both ways) about 3 or 4 times. Following the break up I tested negative at 27 days on the 20 minute rapid test. However, the same day that i did the test I came down with a very high fever, headache, chills and tiredness. I fully acknowledge that these symptoms are consistent with flu as well as ARS and many other things.
In light of my potential exposures, my 4 week test and my possible symptoms do you think further HIV testing is warranted?
Thank you.
I recently (January 1st) split up with my HIV+ girlfriend. In November I tested negative for HIV and since then we engaged in protected vaginal sex once and unprotected oral sex (both ways) about 3 or 4 times. Following the break up I tested negative at 27 days on the 20 minute rapid test. However, the same day that i did the test I came down with a very high fever, headache, chills and tiredness. I fully acknowledge that these symptoms are consistent with flu as well as ARS and many other things.
In light of my potential exposures, my 4 week test and my possible symptoms do you think further HIV testing is warranted?
Thank you.
MEDICAL PROFESSIONAL
Even with entirely unprotected sex, you probably were at no risk for HIV. Your final test result will be negative. Let's hold off on further comments unless and until you return to let me know the result. In the meantime, don't worry at all. You don't have it.
Thanks again for your reply and apologies if I seem to be repeating myself. My ex-partner is on treatment and her last blood results showed that her viral count was low (under 100).
MEDICAL PROFESSIONAL
Dr. Hook answered basically the same questions in your other thread 2 months ago. It would help to know the status of your partner's HIV infection, especially her viral load, if you know it; and/or whether she was taking anti-HIV drugs. If low viral load and/or she is on treatment, likely the risk was near zero, even for unprotected vaginal sex. But even with high viral load, since you only had condom-protected vaginal sex, and transmission by receiving oral sex is very rare (if it occurs at all), you were at near-zero risk.
I cannot speculate on the cause of your fever, except that almost certainly it wasn't due to HIV, for the reasons already discussed.
Have a final HIV test, as I advised above, and let me know the result. As I already said, you can expect it to remain negative.
I cannot speculate on the cause of your fever, except that almost certainly it wasn't due to HIV, for the reasons already discussed.
Have a final HIV test, as I advised above, and let me know the result. As I already said, you can expect it to remain negative.
Dr Hansfield, I apologise for the repeated follow up questions but I would like to add one more if I may. How would you assess the risk of the exposures I described above? Having read these forums a few times I suspect that if I had posted this on the general HIV forum the moderators would have said that I had zero risk. There seems to be an assumption there that oral sex and protected vaginal sex have no risk whatsoever. I think that you probably disagree with this. Your comments would be greatly appreciated.
Thank you
Thank you
In the absence of cough, runny nose or other respiratry symptoms could my symptoms have been flu?
Thank you for your reply. I did have a slight sore throat but as this was mild in comparison with my other symptoms I didn't mention it. Also, as a smoker this happens from time to time. I did not however have a rash.
Would you advise that I abstain from sexual contact until I retest in a few weeks?
Many thanks again.
Would you advise that I abstain from sexual contact until I retest in a few weeks?
Many thanks again.
MEDICAL PROFESSIONAL
I took this comment into account in my reply above.
MEDICAL PROFESSIONAL
Welcome back to the forum.
The timing, short duration, and lack of certain other symptoms argue strongly that your fever was not due to ARS. Onset of ARS fever or other symptoms typically is 10-20 days after acquiring the virus; fever typically persists 10 days or more; and absence of sore throat (which you don't mention) and rash also argue against ARS. Recent research indicates that 70% of those with ARS have all three of those symptoms, and around 90% have at least two of them.
And a negative HIV antibody test at 4 weeks is at least 90% reliable. However, as the past partner of an HIV infected person, it would make sense for you to have additional testing to be 100% certain. You could have a duo test (i.e., the combo test for both HIV antibody and p24 antigen) at any time, or another antibody-only test 6-8 weeks after your last sex with your former partner; either of those results will be 100% reliable.
In case you have further questions about the reliability of HIV testing at various intervals, take a look at this thread from earlier today -- and the other threads whose links are in that one: http://www.medhelp.org/posts/show/1449423
All things considered, it is extremely unlikely you have HIV. You can expect any additional tests to remain negative.
Best regards-- HHH, MD
The timing, short duration, and lack of certain other symptoms argue strongly that your fever was not due to ARS. Onset of ARS fever or other symptoms typically is 10-20 days after acquiring the virus; fever typically persists 10 days or more; and absence of sore throat (which you don't mention) and rash also argue against ARS. Recent research indicates that 70% of those with ARS have all three of those symptoms, and around 90% have at least two of them.
And a negative HIV antibody test at 4 weeks is at least 90% reliable. However, as the past partner of an HIV infected person, it would make sense for you to have additional testing to be 100% certain. You could have a duo test (i.e., the combo test for both HIV antibody and p24 antigen) at any time, or another antibody-only test 6-8 weeks after your last sex with your former partner; either of those results will be 100% reliable.
In case you have further questions about the reliability of HIV testing at various intervals, take a look at this thread from earlier today -- and the other threads whose links are in that one: http://www.medhelp.org/posts/show/1449423
All things considered, it is extremely unlikely you have HIV. You can expect any additional tests to remain negative.
Best regards-- HHH, MD
I would like to add that my fever and headache lasted almost exactly 3 days,
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