Scared - risk?

[Ms8787]

I stupidly engaged in a threesome with a couple (man and woman) what's even dumber is that it was unprotected. Before I met them I asked about their testing history, the male said his female partner tested recently and was fine and that he had not tested but just got out of a sexless 13 year marriage. We both had penetrative sex with her vagina and anus. I was inside her vagina for maybe 3 minutes but I'm concerned because there was semen from the male in her vagina. I wasn't fully erect and was in her anus after that for maybe 3 minutes. I understand the risk of transmission from other posts, for unprotected vaginal (around once every 2000 sex acts) and anal (around once every 500 sex acts) it has been 2 days since and no symptoms of other stds. I will get tested for all at the appropriate times. I know chances are neither of them had hiv but I'm wondering how concerned I should be in he meantime. I plan on taking an oraquick at 4 weeks and 6 weeks to ease my mind.

[Edward W Hook, MD]

The best way to find out about the availabiltiy is to ask.  since I have worked at the VA, I know that sometimes answers are hard to get but that is worth a try.  Further, you can call either your local health department or an HIV Advocacy group (try googling it) to ask wher eyou can find one. they are increasingly widely available although many providers are not aware of this.  EWH

[Ms8787]

Thank you for your response and reassurance Dr. I am interested in getting a 4th generation test done. I do not have health insurance and am wondering if you know the best way to pay out of pocket for one. Would something like quest diagnostics work or do I need a healthcare provider for this? I belong to the VA hospital but I'm unsure of what test they use to screen. Thank you again.

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to comment.  While, based on the conversations you had before the encounter I suspect that this was a low risk encounter, testing is reasonable.  If you are interesting in putting your concerns about HIV aside sooner than later however, the OraQuick is the wrong test to use.  While there are no formal scientific studies which compare all test types to one another, there is an emerging consensus about how quickly test results can be expected to be definitive.  The quickest way to be sure that a person has not acquired HIV is with a combination HIV antigen/antibody test (also called 4th generation or DUO tests).  these tests give completely reliable results 4 weeks after an exposure.  The combination of a PCR plus a standard antibody test would provide results in a similar time despite what the people who sell them tell you and the PCR tests are typically the most expensive tests one can get.  If you are tested only with an antibody only test, results will be definitive at about 8 weeks whether that is a laboratory-performed test or a rapid, finger stick test.  The OraQuick which tests for the [presence of antibodies in saliva provides reliable test results a bit later, perhaps taking as long as 12 weeks in a very small proportion of persons with recently acquired HIV.

I hope these comments are helpful to you in choosing when to test and what to test with.  I suspect that your risk for HIV is low and that when you test your tests will be negative but I also understand that you are interested in clearing out any concerns sooner than later. EWH