Should I be worried?

[worriedgirl1111]

Hello,

Thank you for taking the time to answer my question. I am a heterosexual female, who had protected intercourse in July with a man who I have known for many years. We have an "on again, off again" relationship.I also know he has had many partners. In the past, we have not always been diligent about using condoms (I am on the pill), but given the risks and his unknown status (I don't know for sure if he is negative for STD's and HIV, although he says he is), we use them now. In fact, last time we were together he brought up using condoms. That is actually one of the things that is making me nervous, as he didn't used to do this. Anyway, after we had intercourse and after he ejaculated, he withdrew and the condom slipped off. It was hanging out of my vagina (sorry to be graphic) and he grabbed it right away. There was no evidence that it broke or ripped and I don't believe any semen leaked out onto my vagina (although there was some on the bed).

I called him weeks later to ask him if there was anything to worry about and he said, "No" and that he remembered that I wanted to use condoms, which is why he brought them up. He also said he wanted us to be "safe". I agree and was relieved. But, then I became anxious again and decided to get an HIV test at 61 days post the event. It was the Oraquick Rapid Test and it was negative. The nurse told me that I should be fine and that result is at least 94% accurate. She told me I could come back after 3months, but I didn't need to because she felt my risk was very low. I felt so relieved, but then started reading on the internet about the "window period" and got anxious and confused again. Can I feel confident in this negative result? I am just anxious that I will be one of the 6% or something.. Please advise. Thank you so much.

[Edward W Hook, MD]

Welcome to the Forum.  I'll be answering your question.  We try to get to them as soon as possible but sometimes there is a delay of several hours.  You may wish to contact MedHelp and see if you can have the charge for your second, follow-up question reversed.

I'll be pleased to address your questions.  First let me encourage condom use when you or your partner have had multiple partners or if you enter into a relationship with a new partner.  Unless you know that each of you is not infected condom use is the safest path since persons can be infected and not know it.  As a matter of personal protection, we recommend annual testing for anyone who has had  a new partner, who has had two or more sex partners in the past year, or whose partner has other partners (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).   Such testing most importantly should include testing for chlamydia and gonorrhea, the most common STDs, and often will also include blood tests for HIV and syphilis.  We DO NOT recommend regular blood testing for herpes - the tests are not reliable enough.

With regard to your most recent exposure, the fact that your partner "left" the condom "behind" as he excited is not a problem. In such situations the condom has done its job and the secretions form sexual activity remain in the condom.  it sounds like he did just the right thing.  

With regard to your testing, any test at or about at 8 weeks (56 days) now provides definitive information on whether or not HIV was acquired.  Thus your 61 day test is conclusive.  The nurse who spoke to you give you the "party line" which is overly conservative.  You can be confident you di d not get HIV form this exposure.  

I hope these comments are helpful.  If not, please respond as part of this thread, do not start another post as you will be charged for it.  We do allow limited follow-ups. EWH

[Edward W Hook, MD]

That your partner was African American does not change the fact that your test iwas performed at a time when you can rely on the results.  You are in the clear. EWH

[worriedgirl1111]

Hi Dr. Hook,

I hope you don't mind me reaching out to you again. In my initial post, I neglected to tell you that my partner is African American. I am aware that HIV rates are higher in the AA population. I got anxious again and retested at 10.5 weeks (Oraquick Ora swab test) and it was negative. Can I finally relax? Am I just creating anxiety where there shouldn't be any at this point?

Thank you again for your time and patience.

[Edward W Hook, MD]

No change in my assessment of your risk and I do recommend that you believe your test results.

As for the leakage, this is typically not a problem.  EWH

[worriedgirl1111]

Hi Dr. Hook,

One more quick thing.. I know this is probably more about my lack of trust in this man (he has lied to me about a lot of things in the past) and my overall level of anxiety. I am really trying to move forward from that, but is it possible that semen leaked out before he withdrew? He didn't withdraw right after we finished having sex and I just don't know if any leakage occurred inside of me. Like I mentioned, some of the fluid did come out because it was on my bed. If that did happen, do you still feel my risk is the same and that my test results are accurate? Thank you again for your time.

[Edward W Hook, MD]

I'm glad you found my comments helpful.  Take care.  EWH

[worriedgirl1111]

Dr. Hook,

Thank you very much for your reply. I feel much better now. I have been so anxious-I just should have written to you in the first place!