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Unprotected Exposure--Risk
Doc,
I'm a 30 year old male. I got drunk in a bar a chatted up a single 42 year old black female with 2 kids. We ended up have unprotected sex (dumb, I know) that night. I asked her the next day whether she had any STDs. She said that she had no STDs and this is the first sexual encounter she's had in 3 years (since she was divorced). Although I had just me her that night, I believe what she says; however, should I get tested just in case? Not experiencing any symptoms, just had some allergy reactions lately. Thanks
I'm a 30 year old male. I got drunk in a bar a chatted up a single 42 year old black female with 2 kids. We ended up have unprotected sex (dumb, I know) that night. I asked her the next day whether she had any STDs. She said that she had no STDs and this is the first sexual encounter she's had in 3 years (since she was divorced). Although I had just me her that night, I believe what she says; however, should I get tested just in case? Not experiencing any symptoms, just had some allergy reactions lately. Thanks
MEDICAL PROFESSIONAL
A negative HIV DNA test in the 12-14 day range is highly reassuring, but not absolute proof. You should also have an HIV antibody test at 4 or more weeks after exposure. That combination -- negative DNA at 12 days and negative antibody at 4 weeks -- will be definitive. You can expect it to be negative.
Thanks for the advice. I did contact her again and she definitely reassured me that she was STD-free. I got a full panel test about 12-days after (with DNA PCR) because I got a little freaked out after your response. Everything came back negative. Do I still need retesting? Thanks in advance.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
In general, we don't recommend HIV testing in response to a single sexual encounter unless it was particularly high risk. But this may be one of those times.
The non-glossy facts are that you picked up someone in a bar, generally a higher risk than most commercial sex encounters; and you didn't use a condom, and presumably she didn't insist on it. You're the only one who can judge her honesty about her sexual lifestyle, but I'll bet there aren't very many women who are picked up in bars and have sex the same night and who haven't done it before! Looked at analytically, does that seem likely to you? My bet is that she has been around the track a few times. And if she didn't insist on a condom this time, probably she didn't on other occasions either.
Then there's her race. Being black in America does not in itself raise HIV risk, but the fact is that HIV is many times more frequent in African Americans than in other race/ethnicity groups. It's a complex issue; see the two threads linked below.
http://www.medhelp.org/posts/show/717093
http://www.medhelp.org/posts/show/1261996
Of course even if she had HIV, the chance you were infected from a single episode of unprotected sex is low, probably on the order of 1 in 2,000 odds --- lower if she is infected but on treatment.
Bottom line: I think you should look at this as a high risk event and should be tested for HIV and, while you're at it, other treatable STDs (gonorrhea, chlamydia, syphilis). Or, if you are still in touch or able to contact her, give her a call. Perhaps she'll further (and honestly) reassure you about her risks; or you may find she is just as alarmed about the event as you are and might even decide to get tested together.
Don't misunderstand: the odds are very strongly in your favor. But it seems to me the risks aren't zero and it would be wise to be tested, unless follow-up contact further convinces you there was no risk.
Regards-- HHH, MD
In general, we don't recommend HIV testing in response to a single sexual encounter unless it was particularly high risk. But this may be one of those times.
The non-glossy facts are that you picked up someone in a bar, generally a higher risk than most commercial sex encounters; and you didn't use a condom, and presumably she didn't insist on it. You're the only one who can judge her honesty about her sexual lifestyle, but I'll bet there aren't very many women who are picked up in bars and have sex the same night and who haven't done it before! Looked at analytically, does that seem likely to you? My bet is that she has been around the track a few times. And if she didn't insist on a condom this time, probably she didn't on other occasions either.
Then there's her race. Being black in America does not in itself raise HIV risk, but the fact is that HIV is many times more frequent in African Americans than in other race/ethnicity groups. It's a complex issue; see the two threads linked below.
http://www.medhelp.org/posts/show/717093
http://www.medhelp.org/posts/show/1261996
Of course even if she had HIV, the chance you were infected from a single episode of unprotected sex is low, probably on the order of 1 in 2,000 odds --- lower if she is infected but on treatment.
Bottom line: I think you should look at this as a high risk event and should be tested for HIV and, while you're at it, other treatable STDs (gonorrhea, chlamydia, syphilis). Or, if you are still in touch or able to contact her, give her a call. Perhaps she'll further (and honestly) reassure you about her risks; or you may find she is just as alarmed about the event as you are and might even decide to get tested together.
Don't misunderstand: the odds are very strongly in your favor. But it seems to me the risks aren't zero and it would be wise to be tested, unless follow-up contact further convinces you there was no risk.
Regards-- HHH, MD
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