exposure to an HIV + female. question for the doc

[curious3872]

I have read a handful of the posts and your responses to them so i have a general idea of how you may respond to my episode. This is probably somewhat anxiety driven as the majority of the posts are here but i feel there is more validity to my concern based on the knowledge i have that the girl i was with is more than likely hiv positive.

as for the details of my encounter with her, i met with her on 2 brief occassions. the first time was about 30 minutes of fingering and brief cunnliingus that lasted ~ 10 seconds and stopped once i realized she was on her period. the next day was more fingering and on 2 occassions i got some of her blood of her finger which i used my mouth to relubricate. there was also about 30 seconds worth of unprotected anal sex with no tearing or visible blood, etc. basically there was not too much contact other than the brief anal sex and the 3 times i had her blood and or vaginal fluids in my mouth. i went in for what was called a rapid hiv antibody test at 3 weeks after the episode as i freaked out when i found out she was likely hiv positive from a couple of her friends. the test involved a pin ***** blood sample from the index finger with a 10 minute return of results. it came back negative. the docs there told me that the hiv rapid antibody test would come back negative near 100 percent of the time even if i had contracted the infection 3 weeks ago. one other thing that concerns me but may not be relevant was a swollen throat that enlarged the uvula to the point of dangling on the back of my tongue for a few days, one week after the encounter. looking back now that somewhat concerns me as ive never had that condition in the past. anyway, what i am trying to figure is approximate ballpark odds on having contracted the virus based on what ive told you here and if it is warranted to go back for a test at 6 weeks/12 weeks and if so, which type of hiv test as i know there are a few different kinds. thank you.

[Edward W Hook, MD]

First of all, if possible it would be to your advantage (and possibly your piece of mind) to ask her directly if she is HIV infected or not.  With all due respects to your friends, in my experience information of this sort from friends is wrong more often than it is right.  

Now for your risk.  Several facts come to mind:
1.  her blood in your mouth- low risk.  the virus does not get absorbed well through the oral cavity and is killed once it reaches the stomach.  I would still put your odds from this exposure, if she is infected at about 1 in 10,000.
2.  Rectal intercourse.  This is your highest risk exposure.  Brevity is on your side but odds are quoted at around 1 in 100
3.  You have a negative HIV test at 3 week.  Well over half of tests that care going to become positive will be at 2-3 weeks.

So should you get retested.  Probably a good idea if she is HIV infected.  At 6 weeks over 95% of tests that are going to be positive will be and at 12 weeks well over 99% will be.  

Any of the available blood tests including the rapid test you had at three weeks will perform similarly.

Hope this helps.  EWH

[Edward W Hook, MD]

Grave's disease- no impact on your test results.

Rash- most likely related to something else.  EWH

[Edward W Hook, MD]

I see no need for firther testing.  Time to move on.  EWH

[NeverDespair879]

Not to hijack the thread, I hope you are well and continue test negative. I just tested negative after 1 year since my risks. I was afraid to get tested for about a year (yes, silly).

I was in a similar situation, where a girl I had sex with was told by my friends to be HIV+. However, it was not true, she was not. I find that in my circles it is very common for people to mess around about people having certain STDs and etc. It think it is an awful thing to say about someone. What was your friend's concerns based upon?

[curious3872]

Doc,
Took a negative PCR and a negative ELISA at 6 weeks/1 day past possible exposure. I'm guessing i'd be better off worrying about a deadly car accident if i need to continue worry about something. Do you recommend a follow up ELISA at 12 weeks ? The people that gave the tests said it would be pointless when these both came up  negative. Thanks for all your responses.

[curious3872]

I side with your numbers along with the other studies online. I do have a few new concerns though and hopefully I am now falling squarely into the anxiety/panic crowd here. However, overnight I developed a dry, red patchy rash on the inside of my arms in certain spots.. under the elbow area and a small blot above the wrist. also noticed a dry rash on the inner shin this morning. this is of course distressing to me as this is another one of the so called early symptoms. also, a question in regards to grave's disease. i was diagnosed with this some 10 years ago and i was wondering if that would have any kind of impact on the hiv antibody tests in regards to onset of detectable antibodies. thanks Doc.

[Edward W Hook, MD]

Our information reflects reading of numerous studies.  Clinics and published statements must, by their very nature be very conservative in their recommendations.  That is not to say that we are not concerned or that we do not recommend safe sex- we do, bu these are our data based estimates.  You have to decide who you want to believe.  EWH

[curious3872]

I took a negative test today at 5 1/2 weeks post exposure. The strange thing is the conflicting information i am getting in regards to the window frame. The clinic I went to is telling me that a test at 5.5 weeks is not significant and really not even worth taking as the majority of all hiv positive tests are between a timeframe of 6 weeks to 3 months after the initial infection. From what I have read from the doctors here, up to approximately 90% of all infected individuals would show up by week 6. Someone's information is not correct and I believe it is the clinic I went to, possibly because they adhere to strict CDC guidelines. They could also be ultra conservative as 3 months is a 99.99% result but they seem to be brainwashed into believing that testing prior to 6 weeks is irrelevant. What is the bottom line on the overall percentages? Thanks for your time, again.

[Edward W Hook, MD]

I suspect (and hope) it is conservative. Please let us know your test result.  EWH

[curious3872]

I hope 100-1 is conservative given my situation. Not being the recipient and only having intercourse for less than a minute hopefully decreases the likelihood. One way or another, I've learned from this experience to be more cautious in the future. Thank You for your response.