please end this worry

[worriedstill3]

I am a female.  About 3 years ago I had a one time encounter with someone  I had only known a few weeks.  This encounter included protected intercourse and unprotected oral ( me being the receiver) My fear is he may have had a scab on his lip. What if it was a sore?  I have had an hiv 1 & 2 anitbody test dont know what generation (and all std's ) through my doctor at 5 months, 10 months, 2 years, and 3 years.  All neg except hsv 1 came up positive this has given me severe anxiety sinse this exposure. My questions are:
1) I dont know when I acquired the hsv 1 assuming it was the same time could this delay my body from making antibodies for the test to detect?
2) Should I take a different test? pcr rna/ dna?
3) I have been on cymbalta (antidepressant) on and off for years can this affect my test results?
4) please advise the best action so I can put this behind me.  Thank you in advance

[Edward W Hook, MD]

Sorry, we do not debate other web sites.  Our information is derrived from years of practice, reading the medical literature and our work an numeroius other advisory committees. If you wish to believe other web sites that is up to you.  

1) They suggest testing out to 180 days.

This is an overly conservative, far out of date suggestion.

2) a person states they are HIV positive from oral only

As I said before there are no proven cases of HIV acquired through receipt of oral sex.

3) they mention the possibility of not making HIV antibodies and suggest a different kind of test. If you make antibodies for let's say for herpes does that mean you make HIV antibodies? And if you didn't would you be sick from the HIV already?

It sounds like they are trying to sell something.  The very, very few people who do not make antibodies become very sick at an early age and most do not survive to adulthood.  Concerns about not making antibodies are not realistic.

Take care. There will be no further answers to this thread. EWH

[worriedstill3]

Thank you. Just one last thing promise. I made a mistake of checking another website( a reputable one ) however the information has now frightened me again.
1) They suggest testing out to 180 days.
2) a person states they are HIV positive from oral only
3) they mention the possibility of not making HIV antibodies and suggest a different kind of test. If you make antibodies for let's say for herpes does that mean you make HIV antibodies? And if you didn't would you be sick from the HIV already?
I realize I am bothering you. I promise this is my last question. I am seeking help regarding this matter I can't take the constant fear.

[Edward W Hook, MD]

Sigh.  The 1 in 1000 figure quote above was the rate of HIV in heterosexual men and for unprotected genital sex. These were given as examples.  You really need to relax.

As I said before "These are facts.  You did not get HIV form the encounter you have described.  If you are having trouble getting by this, I suggest you discuss it with a counselor or qualified health care provider such as the person who has prescribed your cymbalta".

EWH

[worriedstill3]

In regards to oral sex and hiv to clarify

[worriedstill3]

I was reading other posts where you use "1 in 10,000" in regards to oral sex. When responding to my post you said 1 in 1,000.  Is there any particular reason ?  Was my situation a higher risk?

[Edward W Hook, MD]

You are over reacting.  Even in the unlikely circumstance that your partner had HIV, you were not infected.  This has been proven by your test results.  

If your body did not make antibodies you would have been sick from other infections long ago.  

Your concerns about the future are causing you to over react and to worry about biologically implausible occurrences. There is no medical or scientific reason for concern.  If you cannot accept this at this time, you do not need more testing, you need to seek the advice and assistance of a counselor who can help you work through the reasons for your difficulties in accepting that you were not infected in the encounter you described which took place over three years ago.  

I say this is a sincere effort to help and for no other reason.  EWH

[worriedstill3]

I was thinking of trying to locate the person from this exposure. I don't know what I would say to him if I could find him but would knowing his HIV status change my test result accuracy?
My next thought was a different test incase my body doesn't make antibodies.  Any suggestions on the appropriate test?
Again I really am only thinking of these things now because it is approaching the time in my life to get married and have kids. I want to go into these endeavors with a clean slate and peace of mind.

[Edward W Hook, MD]

Welcome to our Forum.  I will try to help by providing factual data.  Hopefully this will allow you to stop worrying about this encounter.  First, irrespective of whether or not your partner had a scab/sore on his lip, this was a low risk encounter for all STIs, including HIV.  Most people do not have STIs of any sort and the likelihood that your partner had HIV is less than 1 in 1000.  Further, even if he had some sort of infection, most unprotected single exposures do not lead to infection.  My statements include both figures for for HIV in which case, IF he had been infected your risk was less than 1 in 1000 of becoming infected yourself and that IF he had an active HSV sore, your risk for getting genital HSV from him performing oral sex is less than 1% (and probably far less).

Further, your negative tests for STDs and HIV are both reliable and definitive at the times you have tested.  Had you acquired HSV-1 (anywhere) from him during this encounter you would have most likely developed lesions and experienced an outbreak - you apparently did not. This plus the statistical facts of unlikely transmission and that most HSV-1 in adults is acquired in childhood also make it unlikely that your HSV-1 is genital in location or acquired during the encounter you have described.

As for your specific questions:
1) I dont know when I acquired the hsv 1 assuming it was the same time could this delay my body from making antibodies for the test to detect?
As I said above, it is unlikely you acquired HSV-1 from this encounter and even if you had, this would not delay production/detection of HIV antibodies.  Be confident you did not get HIV from this encounter.  

2) Should I take a different test? pcr rna/ dna?
Further testing would be a complete waste of time and money, no matter what the "generation" of tests.  Your results at 5 and 10 months, as well as at 2 and 3 years are definitive.  Again, be confident you did not get HIV from this encounter.

3) I have been on cymbalta (antidepressant) on and off for years can this affect my test results?
No your cymbalta would have no effect on the accuracy of your test results.

4) please advise the best action so I can put this behind me.  Thank you in advance .
See above.  These are facts.  You did not get HIV form the encounter you have described.  If you are having trouble getting by this, I suggest you discuss it with a counselor or qualified health care provider such as the person who has prescribed your cymbalta.

I hope my comments are helpful.  EWH