Another risk assessment

Dr.,

I am a 26 year old mail who live in NYC and am sexually active, always with a condom. I went out to LA last week and met a girl at the hotel pool and eventually one thing led to another and we ended up having sex that night. We had unprotected oral sex and some protective and then unprotected vaginal sex. During intercourse my condom broke and I don't believe I noticed for a little while, we probably had sex for around 15 minutes. Later still that night we had sex again without a condom this time. I did not ejaculate inside of her either time.

I asked her that night, in the morning, and then again after I got back to NYC (I'm a worrier by nature) if she had anything and if I need to get checked out to which every time she told me no and that I had nothing to worry about. I remember during sex the thing she seemed most worried about was getting pregnant. She also made the comment about not having sex for two monhs This is extremely unnerving to me since I don't usually do this and I am worried since I don't know anything about this girl at all. This might sound judgmental but she had lots of tattoos and works in entertainment but thats probably my own stupid bias. With my worrier self there is not an once of doubt that I won't be getting a full run of all tests, but I am still worried with having to wait for HIV and it's really bothering me.

What would you say my risk percentage is here? Also, is it possible to feel the flu-ish symptoms within a week? I started some hot flashes last night (not normal for me) and its been about 5-6 days since the encounter. I feel like I am going to drive myself insane. Thanks in advance.

[Edward W Hook, MD]

Welcome to our Forum.  I am sorry to hear of your condom mishap an hope that it won't keep you from using condoms in the future.  Condoms fail about 1% of the time they are used but remain one's best protection against STDs, including HIV.

The likelihood of a heterosexual woman in the U.S. who does not use IV drugs having HIV is about 1 in 1000 and if anything, that estimate is on the high side.  The risk of transmission of HIV through heterosexual intercourse with an infected partner is about 1 infection per 1000 acts of intercourse so your risk, IF (unlikely) she was infected is about 1 in 500.  Putting these two figures together your mathematical risk for infection is about 1 in half a million.  

The symptoms you describe have occurred too early to be a reflection of early HIV infection.

My advice.  Don't worry.  Go on and get checked now for usual STDs like gonorrhea and chlamydia, both of which are far, far more common than HIV.  In about 8 weeks get checked for HIV just for the peace of mind it will provide.  I would not spend a lot of time worrying however.  What's done is done and your risk is very low.  EWH

[NYCguy84]

Thanks so much Doctor, I will do just that. I am heading out tomorrow morning to get the full round of tests. A follow up question I have is what is the chance of a person having HIV if they DO have IV drug use in their past? I really know nothing about this girl or her past, but she seemed to have a very active work life and pretty responsible so I don't believe she was a user, she also has told me she wasn't, but like I said I know nothing about her. Thanks again Doctor you have made me feel much better now, all I have to do now is be patient for assurance.

[Edward W Hook, MD]

Use  of IV drugs increases the risk somewhat but there is a lot of variation, depending on whether or not they share needles. IV drug use without needle sharing is not particualrly risky.  Unfortunatley neeles sharing is rather common.  Among persons who regualrly share needles in shooting galleries, the rate of HIV can be higher than 10%.  EWH