DO I NEED TO WORRY

[rsmid82]

Hello DR, a few months ago i had a couple of episodes of unprotected vaginal sex with a friend i was dating back then and that i knew. She is female, 20 years old in college non IDU user and heterosexual as for what i know she is not a promiscuos girl at all and told me she only had 3 partners before me. When i asked her about HIV or any other STDs she told me that she doesnt have any as she got tested and came out clean but i dont know what to believe.
about 2-3 weeks after the last time we had sex i took a DUO antigen P24 antibody test that came out negative. I heard the window period can take up to 3 months but also heard that a DUO test reduces this period and its very reliable. my questions are:
1. What is your understanding of the DUO ag/ab test and its reliability at 2-3 weeks after the risk situation?Isnt it true that it would pick up either the antibodies or the antigens by that time?
2. What are my odds of being infected after only 2 single episodes with this female?
3.  What is my risk for other STD's if i havent notice any symthoms at all?
4. If i was your patient would you recomend me further testing, or i shouldnt worry about it and move on?
thanks

[H. Hunter Handsfield, M.D.]

You are overreacting in a big way. You obviously have a very inflated view of the risks of HIV in heterosexuals in industrialized countries.  The chance a partner like you describe has HIV is almost zero.  The risk you caught it, if she was infected, average once chance per 2,000 episodes of sex.  Combine the two very low odds and you come up with less than 1 in a million chance you caught HIV.  You didn't need testing at all.

1) Probably ~90-95% of newly infected people would have positive results at 3 weeks, by either p24 antigen or antibody.

2) Zero for practical purposes.  See above.

3) The risk for STD is much higher than for HIV.  You could have asymptomatic chlamydia, HPV, or herpes. Most likely none of those, but no way to know without testing.

4) Based on this particular event, I would recommend no testing at all and move on. However, all people who are sexually active outside mutually monogamous relationships should have routine STD and HIV testing from time to tlime, like every 1-2 years.  If you haven't been tested recently, this seems like a good time, since it's on your mind.

Regards--  HHH, MD

[rsmid82]

Thanks a lot for your answers,this is just feaking me out a little bit.
I forgot to ask you if you have ever seen from your own experience someone testing positive after a few episodes of unprotected sex with a low risk partner like mine??


.

[H. Hunter Handsfield, M.D.]

No, I have never seen such a case. I'll bet there aren't 10 people per year in the entire US who acquire HIV from exposures like yours, maybe none at all.

[rsmid82]

Sorry, i meant to say in my question if you have ever seen a negative DUO test at 2-3 weeks turn positive?, I dont know if you are really familiar with those kind of tests. And how sensitive is the P24 around that time?.
I just dont understand why if the risk of HIV in heterosexuals is so low there are so many people infected this way.
Thank you Dr. I wont have any further questions.

[H. Hunter Handsfield, M.D.]

No I haven't seen that either.  I suspect p24 is ~90% senstive at 2-3 weeks, but don't know for sure.

In the US and most western countries, almost all heterosexuals with HIV are the regular partners of infected people, not one-time contacts.

Last comment. Thread closed.