Dr please advise if I should get tested again

I had an encounter with a CSW about 7 weeks ago today, It was in the united states, and the person stated she was clean and to trust her 500% I have nothing to worry about. I take this with a grain of salt as to the profession she is in, and by reading some previous posts I know I am at little risk, but here is my situation, I had a protected oral and vaginal sexual encounter with the CSW, no tears in the condom whatsoever, condom was removed and appeared to be fully in tact, I washed my entire genital area after the encounter. I also had french kissed her as well, I commonly bite my lip although there was definately no bleeding on my part, I also get oral cold sores or herpes orally once every other year or so, so I guess you could say Im positive when it comes to oral herpes, not sure if this increases my risks and to what degree, It was a very short encounter, I was protected during the entire encounter, I had a OraQuick Rapid test at exactly 28 days or 4 weeks which I have read is 90% accurate, it did come back negative, the counselor at the testing center seemed to be confused as to why I was there at all as he said I had a very low risk encounter, Would you suggest further testing at 6 weeks or presently? or at 12 weeks just to be safe or am I overreacting to a relatively safe situation?  I did suffer from severe anxiety which led me to believe I had symptoms which of course started as soon as I started reading info on HIV and ARS, all symptoms dissappeared as soon as I had my negative test result, so I know they were anxiety related, I had unprotected sex with my regular partner one time since this event and have held off since then, do you think Im ok, or should I go for one more test just to be sure? I thought 4 weeks was pretty assuring but apparently from what I read some people say 4 weeks is far too soon? Whats your advice, is another test nessecary? and If I had dormant no lesions showing genital herpes how much would that increase risk.

[Edward W Hook, MD]

You had a single, protected exposure (oral and vaginal) to a commercial sex worker (CSW).  Your chances of having gotten HIV from this exposure are extraordinarily low.  Here's why:

1,  Chances are, your partner did not have HIV.  Most CSWs do not. (BTW, the fact that she is a CSW by no means makes her a liar, most CSWs will tell the truth)
2.  You were protected, this further reduces your risk in addition to the rest of my comments below by over99%
3.  Your chance of getting HIV from your vaginal exposure, if she was infected is less than one in 1000 per exposure.  the oral expsoure still lower and no rsik from French kissing
4.  You have had an HIV test at 4 weeks.  After 4 weeks between 85 and 90% of tests that are going to become positive will have.

When you put all of these facts together, your chances of being infected from the exposure you describe is less than one in 100,000 and approaching 1 in a million..  If you get retested in the future, you will be a little bit, but not much more sure that you are not infected.  If I were you I would take the results I have, forget about your risk of having gotten infected and move on with your life.  I would not get further testing.  Hope this helps.  EWH

[joggen]

There are a lot of posts in the archives about 1 time protected encounters with sex workers. Read through the doctor's answers and you will see this is nothing to worry about.

[somewhatworriedguy]

I understand, my partner I found out soon after is pregnant, and my fear is that I might have passed it on to her If I were infected, I get real anxious if I notice a new blemish on her, she sneezes, if she feels hot, and yet I know these are all common symptoms of pregnancy... I know risk was low but is a 4 week oraquick test pretty reassuring 90%~? I can go get tested again at 7 weeks being now if suggested. I am otherwise very healthy, no immune disorders, have had cold sores or herpes all my life in the oral form, but there was no outbreak at the time of the encounter. Would a 7 week test put everything to rest or is 4 weeks sufficient do you think Dr.

[somewhatworriedguy]

THank you Doc. I will move on. This is what I wanted to hear. I think I just need to disconnect from this cyberchondriac spriral ive been going through.

[somewhatworriedguy]

Hey doc
I unfortunately haven't been able to completely move on although I am trying I ended up visiting a rapid STD clinic that charges high fees and got a full panel at 7 weeks or 50 days my HIV syphillis (syphilis) chlam and gonna. Were all negative however the doc did squeeze the head of my genitalia and smeared it on a slide and diagnosed me with nsu or ngu. Said there was bacteria on the slide I never had any symptoms of anything no irritation or anything but he gave me doxy which I took for a week. This made me stress worse can my nsu be non STD related? I had held going to the bathroom for hours before seein the doc dunno if that makes a diff. Is my 7 week test for HIV reliable? I worry cuz my partner is pregnant we already informed her obgyn of the situation and they are gonna run tests as well  I know ppl say my event is no risk but they also say 12 week is conclusive? I've also felt dull aches in my armpit and behind one knee now being 9 weeks post exposure. No swelling or fever tho I figure it could even be from the doxy or just extreme anxiety. Waiting on my partners results and thinking about going for 10 week test.

[somewhatworriedguy]

partners results came back all negative even for bacteria swab ob gyn said antibiotic is not nessecary for her as everything was clear her tests were 7 weeks after our last unprotected sex or 6  1/2 weeks I'll still keep it protected until 12 week conclusive I figure if tests are 95-98 percent accurate at this timeframe we should be safe but I was the one with the possible exposure so I'll wait till week 12 before any unprotected sex.  This has been the worst experience of my life and I'm glad she tested negative as well.

[Edward W Hook, MD]

From my perspective you are safe now.  You are doing this to yourself.

The significance of your non-chlamydial NGU is unclear but with negative tests of your partner, again, you do not need to worry.  I appreciate your concern for your partner but your guilt over this thing in not helping you any.  Time to move forward.

No further questions please. EWH

[somewhatworriedguy]

thanks for your reassurances doc I got a oraquick rapid test done at 75 days or just shy of 11 weeks I feel I can only shake this if I know for sure I wasn't exposed as I've noticed an increase in angiomas tiny angiomas over the past month. Is 12 weeks absolutely definitive? I was planning on going for a full blood draw I'm a generally healthy individual.  Is it not possible to seroconvert after 12 weeks and for my sanity would a combo pcr antibody test at 12 weeks basically rule it out with absolute certainty the money isn't a. Factor for me

[Edward W Hook, MD]

Neither of us has ever seen a person seroconvert to HIV after 12 weeks in over 25 years of taking care of persons with and at risk for HIV.  Does that mean that it never happens - no.  On the other hand there is simply no reason for you to thingk that you will be one of the very few person who is a very late seroconverter.  these peole uniformly have unusual situations relating to their infections.  Can I promise you that you do not have HIV -no.  Would I bet my paycheck on it - yes.  

My guess is that nothing I can say will help you deal with your anxiety.  I do not suggest further HIV tesitn.  In fact, I recommend against it.  You however are going to do what you wish to do. You don't have HIV - I know that now.  I can only hope that at some point after additional unwarranted tests, you can believe it too.   EWH

p.s.  The false positve rate for PCR tests is higher than for blood tests.  I hope you are not one of the unlucky ones who gets these.

[somewhatworriedguy]

thank you dr hook I am officially moving on I had a DNA pcr not detected and antibody negative at 90 days thank you for your guidance I know this last test was unwarranted perhaps but I can officially smile again and looking forward to a healthy future I've learned a lot from my e xperience. I know with these last two tests there is no
Possibility of late seroconversion as rare as it might be thank you again

[nsar666]

A related discussion, please i need help i can't sleep was started.