HIV Test Times

[DumE]

Thank you Doctors for what you do. I understand your time is valuable and will get right to the chase:

I'm a male and I was on a business trip almost exactly 8 weeks ago, got too drunk and had an encounter with a female CSW. We had protected intercourse twice and to my knowledge the condom stayed in tact, it certainly didn't "burst wide open." I also received protected oral. In the very beginning, she gave me a small amount of unprotected oral to get me erect before putting a condom on, but this was only for a few seconds. She put the condom on and took it off every single time and I noticed her washing up in the restroom with a wet towel after each encounter, she may have used soap too, I'm not sure. I did not ask her about her HIV or other STD status, but she was working in the bar of a high end hotel that is frequented by business travelers. I've already been tested for Gonnorhea and Clamydia, both were negative. This is the first and only time I've ever done this, but I'm married and want to make absolutely certain I don't give my wife anything.

My questions are:

1.) I've read several forums on this and it is my impression that my risk is extremely low for HIV and other STD's, is that correct? If so, how low?
2.) In your opinion, do I need an HIV test or would you confidently say I can resume unprotected intercourse with my wife?
3.) If I choose to get a test for piece of mind, can I have 100% confidence in the 8 week antibody test?
4.) If you're answer to question #2 is yes, please explain. I've read that a test can't be 100% reliable until 3 months.

Thank you.

[Edward W Hook, MD]

Welcome to the Forum.  I will try to give you answers to your questions but even before I start, I need to inform you that there is just no way to give a person specific numerical risk assessments.  That said, let's go on to your questions:

1.  Your risk if close to zero.  the negative STD tests tell you that you did not get the most common STDs.  As far as HIV is concerned, even before testing, condom protected sex (oral or genital) is virtually no risk and not a concern.  Similarly, the risk from brief receipt of oral sex is also low.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  
2.  In my opinion there is no need for HIV testing.  there is no reason for you to abstain from unprotected sex with your wife.
3.  If you choose to be tested, you can have complete confidence in an 8 week test result.  In the past few years the tests have gotten much, much better in terms of time to positive tests. In our own practices, in the literature and in conversation with other experts, we have not found anyone who has seen a person take more than 8 weeks following exposure to develop a positive HIV test and in most cases, it takes less than 8 weeks.  


Hope these comments are helpful.  EWH

[DumE]

Thanks Doc, that certainly helps.