HIV Transmission from Pre-Ejaculate Continued

Dr. HHH,

I completely agree that it is only fair to start a new thread. My follow up comment is contained below.

Thank you for your comments above and sorry for the delay in replying. If I understand correctly, I should not be worried about the volume of precum I may have been exposed to from a half second insertion as precum is not known to transmit HIV? I have been greatly troubled by this episode for a few weeks now. I have spoken to my friend about this incident, and expressed my concern as I prepare for testing. When I asked him if I had anything to worry about, he was very open and offered that everything was fine. However, I did not point blank ask him his HIV status, but it seems he thinks he is negative. He is a white, hetero, 22 yo non drug using, male who I am friends with at college/work with. He has had a few girlfriends (college students,white) but to my knowledge he has never been tested and probably doesn't ask their STD status, as he never asked me mine. This is completely out of character for me, and was truly a half second "slip-up", we did not continue after this, and there was no ejaculation of any sort. I am probably worried because I always ask, an wonder if maybe he just doesn't think about infection because it's not brought up a lot in our small town. Am I overreacting? I feel like I should expect a negative test, but wanted your opinion. Thanks, veryworried.

[Edward W Hook, MD]

As you may know, Dr Handsfield and I share the Forum. As it turns out, I picked up your question.  FYI, while our verbiage styles vary, Dr. Handsfield and I always agree on our responses to clients.  

I have reviewed your earlier interaction with Dr. Handsfield and I fully agree with his comments, as well as your summary above- I would not worry about this exposure.  In addition to the comments already made regarding the exposure and the biological aspects of transmission, the chance that your partner had HIV is vanishingly low.  If you are having trouble overcoming your concerns, since you know this person well, my advice would be to ask him get tested.  I am confident that his test will be negative and when it is, you can be confident you were not exposed.  This would provide a more rapid answer to your concerns than waiting the 6-8 weeks it would take for your own test to be conclusive.

I hope this comment is helpful.  I urge you not to worry.  EWH

[Veryscared001]

Just an FYI, I was the thread jumper from earlier tonight, who reported. My apologies again.

[Veryscared001]

Doctor,

This exposure happened 3 weeks ago. I talked to him in passing yesterday and was about to ask whether or not he has practiced safe sex in the past, but seem to have a hard time doing this. I have learned from a mutual friend that he has had a few one night stands with college girls in our town, but do not know if protection was used. He already expressed once that he was a little worried about me because I sounded like it was really bothering me, I am afraid if I ask again he'll think I'm going crazy. I felt very reassured by your post earlier, but this new information has me slightly concerned again, so I did some research.

In our county, there are 188 people with HIV, of which only 11 are women, perhaps this shows just how rare heterosexual transmission is? Also, in 2008 our county had 7 new cases diagnosed total, not sure what the mode of transmission was in those cases. I am not sure if any of these statistics include the college students in the county either. Further in our state, only 21 white heterosexual cases were found in 2008. All of these things seem to point to the fact that heterosexual transmission is very rare, and perhaps more so among educated persons. However when I read stories on the internet of people who's partner's turn out to be positive, it starts the cycle of fear over again.

The last two days I have had a sore throat with white spots and felt very weak. Yesterday my mom who is a nurse took blood because she suspected mono, the test came back positive for mono today. I did not tell her about this exposure, as I was afraid to because it would greatly disappoint her. I feel like an idiot for having put myself at any risk at all, and feel like I am starting to beat myself up. Perhaps the mono diagnosis is also causing me more concern. I really appreciate your reassurance so far, and apologize if I am dwelling. There is just so much conflicting information on the internet. Thanks, Veryscared001.

[Edward W Hook, MD]

Not sure a response is called for here.  the data you ahve presented both shows how much you are concerned about this and verifies my earlier assessment.  No change in my assessment. EWH

[Veryscared001]

Doctor,

I just wanted to post the information about his possible one night stands to make sure that didn't change your assessment. I also thought I already had mono as a high schooler. I may ask him for more details, or perhaps wait another week and test. Hopefully negative.  Many thanks for all your help.

[Veryscared001]

Doctor,

I promise this is the last post as I can see I am probably aggravating you. The mono issue really has me worried. Does having mono twice change your evaluation or should I still expect a negative result? I am undecided at asking him to test or wait a week for my own test.

[Vance2335]

Think about it for a second, why would mono have anything to do with HIV?

[Veryscared001]

The concern was from having mono twice. I have always heard you only get it once, and some people believe that ARS could cause a false positive mono test. That was the concern.

[Edward W Hook, MD]

You have heard wrong.  Mono can be caused by several ifferent viruses, the most common of which are called Epstein-Barr Virus and CMV.  There are others as well.

It is time for this thread to end. There will be no further answers.  You have received my assessment and advice.  EWH .