HIV anxiety, Risk question

I am a 31 year old hispanic male. I am uncircumcised. I have been married to the same woman for 11 years and had been faithful until 3 weeks ago. I was away on business and met a woman at a bar. We had a couple of drinks and went back to my hotel room where we talked and got physical. There was a lot of heavy petting, kissing. I performed unprotected oral sex on her for about 10 minutes. She then gave me oral sex for about a minute. When we realized neither of us had a condom we asked each other if we were clean. She told me that she had been tested for everything including HIV and herpes 3 months prior during her yearly gyno exam. Since she was the one to ask me if I had a condom it lead me to believe she doesn't usually go without. Needless to say we went ahead and had unprotected vaginal sex for about 5 minutes. Stopped for a few and went again for another 2 before I ejaculated. I don't know if it makes a difference but she was 30, white/native american, and a teacher at a local university. I realize I made a mistake and have since stopped going to bars as I don't want the same to happen and jeopardize my marriage even further.

Should I be concerned with getting tested for HIV or other STDs over this exposure?
Last week I started freaking out and started manifesting weird symptoms.(head aches, upset stomach, 1 day diarrhea, joint/muscle pains, sore throat for 2 days, what felt like fever but didn't go over 99.5 and would go down if I calmed down.) I do suffer from anxiety/depression and am under treatment for that.
I am near a place that does free HIV rapid tests and am considering it though it's only been 21 days.

[Edward W Hook, MD]

Welcome to our forum. From what you tell me this encounter was low risk for acquisition of any STD, including HIV. The characteristics of your partner, the fact that she indicated that she had recently been tested, and that she expressed an interest in using a condom all suggest that she is at low risk.  Thus I suspect she is on the low side of the 1 in 10,000 average likelihood for heterosexual American women that she has HIV.  Nonetheless, testing is always reasonable following a sexual exposure with a new partner.  When you get checked, I would urge you to be checked for other, far more common STDs like gonorrhea and chlamydia, as well as HIV.  The result of testing for gonorrhea, chlamydia and NGU will be completely reliable at this time.  

At 21 days, currently approved Rapid HIV tests detect between 50% (the figure for testing at 2 weeks) and 90% (the figure for testing at 4 weeks) of recently acquired HIV tests.  While you are waiting for your test results however, I would not worry.  Your symptoms are far, far more likely to be due to the sort of non-STD community acquired virus that we all get from time to time, perhaps amplified a bit in your case by your guilt/anxiety over the exposure.

I hope my comments are helpful.  EWH

[scaredstupid272]

Thanks for your response Dr. I figured my chances were pretty low by the numbers but I am aware that statistics are just that. I plan on getting tested for gon/chlamydia either today or tomorrow. I will be getting the rapid HIV test as well this week. Then again next week which would be week 4. I did speak with my exposure partner a few times the weeks following and she reassured me she is confident of her negative status on all STD's. Like you said, I think that the guilt/anxiety have been getting the best of me. I would just hate to be at the low end of the statistics.

[scaredstupid272]

Another related question. A week post exposure I was prescribed a five day course of amoxicillin 500mg/twice daily for a sinus infection. Would this interfere with the results for any of the STD tests?

[Edward W Hook, MD]

Understood.  Glad I could help. EWH

[scaredstupid272]

So the amoxicillin won't affect the test results for the other STD's?

[Edward W Hook, MD]

Amoxicillin might reduce the accuracy of tests for gonorrhea or chalmydia but it would not effect your HIV test.  EWH

[scaredstupid272]

Well I just got my rapid test done and it was negative, thank God. I know it's too early to know for sure but I feel a ton better.  How likely is it that someone would turn positive after a negative result at 22 days? I want to put this behind me and start living my life again soon.

[Edward W Hook, MD]

this question has been answered.  From my original answer; "At 21 days, currently approved Rapid HIV tests detect between 50% (the figure for testing at 2 weeks) and 90% (the figure for testing at 4 weeks) of recently acquired HIV tests."   EWH

[scaredstupid272]

I purchased the Home Access Express HIV kit at a local pharmacy. Took the test at the 40 day mark. I am waiting for the results as it is the weekend and it takes 1 business day. My 2 part question is about the reliability of said test. I have read a few posts where you have stated that a 6 week antibody test is very reliable nowadays. Would the same apply for this self test kit? And part 2 is: When I get my negative result, would this be good enough? Or should I wait until 3 months after exposure?
Thanks for all your help Doc.

[Edward W Hook, MD]

The Home Access tests have to pass the same benchmarks for approval by the FDA as the laboratory based tests an are about as reliable. At 6 weeks they would detect well over 95% of recent infections.  EWH