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HIV fears, partner tested negative but worried about window period
Been dating the same guy for the past 2 1/2 months (Both gay men). When we started dating he said he had recently tested HIV neg. While dating we had one accident where I entered him briefly. In future dates, he showed add'l interest in having unprotected sex. We had numerous conversations and he said I was his only sexual partner. In the past week, we decided to be exclusive boyfriends. The day after we had unprotected anal where I inserted (4/13). After, I freaked out. I told him I was out of my comfort zone. We went together and got tested on (4/17) and both tested neg. We then discussed the window period and both said we were out of it and he wanted to have unprotected sex and I should trust him that he has only been with me. I told him I wanted to wait until I was more comfortable. We fought. After much discussion and add’l assurances I am the only person he has been with in the past 3 mos. I agreed I should trust him and we had unprotected anal on 4/19 – I inserted. However, I am still freaking out. I am fearful we aren’t really out of the window. He was getting texts from other men while we dated. I have decided I need to hold off on unprotected sex for at least 3 months until we have another HIV test. Sadly, this could destroy the relationship, but I need to be comfortable having. However, I am so upset at myself for having unprotected sex when I wasn't ready for it. How worried should I be about being positive? Also, I started PEP meds after the 4/13 incident, but stopped when I thought I was ready on the 4/19 incident for over 24 hours. I started them again about 34 hours after the 4/19 incident. I know this will not help me for the 4/13 incident and the brief penetration, but maybe it will for the 4/19 incident. I know I will additional meds from the doctor for a full 28 days. How likely do you think it is that I am infected? We got tested at Whitman Walker in DC where they said their tests have been showing pos results sooner that West Blot.
MEDICAL PROFESSIONAL
I always thought that neither you nor your partner needed any further testing and that remains my view. I see no need for any more HIV testing ever, as long as the two of you have an exclusively monogmaous relationship.
However, you should be aware that one downside of PEP is that in theory, it prolongs the window period. Although how important this really is (in the era of p24 and RNA/DNA testing) isn't known, many experts still recommend waiting 6 months for a definitive test result, in case infection occurs despite PEP. So if you want an officially negative result after taking PEP, don't be surprised if WWC recommends waiting that long. Don't misunderstand: I don't believe you were at risk and didn't need PEP, and my main advice is that you discuss stopping it with WWC. But if you follow through with your "extreme phobia" concerns and "taking the highest precautions" before resuming sex with your new partner, that might not happen until October.
That's all for this thread. Good luck with it all.
However, you should be aware that one downside of PEP is that in theory, it prolongs the window period. Although how important this really is (in the era of p24 and RNA/DNA testing) isn't known, many experts still recommend waiting 6 months for a definitive test result, in case infection occurs despite PEP. So if you want an officially negative result after taking PEP, don't be surprised if WWC recommends waiting that long. Don't misunderstand: I don't believe you were at risk and didn't need PEP, and my main advice is that you discuss stopping it with WWC. But if you follow through with your "extreme phobia" concerns and "taking the highest precautions" before resuming sex with your new partner, that might not happen until October.
That's all for this thread. Good luck with it all.
Thank you doctor for your guidance. I want to make sure I am taking the highest precautions before exposing myself to a potentially life changing virus. I have an extreme phobia of HIV and don't to find myself regretful of my actions later. Therefore, in your professional opinion would you recommend that my boyfriend or I need additional HIV testing before engaging in unprotected anal sex? We are in an (rather new) exclusive, non-open relationship. And if so, how long of a period should we wait until such testing would be conclusive? Does the window need to be closed?
MEDICAL PROFESSIONAL
Welcome to the forum.
Your concerns really aren't very rational. You give strong evidence your new partner does not have HIV. I can't judge whether or not he is lying about other recent exposures -- only you can do that. But most people don't behave that way. And the odds of catching HIV from any single exposure is one in several hundred, tops -- and that's for the highest risk sexual exposures, such as receptive anal sex (bottom). And you'd also have so assume that such a partner was himself HIV infected.
Adding up these factors -- the chance your partner was lying, the odds that unknown recent partner of his had HIV, the chance of transmission if he did, that if all these things happened your partner was in the window perid when last tested, and that on top of all that, the chance you were infected yourself -- comes to an astronomically low chance. Zero for all practical purposes.
Therefore, I believe it was a mistake for you to start PEP. If you accurately described the sequence of events, I find it very surprising that such an expert clinic as Whitman Walker agreed to PEP. Also, from what you say, it appears you have jeopardized a potentially promising relationship for no good reason -- not only no good reason from an HIV prevention standpoint, but perhaps also because of the distrust you displayed toward your partner.
My advice is that you return to WWC and re-discuss whether to continue or stop PEP. They'll probably say you should continue, but in any case follow their advice. You could consider printing out this thread as a framework for discussing it with them.
Regards-- HHH, MD
Your concerns really aren't very rational. You give strong evidence your new partner does not have HIV. I can't judge whether or not he is lying about other recent exposures -- only you can do that. But most people don't behave that way. And the odds of catching HIV from any single exposure is one in several hundred, tops -- and that's for the highest risk sexual exposures, such as receptive anal sex (bottom). And you'd also have so assume that such a partner was himself HIV infected.
Adding up these factors -- the chance your partner was lying, the odds that unknown recent partner of his had HIV, the chance of transmission if he did, that if all these things happened your partner was in the window perid when last tested, and that on top of all that, the chance you were infected yourself -- comes to an astronomically low chance. Zero for all practical purposes.
Therefore, I believe it was a mistake for you to start PEP. If you accurately described the sequence of events, I find it very surprising that such an expert clinic as Whitman Walker agreed to PEP. Also, from what you say, it appears you have jeopardized a potentially promising relationship for no good reason -- not only no good reason from an HIV prevention standpoint, but perhaps also because of the distrust you displayed toward your partner.
My advice is that you return to WWC and re-discuss whether to continue or stop PEP. They'll probably say you should continue, but in any case follow their advice. You could consider printing out this thread as a framework for discussing it with them.
Regards-- HHH, MD
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