High risk sex with TS professional

Dear Dr

I have had and anal sex  (top&bottom) with a TS prostitute in asia. We both used condoms and as far as I’m aware for him, he kept it on all the time, for myself I’m shore I did. We exchanged oral sex.

I had couple of symptoms which can also been found with HIV infection, sore throat for a longer period, fever but not high one and I was totally broken with the negative thoughts  . I didn’t have swollen nodes or some other symptoms.

This had happened 9 weeks ago. I have done some testing:
1. After 37 days I did blood antibody test-negative
2. After 7 weeks I did QuickOral antibody test-negative
3. After 8 weeks and 1 day I did blood anybody test-negative

I also ask him to go for a test 11 days after we had sex and it came out negative too.

As you can see I’m a paranoid person and last 2 months were hell for me. I read a lot about different % when does results become valid and a lot of times after 8 weeks is quit a high percentage.
My questions if this was a high risk what would you say is the current %?  I’m also concern because after 7 and half weeks a sever upper back  and shoulder pain occurred and it’s been there ever since but is getting better.

Thank you so much for your answers.

[Edward W Hook, MD]

Welcome to our Forum.  Your questions are questions that we deal with repeatedly on our Forum.  the starting point of my answer to you is that the exposure that you describe is zero risk for acquisition of HIV.  I say this with great confidence because of several things you have said.  these include:
- that you used condoms for the encounter you describe.  Condom protected sex is safe sex.
- that you partner tested negative for HIV 11 days after the encounter.  You cannot get HIV from a person without HIV and he does not (the chance that he was in the so-called "window period" is tiny and not worth worrying about).
- Since then you have had multiple negative HIV tests, including one at the 8 week time period when over 99% of persons who have acquired HIV will have positive tests.

Putting all of this together, you can be totally confident that you did not get HIV from the exposure you describe.  You do not need to be concerned and do not need further testing.

As far as your symptoms are concerned and consistent with what I have just said to you above, you do not need to worry at all that your symptoms may be due to the ARS from the exposure you describe.  This is not possible, both for all of the reasons I have outlined above, as well as because the onset of these symptoms has occurred far after the ARS would be expected to occur if there was any risk.  

I hope these comments are helpful to you.  You have no reason to worry further about the exposure you describe.  EWH

[zaskrbljen]

Dear Dr.

Thank you very much for your answer, your comments were very useful. I did browse the archives looking for similar cases but as for many others I think my situation is special :)

I know that you are a very busy man and I don’t want to take too much of your time, so that you can also answer and help other people but please allow me to ask you two more questions.

In your answers to other people you are mentioning different % for antibody detection 8 weeks after the exposer , sometimes is 95% other 99%.

Two questions:
1. Why the different %?
2. What kind of people usually don’t develop antibodies in 8 weeks time and can’t be discovered with antibody tests?

Thank you very much for your answer and for helping me and all the other people.

Regards.

[Edward W Hook, MD]

If I have mentioned different proportions of positive results for the same time points, I apologize.  I typically check  to make sure that he numbers I provide are the correct ones.

At 6 weeks the proportion of infected persons who have positive tests is over 95%.  Two weeks later, at 8 weeks, that figure increases to be more than 99%.

The only group who are really at risk for not developing positive antibody tests at 8 weeks are those who may have taken therapy for HIV in efforts to prevent infection or perhaps, persons with chronic immunosuppression such as cancer chemotherapy at the time they are beginning to produce antibodies.  Virtually everyone else produces antibodies at 8 weeks and 8 week results should be accepted as  being highly reliable.  In your case, please believe your test results--they are reliable.  EWH

[zaskrbljen]

Thank you very much Dr. for your kind answers. I understand things now much better. For surelly I'll go and test my self after 12 weeks but your answers have helped me to move on.

Good luck and thank you again for doing such a great work.