Insti Rapid Test - 2 weeks after

[negative101]

Dear Doctor:

Id like to say thank you for the service you provide, its a great source of information.
Im a white male in my mid 20s that lives in Ontario, Canada. From my understanding, our statistics are very similar to the United States.

13 days ago, I had unprotected sex with a woman. This involved oral (both given and taken) as well as unprotected sex for about 10minutes, until I put a condom on. Stupid decision, I know.

The woman is in her mid 20s, is white, not a drug user, and has no history of being with bi sexual males. She tells me she got tested recently and everything came back negative... However, Im rely more so on my own tests rather than her telling me shes had one done.

3 days after the exposure, I got a Insti Rapid Test (which took about 1 minute for its result). It came back negative.
Today, 13 days post exposure, I did the same test, and again, it was negative.

My specific questions are below:

1) In your opinion, what are the chances that I could have contracted HIV? I should mention that I am a circumsized male whos generally in good health.

2) I understand it takes upwards of 6 weeks for tests to become positive, however, is my Insti rapid test at 13 days worth anything? By worth, I simply mean does it reduce my risks? Ive read elsewhere that 50% of people test positive by this time -- is this true?

3) The lady at the clinic kept repeating the 3 month rule and how it could take that long for the antibody to develop. I know youve stated many times that 6 weeks is concluive. My question is, does the Insti test require additional time, or is the nurse just suggesting 3 months as per the old guidelines?

4) The only symptom I have at the moment is constant nausea. Ive had it for about 4 days -- roughly between 9-13 days after exposure. I know this is one of the symptoms of anxiety, but am curious to know whether you think it could be an HIV symptom.

[negative101]

Doctor,

quick follow up question.
Its been about 17 days now, and I have a herpes outbreak. I had the herpes from before, but am wondering if a herpes outbreak 2 weeks after exposure is a potential symptom of HIV?

[Edward W Hook, MD]

I'm sure she was well educated on safe sex and testing.  As I said above however, I suspect she was telling yout hte "party line" which in fact is overly conservative.  EWH

[Edward W Hook, MD]

No, this is an unfortunate coincidence and in no way suggests that you have acquired HIV. EWH

[Edward W Hook, MD]

Thanks. No change in my assessment. EWH

[negative101]

sorry... for clarification, I meant the girl I had the unsafe sexual run in with was also a nurse lol

[negative101]

Thank you Doctor.

For additional reassurance, the woman in question was a nurse -- I assume she'd be well educated on safe sex and getting tested.

I will be sure to follow up for an additional test at 6 weeks just for personal reassurance, although I fully expect them to be negative.

[Edward W Hook, MD]

Welcome to the Forum.  I'll be happy to try to help.  You are correct that the risk for HIV is Canada is similar to the reported for the U.S.  Your risk from the exposure you describe is tiny. Mathematically, before you consider issues like test results, I can tell you that the statistical likelihood that a Caucasian woman in North America, who is not an IV  drug user, has HIV is about 1 in 10,000. Then, the risk of HIV from a single episode of unprotected intercourse is about 1 in 1,000. Thus your risk is mathematically less than 1 in 10 million.  When you factor in that she said she had been tested and was negative (most people tell the truth), the risk is even lower.  Finally, at 13 days post exposure, currently available rapid tests would detect over half of recently acquired HIV infection.  

Bottom line- you have almost nothing to worry about. (On the other hand, your risk for other STDs, chlamydia, NGU, gonorrhea) is a bit higher- I suggest you get checked for more usual STDs if you have not already).

Finally, regarding test performance, the counselor you spoke with give you the party line. it is overly conservative.  I know of no expert who has seen anyone who took more than 8 weeks at the outside to develop HIV in several years, unless they were taking anti-HIV medication in an unsuccessful effort to avoid infection.

I hope these comments are helpful and reassuring.  Your risk in very, very small. EWH