Need Advice :)

[jay251]

Hi there, about 4 and half weeks ago i did the most stupiedest thing while intoxicated on holiday in Czech republic. I lost my viriginity to a prostitute in a brothel. I deeply regret it. I engaged in unprotected vaginal and anal sex for about 5 to 10 minutes. I know unprotected anal carries a high risk. I have been tested 5 days post exposure for stds and HIV in my local GUM clinic and was negative. I would like to know the following. 1. What are my chances of been infected with hiv after this exposure. 2. Is HIV common within sex workers? I haven't so far had any symptoms related to any stds or hiv. I intend to re test at the 6 week mark and once again at the 3 month mark. The woman i had sex with did look healthy, however i know you cannot tell if someone has hiv just by looking at them. Thank you for you time.

[Edward W Hook, MD]

Welcome to the Forum.  I will address your questions, expanding a bit on the answers already provided from members of the HIV Prevention Community.  First let's examine your risks, then we'll discuss a recommended course of action:

Your risks.  Before we talk about risks related to specific sex acts, please realize that most commercial sex workers (CSWs) do not have HIV. the  likelihood that your partner had HIV is low.  In addition, different sex acts have different risk associated with them, if your partner did have infection.  The risk, if your partner had HIV, for vaginal sex is 1 infection per 1,000 exposure while the risk for anal intercourse is about 1 infection per 100 exposures.  Thus, considering these facts, IF your partner had HIV (see above - unlikely), your risk for HIV is slightly more than 1%.

What to do.  Get yourself tested for HIV.  At 2 weeks about half of persons who have just acquired HIV have positive antibody tests, at 4 weeks, about 90% have positive tests and at 12 weeks virtually all who are infected will have positive tests.  If you are tested with one of the Duo, combined antigen-antibody tests, the proportion of infections detected is even higher.  Thus I would test, perhaps at 2 weeks, certainly at 4 weeks and then at 12 weeks.  With each negative test result it becomes less and less likely that you have HIV.

Finally, assuming that you did not get HIV from this mistake, it is time for you to plan to use condoms in the future.

I hope these comments help.  EWH

[jay251]

Hi Doctor. Just to let you know i tested negative at the 6 week and 3 day mark post exposure in my local GUM clinic here in the UK. The doctor i spoke to told me results take 2 weeks to arrive it now is close to 3 weeks and still have heard nothing from the clinic ( They said they only ring if something is wrong so i am suspecting i am negative.) I have a few follow up questions-

1. I read that you and Dr. Handsfield have never seen anyone who tested negative at 6 weeks then turn positive at 12. Does this still stand or have u since seen someone test positive at 12 weeks?

2. How reliable is my test at 6 weeks? Do i stand a good change of been overall negative?

3. I dont know which test was preformed on me, meaning unsure of what generation, i read that UK GUM clinics will be using 4th generations or atleast 3rd generations. I wanted to know if i was tested with a more older generation test would this make my 6 week negative not as strong? ( the test was a blood test)

I would just like to add i thank you deeply for the work you do and really appreciate you advice, without i dont know how i would of coped these last 2 months so thank you very much.

[Edward W Hook, MD]

I stand by the answers you have recieved and will  not repeat them.  The answers to each of the questions you asked has been answered. The answers are the same.  EWH