Important Question

[BeautyBeast2111]

Female (in late twenties- Living in southeastern Virginia) that had couple brief unprotected encounters with male 14 years my senior.  Didn't have unprotected sex to completion either time.  First time - did not begin protected, but stopped after a couple minutes because he lost erection. Started few minutes later with condom.  Second time - roughly a month after first -- also began unprotected, but stopped because it began to hurt (no lubrication). Started again with lubricated condom.  Didn't worry too much, but later asked about STDs/HIV, he indicated that he "thinks" he last tested last year and all was negative.  Him "thinking" was not too reassuring to me.  Took Home Access test on the 22nd (of this month) - negative (last tested negative in May).  Went to planned parenthood yesterday for full panel STD screening (last tested negative for STDs in July) and yet another HIV test (via blood draw)  I'm not sure if he's circumcised. (I'm not sure of his race-- I think he may be black because of his complexion and facial structure -- and bald head--if race even matters) I test every year -- a couple years back had a false positive -- which ended up negative after much stress and anxiety -- which also leaves me a bit anxious about this round of tests and possible results.  Could I possibly be in the "window period"?  What are my results likely to be? Waiting on results is nerve wrecking.    

Thanks Doctor!

[Edward W Hook, MD]

there is no need for further testing.  the Duo (combined HIV p24/HIV antibody) tests provide definitive results at 4 weeks,  You can be confident that you did not get HIV.  Take care.  EWH

[BeautyBeast2111]

Home Access 4 weeks after 1st approximately 1 week after second: Negative
Home Access 6 weeks after 1st approximately 2 weeks after second: Negative
Planned Parenthood Duo: 6 weeks after 1st 2 weeks after second:
Negative.

I plan to put this behind me and just confirm a negative result at 8 weeks.  Would u recommend this?

[Edward W Hook, MD]

Yes you can post your test results/

Until then, last answer.  You are correct that an uprotected encounter is an unprotected encounter however there are immeasurable factors which are also likely to influence the risk of transmission and exposure is most probably one of them. Thus if you start to have sex and decide to use a condom, do so, don't wait for completion.  Better to start with a condom however.  

No further comments unless you need a brief comment on your test results.  EWH

[BeautyBeast2111]

When I receive my results, can I report back to you so that you can provide me with feedback?

And one final question--- I have also read that an unprotected exposure is an unprotected exposure.  Suppose two people having unprotected sex and 2-3 minute into the act either one or the other realizes that it is a bad idea to be having sex without a condom---would it be best for them to stop and continue with a condom?  Or since an unprotected encounter is an unprotected encounter, should they finish until completion?

Thanks!

[Edward W Hook, MD]

I'm sorry you are having to go through this.  The odds of you having HIV are very, very low.   ...and yes, Dr. Handsfield's statement is correct.  Try not to worry.  EWH

[BeautyBeast2111]

Just to add, I couldnt get him to test -- not because he didnt want to, but because he's out of town right now visiting family.

On a separate note, in a few threads I've read (similar to my situation) you advised the poster that you expect them to test negative, or that their situation was low risk.  They eased my anxiety a bit.  

And this post peaked my interest:

http://www.medhelp.org/posts/HIV---Prevention/3rd-vs-4th-gen/show/1782715

Do you agree with Dr. HHH about no one in the forum reporting a positive test and his take on who might report a positive test in the forum (if and when that occurs).  This gives me a glimmer of hope.  I apologize for bombarding you with so much "stuff" but I am just trying to gather as much info as possible as I am very ignorant regarding this subject.  

[BeautyBeast2111]

I mean 6 weeks.  

[BeautyBeast2111]

Couldn't get him to test ... which doesn't make me feel any better about the situation --- it actually makes me feel worse.  I'm about to be in tears.  
Guess I have to wait 10 more weeks for an accurate result.

Doc, in all likelihood do things look good for me?  

[Edward W Hook, MD]

The DUO tests provide definitve results art 4 weeks.  Otherwise standard HIV antibody tests don't give definitive results until 8 weeks.  At 2 weeks each test detects over 50% of recent infections.

BTW, if you can get him to tet now and he is negative, there is no need to worryfurther- this is an alternate approach.  EWH

[BeautyBeast2111]

It has only been about two weeks since the last exposure.  I think Planned Parenthood uses the DUO tests.  How accurate are they?

My risk of infection is probably quite low? Can I rest just a little easier with that being said?  

[Edward W Hook, MD]

Welcome to our Forum. I will try to help.  It will be a bit difficult for me to provide you with good estimates of the accuracy of your HIV tests as it is difficult for me to determine just how long it has been since your last exposure.  If you provide this information I can annotate the comments I am about to take.

I can understand how is "thinking" he was last tested a year ago is too imprecise to be comforting- I agree.  The fact is, you have now been exposed on two occasions to a man of unknown HIV status.   The data on HIV transmission probabilities do not distinguish based on whether or not ejaculation has occurred. While ejaculation no doubt leads to exposure to more virus, we also know that there is virus in pre-ejaculatory fluid and therefore if your partner was infected, you should still assume that there is some, small risk associated with these exposures.  The average figure is that, IF your partner was infected, the risk for transmission is, on average, 1 infection per 1000 exposures.  Gender makes little difference (unlike other STDs where male to female transmission is more likely than female to male transmission).  Thus, after two exposures, your risk is about 1 in 500, again, IF HE WAS INFECTED (which is unlikely- few heterosexual men are).  

Assessment for other STDs at any time more than 3 days after your exposure will provide accurate information., For HIV however, you'll need to wait until 8 weeks after an exposure to be certain that you were not infected.

All in all, your risk of infection is probably quite low but testing . both for STDs and HIV is reasonable.  EWH

[BeautyBeast2111]

Meant to include this in my initial post.  Obviously, i wasn't exposed to his ejaculate; but there might have been pre-ejaculate.  What is the risk exposure for that.  Secondly, I've noticed that most of your questions are from men:  Does your advice and assessment apply to both men and women and finally.  I'm afraid to have sex with my regular partner--boyfriend (this all happened during a brief separation) and he's becoming a bit suspicious ... would it be wise to continue sex with him?