Please advise

Dear Mr. Handsfield,

I have a question for you. I am sorry if you have already answered this question in the past but I am just really worried and this is all I think about everyday.

I (male) had unprotected vaginal intercourse with a massage parlor woman on 2/22/08 for about 4-5 minutes total.

1. I was wondering when I should get tested to feel confident I don't have HIV. How many times should I get tested?

2. What are my chances of getting HIV considering this action? Is it low?

3. When should I experience the ARS symptoms assuming I get them?

[Edward W Hook, MD]

These questions have been answered numerous times.  I will answer them briefly, but I also recommend you read other posts on this site for additional detail and to see that my answers are consistent with the answers we give many other people.

1.  If your partner was infected (and odds are she was not), chances that you got HIV are less than 1 in 1000.  A HIV test at 6 weeks will provide you with 95% confidence that you did not get HIV from the experience you describe (in other words, over 95% of tests that are going to be positive will be).  At 8 weeks, the test results will provide 90-99% confidence.
2.  See above- very low
3.  The ARS typically begins about 2 weeks after exposure.  You will not get ARS.  Please look at other posts. If you read 10 posts you will find that we have told others that symptoms are unreliable indicators of infection in about 7 of our replies.

Hope this helps.  EWH

[baller99]

So do you recommend getting tests at 6, 8, and 12 weeks and be done with it? Also are the odds low because it was female to male transmission?

[Edward W Hook, MD]

You decide.  From my perspective, after the 8 weeks test in your situation your risks are sufficiently low that I would stop there.  Certainly no testing is warranted beyond 12 weeks if you cannot get over your insecurities after the eight week result comes back negative.

Gender has less to do with risk than the type of exposure.  The odds are low because it was vaginal intercourse, single episode..  The odds are higher with rectal sex (about 1 in 100) and lower for oral (1 in 1000 or less).  EWH

[baller99]

So if you were in my situation would you stop after 8 weeks?

[Edward W Hook, MD]

Yes I would.

And BTW, I made an error in my earlier post when I quoted estimates for aquiring HIV through oral sex.  I suggested the chance was one in 1000 whenI hsould have indicated the estimate is actually 1 in 10,000.  Sorry. EWH

[baller99]

Thanks for the clarification. Last question was, is there even a need to get tested since it was a one time unprotected vaginal exposure for about 3-4 mins. and you said the chances I have hiv are low and it has been about 10 days and I haven't had any symptoms up to this point.

[Edward W Hook, MD]

I answered the question.  No you do not need further testing.  EWH

[baller99]

I meant do I need to get tested at all?

[Edward W Hook, MD]

NO!  EWH

[baller99]

Thanks a lot Doc for your help. I am going to be stress free now and not get tested and worry about this!

[baller99]

Hi I have a strep throat after 18 days, but no fever, or rash. Do you think this is a sign of HIV? Please help.

[Edward W Hook, MD]

Of course not, what a silly question.  EWH

[Edward W Hook, MD]

Of course not, what a silly question.  EWH

[baller99]

Hi Dr. Hook, sorry, I was just concerned because I thought you get strep throat because of a weak immune system which HIV causes. I'm just worried.

[baller99]

Hi,

I got tested at 25 days and it was negative. How accurate is this given my situation?

[Edward W Hook, MD]

About half of tests that will be positive become positive by two weeks, at four weeks this rises to 85-90%.  EWH

[baller99]

Dear Mr. Hook,

Based on your above statement after 25 days negative test that I had, since I have a low risk of one time unprotected vaginal sex with female, I should consider this test as conclusive. Is this correct?? Sorry I am not tying to bug you. I am just waiting for your expert opinion so I can put this past me once and for all since I'm very worried.

[Edward W Hook, MD]

I think you are fine. I doubt that you needed the first test.  EWH

[baller99]

Thank you!

[baller99]

Doc, just out of curiosity how many people test positive for HIV after 25 days is it around 85-90% as you mentioned or little less since its not exactly 4 weeks. Take care.

[baller99]

Dear Dr. Hook, Can you please answer my last question above about how accurate the HIV negative test is after 25 days, because the lady who gave me the test said it won't pick up anything until atleast 6 weeks. Thanks a lot.

[Edward W Hook, MD]

I have the feeling we're going round and round here.  There are not day by day data on the positivity rates for HIV tests.  the average time to a positive test is now in the range of two weeks.  Since this is hte avearage time that means that there are a substantial number of tests that do not become positive in that period.  As I said in my orinal answer, A HIV test at 6 weeks will provide you with 95% confidence that you did not get HIV from the experience you describe (in other words, over 95% of tests that are going to be positive will be).  At 8 weeks, the test results will provide 98-99% confidence. (I fixed a typo that was in the original answer, sorry).  EWH