Please help- What are my risks?

[tommy805]

Hello Doctor,

Thank you for running such an informative and helpful forum.

Approximately 1 month ago I made the mistake of my life. I recently got engaged and was given a celebratory night by my friends. It my impaired state I took home a stripper. We performed protected vaginal intercourse and anal intercourse where as my condom broke in the process. I did not ejaculate in her.

I tested negative for all STD's but did experience what I thought was a UTI but have been told that it seems to be more along the along the lines or prostatitis as the urine culture was clean.

I tested negative for HIV roughly 2 1/2 weeks after exposure. It is now going on 4 1/2 weeks. As of a week and a half ago I have experienced some mild headaches, stiff neck, and oral thrush with occasional nausea. Please note that I was on antibiotics for 3 weeks (doxy, bactrim, then cipro) and I understand this could have cause my thrush. I also experience back pain which could be a result of the prostatitis. I fear that some of my symptoms could be a result of stress and anxiety but I do not know. I do have a history of anxiety. I had a rash prior to the exposure and has continued so I cannot accurately determine this is from my incident.

I managed to get in contact with the woman who insisted she has never had an STD and did not confirm her HIV status, simply stated "I have never had anything".

I will be taking the test again at 6 weeks for a conclusive result.

I have been a mess with anxiety and what i perceive as symptoms. How accurate would my 2 1/2 week test be? I understand it is not conclusive but does it cut my risk down significantly? Assuming this woman is of unknown status what type of concerns should I have?

I also elected to get a PCR test which I am waiting on. I understand this not always accurate (false positives) but if it is negative is it conclusive?

Thank you so much for your feedback.

[Edward W Hook, MD]

Welcome to the Forum.  I presume this is the same exposure that you recently exchanged information with Dr. Handsfield about.  STDs are not an issue.  I will limit my comments to issues related to HIV risk.  The risk from this exposure is low.  For starters, it is unlikely that your partner had HIV, few women in North America do, even strippers.  If she did have HIV, your risk is still low.  If the condom broke during the rectal intercourse you mention and she had HIV, the chance of getting HIV is still less than 1%, even before testing.  You tested at two weeks and had a negative test.  Typically at 2 weeks over 50% of recently acquired HIV can be detected.

So, what would a negative PCR test mean?  If you also had a test for HIV antibodies at that time that would represent conclusive evidence that you did not get HIV.  As for the PCR alone, it would be strong but not definitive evidence that you did not get HIV.

As I said, you really have little to worry about at this time.  I hope my comment will be helpful.  EWH

[tommy805]

Thank you Doctor. Your work along with Dr Handsfield's is incredibly helpful and of great service to many.

[Edward W Hook, MD]

You have unerstoo what I sai.

As for your symptoms, please ignore them.  Not only do your symptoms not suggest HIV but even "suggestive" symptoms are terrible non-specific.  Believe the tests.  EWH

[tommy805]

Thank you Doctor. Yes this has to do with the same exposure I discussed with Dr Handsfield. My concerns with HIV were not prevalent at the time as I was not experiencing any symptoms nor the same anxiety. I did elect for them to perform an antibody test at the same time as the PCR. I am expecting the results this week. The second round of testing was done exactly 28 days past the incident. To confirm, these tests should be conclusive and I can hopefully get some relief after these results?

Thanks you for your insight. It is greatly appreciated.