Question about possible exposure

Hi there,
Thank you so much for your time, this site is wonderful.
I know I posted a similar post a couple of years ago, but I recently had another possible exposure. I am a female who had unprotected vaginal and anal sex with a male. This was on Aug 16 2010.  I know you said before that the chances of getting HIV with vaginal sex was 1 in 1000 (assuming the person is HIV positive.) You also stated that catching HIV from receptive anal intercourse was 1 in 100. My questions are -
Are the chances of catching HIV through receptive anal intercourse 1 in 100 assuming the person HIV positive?
If I go to Planned Parenthood on September 14 2010 to get a HIV test, how accurate are those results? Would you recommend getting tested again at 6 weeks, 8 weeks, 3 months, and then 6 months? And how accurate would they be at some times?
Do you think my risk of HIV is low?
Thanks again for your time. I know I should probably get all my answers from what you told me two years ago, but I guess when anxiety is high, reassurance is needed sometimes. Thanks again. You guys are awesome.

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.  You got me this time.  Dr. Hook and I have somewhat different styles, but the substance of our replies is always pretty much identical.  I agree with everything he said in your thread 2 years ago.

The odds of catching HIV that you quote are for exposures with an infected partner.  The odds any particular heterosexual male has HIV (in the US) are no higher than 1 in 1,000 (although higher in African Americans).

As for when to test, you are asking exactly the same questions as you did 2 years ago.  As you predicted, the answers are the same.  In newly acquired HIV infections, the standard antibody tests pick up about 90% of infections by 4 weeks, almost 99% at 6 weeks, and 100% by 3 months.  Or, if Planned Parenthood offers the newly approved Combo test (which checks for both HIV antibody and for p24 antigen, a marker of the virus itself), that test is postive virtually 100% of the time by 4 weeks.  The combo test was approved for marketing in the US only a few weeks ago, and is not yet widely available.

In general, I recommend against getting HIV tested after individual exposure events, unless particularly high risk -- e.g. a known infected partner, sex with an injection drug user, etc.  Instead, sexually active persons (outside mutually monogamous relationships) should just have a routine tests for HIV and STDs at regular intervals, like once every 1-3 years.  But assuming you go ahead with plans to get tested at this time, I recommend a single antibody test 6 weeks after the sexual exposure or a combo test at 4 weeks.

Best regards--  HHH, MD

[Lea239]

Oh, and when I say you answered my questions a couple of years ago and you stated this and that, you is Edward W Hook MD.... but answers from all are greatly appreciated!!

Thanks again.

[Lea239]

Hi there,

Thanks for your response. I forgot to mention that he is a heterosexual male who has never used needles (well, that's what he told me).  I asked him to go to Planned Parenthood to get tested. This was on Aug 17. I went with him, and he got tested  for HIV, Chlamydia, Syphilis, and Gonorrhea. They gave him a rapid HIV test. The HIV test was negative, and a week or so later the other test came back negative. He told me his other possible exposures this year where sometime in January, the end of May and on Thursday Aug 12 (unprotected sex with a woman).
With the information you've told me,  the only possible HIV exposure of his (assuming he is telling me the truth) that was not ruled out by the rapid HIV test he took on Ag 17, would be the unprotected sex with a woman he had on Aug 12? With this information, do you think my risk of catching HIV from him is low?
I hope I'm not being too confusing or annoying... Anxiety makes me tend to try to be as precise as can be, but it seems to make me sound like an idiot!

Thanks again.

[Lea239]

Oh, and you said the odds of any particular heterosexual male having HIV was 1 in 1000. I thought I read somewhere that it was 1 in 10,000. I'm assuming the 1 in 10,000 is inaccurate?

Thanks again - I was also wondering the best way to donate to HIV prevention or studies. Can I do that thru the forum?

[H. Hunter Handsfield, M.D.]

It is splitting hairs to worry about the difference between 1 in 1000 versus 1 in 10,000.  In some communities it could be 1 in a few hundred, in others 1 in 20,000.

"With this information, do you think my risk of catching HIV from him is low?"  Yes, extraordinarily low.  But it seems obvious my reassurance isn't helping.  Like most anxiety disorders, this one is not amenable to facts and reasoned analysis; there is always a "yes, but" or "what if" question, usually several of them.  (And I do believe the extent of your concern amounts to a psychological disorder -- most people don't react the way you have to such situations!)

That will have to be my last comment.  Feel free to post your negative HIV test result when you get it, if you will find it reassuring for me to affirm that you indeed don't have HIV.  But only one result, please!

Really, try to mellow out about this.  You're not likely to be the first person in the several year history of this forum to report an exposure that concerned them who actually turned out to catch HIV.  That's right -- it has never happened on this forum.  And the first time it does, it isn't likely to come from someone with a virtually zero risk exposure!

[Lea239]

Thank you!

[Lea239]

Hey there,

Me Again! Well, I went to Planned Parenthood today (9/27/10) and my Rapid HIV blood test was negative. Thank God! Do you think this negative result is conclusive for the exposure  I described to you? The possible exposure was on 8/16/10.

Thanks again for your time.

[H. Hunter Handsfield, M.D.]

The result is conclusive.  You don't have HIV and can stop worrying about it.