Streetwalker - Belize

[dafodil]

Hello doctors I hope to get some clarification from you guys. I was in Belize (South America) earlier in 2008. I hooked up with a STREET WALKER (not a call girl but the actual prostitutes walking along the streets). It's to my understanding these women are at the highest risk of all prostitutes for STI's/HIV. and accompanied with the high rates of HIV in Belize I am worried...

I had receptive oral sex and gave her anal sex all unprotected... I am not circumcised...

I got tested after exposure 2 months for all STI's and HIV with RNA & ELISA and it was negative...
Again at 4.5 months I got tested for all STI's and HIV again with RNA & ELISA and it was negative...
Also @ 14 weeks I got a negative test for HEP C and I have the shots for A&B....

It's been almost 6-7 months now since then and I don't feel anything weird in my body... Before the experience I worked out everyday leading to the vacation so I'm sure my immune system was in good health..

Questions...
1) I have been told to stop testing for HIV/sti's. Am I 100% conclusive negative?
2) I heard getting HEP C and HIV together can make testing unreliable? Is my 14 week negative HEP C test reliable? Was I even at risk for HEP C??
3) is there any way to be negative on all these test and still have something?
4) should i go in for the 6 month test or am I ok??
5) I have been telling my self all along that I'm sure I got something, and never really contemplated the idea of not getting anything from such a risky encounter... Is it really possible I got so lucky to not get anything?

[Edward W Hook, MD]

1. Testing is recommended on an annual basis for persons who have new or multiple partners over that period or whose partners may have other partners.  If you are not sexually acitve or are in a monogomous relationshiop with a partner known to be HIV negative, you do not need annual testing.
2.  You are not infected and have nothing to worry about from the exposure you describe.  EWH

[dafodil]

Thanks for the response... I know it was a high risk I think I put my self at almost as high risk as I could when it comes to having sex with women... I don't know what it is with some Latin women but it seems they prefer anal sex to vaginal sex I'm not sure if it has something to do with the culture...

I also don't know why the hell I was so stupid I should have used a condom I just never use them because I don't like how it feels but that's a stupid excuse and poor reason not to use them. And I guess I definitely lucked out this time, thankfully.

Last couple of questions...

1) I'm planning on never putting myself at risk like this again I can't take the anxiety of testing, wondering and all the rest of the stuff that comes with this territory. Now they say to get tested every year do I really need to do that  considering I know now I don't have anything??

2) Last question, so 100% I don't have HIV from this exposure correct? It's like being pregnant right? If I got it from her then one of the test's I took would have 100% picked it up right?

[Edward W Hook, MD]

I will look at your specific questions in just a moment but before I do, let me reassure you that, despite your relatively high risk exposure (and it was, particularly the rectal sex), you do not have HIV or hepatitis C.  You do not need further testing for either of these infections related to the exposure you describe.  Now for your questions.

1.  See above. All of your results are conclusive.
2.  This is incorrect.  Each of the tests are reliable.  furthermore, just as an FYI, sexual transmission of hepatitis C is incredibly rare.  Far rarer than transmission of hepatitis B, HIV, or other STDs.
3.  No, you are not infected
4.  No, you do not need further testing.
5.  Get over your concerns, you did not get infected from the exposure you describe.
EWH