Testing after a rape

[jenn8283]

I was raped six weeks ago. A man broke into my house and raped me while I was sleeping. I woke to him yell profane words at me and told me he gave me hiv. I took a six week hiv test today. Two weeks after the rape I was not sure if he came back and raped me again b/c my clothes were on a little different and I had a lot of wetness.

My question is the six week test conclusive even if i might have been violated two weeks after the first incodent?

[H. Hunter Handsfield, M.D.]

All I can say is that a test 6 weeks after the last exposure is close to 100% certain.  However, after sexual assault, most authorities recommend a final test 3 months after the event.

You're the only one who can judge whether or not you were sexually assaulted a second time.  Just be sure you are tested a final time at least 3 months after the last possible exposure.  But in the meantime, the negative result 6 weeks after the first event (possibly only 4 weeks after a second event) still is highly reassuring.

You need to be tested for other STDs as well, if that hasn't been done.

HHH, MD

[skerdstraght68]

Two weeks after the rape I was not sure if he came back and raped me again b/c my clothes were on a little different and I had a lot of wetness.

You're not sure????  I doubt anyone sleeps through a rape..

[jenn8283]

I doubt anything happened to me two weeks after the rape but I wanted to be sure that if anything did happen the six week test covered it. I take kolonopin that makes me sleep really deep so yes, it's possible that something happened again.

[jeremy_0808]

Hello Dr
I'm new in this forum. After reading many threads i'm a little confused about your answers.
You recommend in this thread a 3 month test. However in your previous answers you said 6-8 weeks are enough.
For example: in a thread from 28/10 you say "You do not need HIV testing at 12 and 24 weeks; a single test at 6-8 weeks would be sufficient."
How can a rape be so different from any other sexual exposures?
Please answer me as I'm approaching my 6 week mark and obviously i'm under a lot of pressure.
Thank you very much

[H. Hunter Handsfield, M.D.]

6-8 weeks is fine for rape as well as anything else. However, so many authorities still recommend 3 months following rape, that it is less confusing to simply go with the flow in that circumstance.

The higher the risk, the more important to have a late test at say 3 months.  This has been discussed in detail; search the archives for "time to positive HIV test" and "HIV diagnosis".

HHH, MD

[jeremy_0808]

Thank you doctor for your quick reply.
I did search in the archives but couldn't find what's different about rape.
What do you mean by saying "The higher the risk, the more important to have a late test at say 3 months"?
I'm sorry if it seems that i'm repeating my question but i just couldn't understand why the risk is higher in rape even after searching the archives.
Moreover, if tests are indeed conclusive after 6-8 weeks why would i have to test after 3 months?
Should i wait 3 months to get tested?
Once again- thank you very much.

[sparkeler]

I'm so sorry to hear of your tragic experience.  All I kept thinking when readin your post was why didn't you go to the emergency room after he raped you?  Especially after cruely stated he gave you hiv.  I would think that would warrant PEP.  Anyway for one time exposure, it's like 1/1000 chance he passed it on to you (if even did have hiv.)  I will definatly keep you in my thoughts and keep my fingers crossed.  Did they catch this guy?  I'm very disgusted at this whole situation.

[o_g]

Yikes!!!!!That happens to be a million dollar question. I am willing to spend 3/4th of my net worth if someone can answer that. If only Einstein was alive :-)

P.S: I know I have lost it

[jenn8283]

Is the 3 month test necessary. You later wrote that 6-8 weeks is usually fine for a rape.

[H. Hunter Handsfield, M.D.]

OK, here it is again (for at least the 10th time).  

Assume a low risk exposure, like a typical heterosexual exposure with a partner of unknown (but probably negative) HIV status.  Say the odds someone acquired HIV were 1 chance in 100,000.  Now assume a test is 95% accurate at 4 weeks and 99.9% accurate at 3 months.  After a negative test at 4 weeks, the odds the person has HIV (despite the test result) is 0.00001 x 0.05 = 0.0000005.  That's 5 in 10 million, or once chance in 2 million.  That's so low to be considered zero.  (It's 75 time LESS than the lifetime chance of someone living in the US being killed by a lightning strike!)

Now assume a very high risk exposure, like a gay man who has unprotected anal sex with a known-infected partner (or being raped by an infected man).  The odds of infection might be 1%, i.e. 1 in 100.  Test negative at 4 weeks.  The odds the person has HIV despite the negative test are 0.01 x 0.05 - 0.0005.  That's 1 chance in 2000.  Pretty low, and the test result is reassuring.  But not nearly reassuring enough; most people will not accept a 1 in 2000 risk of being infected an not knowing it.  Therefore, that person needs another test at 3 months.  At that time, a negative test result translates into 0.01 x 0.001 = 0.00001, 1 chance in 100,000.

Same test, but the differenence in circumstances leads to different levels of reassurance.  The bottom line is that the higher the risk, the more important it is to carry out testing to a later time, such as 8 weeks or even 3 months.  The lower the risk, the less it matters to wait that long.

Only you can decide whether you "need" testing as long as 3 months after exposure.  But for most people, a single test at 4-6 weeks is sufficient.  (If you're going to worry about the possibility of HIV despite a risk of less than 1 in a million, I have to assume you never drive, don't cross busy streets, and never take commercial flights--all of which have a much higher chance of killing you.)

HHH, MD

[jenn8283]

What I meant to say in my last post is would my test I took yester day six weeks possibly four week test be conclusive/accurate? I don't want to take a three month test unless it is absolutely necessary.

[H. Hunter Handsfield, M.D.]

As I said originally, "a test 6 weeks after the last exposure is close to 100% certain. However, after sexual assault, most authorities recommend a final test 3 months after the event."  So the final testing time is up to you.

HHH, MD

[shygirl1981]

I don't think the doctor can be any more thorough than he already has been.

[t_from_bayarea]

I would certainly recommend a 12-13 week HIV test to be absolutely sure. Since you are so riddled with uncertainty as to "if you were" assaulted a second time. I have known someone who was slipped HGH in her drink at a nightclub and woke up on the sidewalk. Of course she didnt know what the heck happened but she knew something wasnt right. She went to the doctor who checked her and confirmed that she indeed was raped. So to the poster above, you can be assaulted without knowing it. Either by being injested or injected with a date rape drug.

Good luck to you and take care.

[jeremy_0808]

Hello doctor
I'm not sure I understood your statement.
If I had high risk situation (sex with HIV+ person)- do I need the 3 months test (because 6 weeks won't be 100%)?
Again, thank you very much.

[anotherdummy]

Jeezuz.  Here's a woman who was raped and here you are only thinking of yourself and your own situation.  Very selfish and uncaring.  This woman has much more to deal with than HIV risk so move on so you do not heighten her anxiety any more than it is now.

Show some respect to the original poster and start your own thread.  Or, just so I don't get the forum police jumping on me, at least post your questions in another thread.

[anotherdummy]

I am very sorry this happened to you but on the good side it looks like, in regards to potential HIV infection from this(these)event(s), that you are fine.

I wish you well.

[jeremy_0808]

Please excuse me. I'm new here and didn't understand how this works.
I just saw other people asking questions in other threads.
So, if I want to ask a question- I need to open my own thread?

Sorry dear Jenn and GoodLuck

[Rob73!]

Hey, Jenn, you're not alone here. I was sexually assualted (i'm a straight guy) 6 months ago. So please don't feel like you are alone. I kinda know where you are now and it will get better. Trust me!

As for testing for HIV - and I am going on my personal experience here, I tested @ four weeks and it came back neg, I also had a rapid test done @ 87 days (12 weeks\3 months). My doc told me that the only real reason to have another test done was for peace of mind, rather than any clinical need. Again, this was my experience. Listen to what your Dr tells you.

HIV and STI testing aside, I hope you won't mind me making a suggestion?  I would recommed getting some councelling. It does help and can you coem to terms with what happened. I did and it made a big difference to me.

As for the sick **** who did this to you, he may just have said that he had HIV - these offences are never about sex, but control and these animals can only control by fear. I hope you have found the courage to report this to the authorites - I did after about 6 weeks, though I did it through the NHS hospital STI clinic. I hope that that route is open to you.

I hoe everything turns out ok - and i'm sure it will. You will certianly be in my thoughts.

Good luck!

PS; most of the regular pposters here will offer you good advice and support as they have me!

[iggyb9]

Hi everyone and Dr HHH,

I have been a long time reader and this is my first post.

First of all my sincerest thoughts go out to the author of this thread. I hope and pray you will be ok and judging from the risks considered I believe you will be.

As was the case with everyone else here I have been reading exhaustable amounts of information on hiv, transmission and testing and have gotten to the point where I do not care to read anymore.

I am a male and I had a brief exposure with a transvetite prostitue. The condom broke exposing my penis for about 1-2 minutes. I completely forgt about the incident until I started getting sore throat, rashes, slight fever, joint aches, nightsweats etc... name it and I had it 5 weeks post exposure. I still get nightsweats, occasional aches, hot flushes etc at 13 weeks post exposure...

I tested at 5.5 weeks negative. I tested again at 8 weeks and that was again negative. I again tested at 11.5 weeks and that result was negative (all STD's except Hep C for which I didnt test yet).

I am from Sydney, Australia. From what I read, DR HHH seems to feel that we have one of the best network of STD clinics in the world. I tend to agree. What I want to share with you is some information on the window period.

The first two tests I did, when they came back on the slip of paper it actually shows that the results may be inconclusive if the blood serum was taken prior to 3 months after possible exposure. However, when I took the 11.5 week test from a newer and very very busy pathologic clinic I noticed that the same disclaimer stated that the window period is only 6 weeks. No mention of transmission risks and so on, just one period for all blood serums tested.

When I saw my doctor (first time consultation with this doctor ever) he also stated that he recently read that most professionals believe the window period of 6 weeks is nowdays sufficient for detectable levels of anitbodies and that serious consideration is being given into redefining the test window period, at least in Australia.

When you consider that Australia is a country of population of 20 mill compared to the USA's 300 mill (or whatever it is) you can see why some governing body like the CDC would take the conservative approach and state that 3 months is the conclusive period. They have to worry about many more people, many more doctors, clinics, testing standards and so on. It's what's called "playing it safe". Dont forget that the 3 month period is to cover the professionals asses, not your own.

I trully appreciate the help you've provide Doc, keep up the good work. If nothing else, you provide thousands of people around the world with a constant source of hope. I will go for my final exam at the 15 week period (so I can be extra sure =P) but I expect nothing to change in terms of HIV. Good luck to you all.

[skerdstraght68]

massachussetts says 6 weeks is definitive period reguardless of circumstance or testing method.  Massachussetts is probably the medical capital of the United States and is also home to a huge MSM and HIV population.

[iggyb9]

Also another thing that I wanted to mention. Australia has only 6 states, not 50. Its easier to develop a more uniform standard, something which is probably a lor harder to do in the US.

[WorriedUS]

Great informative thread. Awesome!

[o_g]

Congrats Jenn....I am really happy to hear that for you...Take care....

[jenn8283]

I took my sixweek test and the results are hiv negative.

[brambles26]

thats great jenn.....

that means you are 99% in the clear... the results must take a load off your mind....