Unprotected encounter

[alotoffovo]

Hello Doctor,

About 6 weeks ago I had an unprotected one time encounter with a women (I'm a man) in Vegas of unknown HIV status.  The encounter was only vaginal intercourse.  She was white and not a sex worker and probably 40 years of age.

I got tested for clamydia (chlamydia) and gonnarhea 10 days later and they came back negative.

HIV wasnt even contemplated so I had intercourse with my wife and she later got diarrhea about 2-3 weeks after my encounter for 3 days. Her mother also did so it could have been a common flu.

That set me off and since then my throat has been soar, tightening and I've also gotten a mouth ulser and have had a couple of nights of cold sweats.

I've been very stressed and fatigued.

Just recently, I've noticed a red rash on my penis head that my doctor said it isnt herpes.

I've just done a base line test for HIV and syphilis and will get the results in 3 weeks.

My questions are:

How likely is it to contract HIV from a single encounter?
Are my symptoms and my wifes diarhhea possible symptoms?
Am I worrying to much?
How accurate is a 6 week test?

Thanks.

[Edward W Hook, MD]

Your risk of HIV form a single encounter is very, very low.  In the U.S., the odds of Caucasian, non-sex worker partner having HIV are less than 1 in 1000.  Then, the risk of a single sex act, in the unlikely circumstance that she had HIV is also 1 in 1000. Thus, just putting these two statistics together, your chances of HIV are very, very low.

As far as your symptoms are concerned, symptoms are a terrible way to judge risk for HIV and indeed, your mother-in-law is correct, it is far more likely that you just have some sort of plain old stomach virus.  Isolated diarrhea is not suggestive of HIV.

I'm surprised that it takes so long for your HIV results to be available.,  Typically such results should be available in 7-10 days.  When you get tested a six weeks, have confidence in the results.  At that time over 95% of persons who got HIV 6 weeks earlier will have positive blood tests.  When you combine that fact with the already low risk of HIV, the negative result that I am confident you will get should be trusted.  I would not recommend further testing after your 6 week test.

Hope this helps. EWH

[alotoffovo]

I read that the rash on my penis head could be a cause of an std such as syphilis.

Is that true.  she als told me she was clean which is cold comfort.

Would you say it is safe to engage with my wife as she is a bit confused with the very little sex we are having.

[Edward W Hook, MD]

Syphilis can cause a rash on a person's penis but if you were tested for STDs you should have been tested for syphilis . It is an easy test to do and syphilis is a rare disease.  On the other hand there are many, many other things that can cause rashes on your penis.  If your doctor was worried about syphilis I presume he/she would have said somethng and/or done the test.  I doubt that you need to worry about syphilis.  EWH

[alotoffovo]

Thank you for your help and patience.

Would have the gonnarhea and chlamydia test also involved a syphilis test?  It was at 10 days post exposure and at a walk in clinic.  They took one swab for chlamydia and the urine sample for gonnarhea.  Can syphilis be detected through a urine sample?

The base line test and syphilis test that I recently took will take 3 weeks to get back as I mentioned.

Thanks again.

[alotoffovo]

Last post

you didnt mention if it is okay to have unprotected sex with my current sex partner.  Do I have much to worry about.  I also didnt mention that the rash does not resemble an ulcer.

[Edward W Hook, MD]

A tet for syphilis would involve taking blood, thus it sounds as though you may not have been tested for syphilis.  As Imentioned, these are easily done.  Nothing you have mentioned suggests you have syphilis

As I mentioned, your risk for STD and/or HIV is very low.  You ahve been tested for the most common STDs, gonorrhea and chlamydia and your partner sounds as though she was low risk for oterh, less common problems such as HIV or syphilis.  This there is little reason for you to abstain from sex with yoru regualr partner althougt this is a jusdgemetn call which you, not I, must make.  Hope this helps.  EWH

[alotoffovo]

Thanks for your help doc.

[alotoffovo]

Sorry to ask another question but I'm reading some of your other responses and you mention that the odds of contracting HIV from a female when using a condom is 1 in 1,000,000.

However, you mention that the probability(for unprotected) of engaging with a HIV positive female who is white in a single encounter is 1 in 1000 and then 1 in 1000 to contract HIV should she be positive.  Doesnt this mean your changes are 1 in 1,000,000.  


I appreciate the feedback as I'm a bit confused.

[Edward W Hook, MD]

Sorry, each of my answers is individualized and this is not a place fo debate.  Condom protected sex wiht a partner of unknown status results in a 1 in a million chance of getting HIV.  The math is as follows - odds of a woman of unknown HIV status being HIV infected are 1 in a thousand.  Odds of getting HIV if the partner are 1 infection per 1000 acts of vaginal intercourse.  Put these numbers together the odds become 1 in a million.

And with that, it is time for this thread to end.  No further questions please.  EWH