Worried about HIV exposure!

Dear Doctor,
I'll do my best to make my story short!
I am a heterosexual male, not a drug user,always performed safe sex until I had an incident during sex 5 weeks ago, my condom broke, and penis was entirely exposed inside the vagina for about 10 sec(or less).
I'm not circumcised, and my fore skin felt raw maybe from nails trying to put on the condom!
After maybe five strokes with a broken condom I removed my penis immediately and saw some menstrual blood on it, not much, immediately washed it off with soap!

The girl I had sex with was a college student, 22 year old African/American from NJ, I am mentioning her race and social status because I got scared from the internet, saying that African/American community has the largest number of HIV infections, I don't want to be skeptic but what I read did not help my anxiety at all, even though she says that she is clean!

I got tested twice in a NYC clinic,(am not sure what method they use for the HIV tests,maybe ELISA),2 weeks and 4 weeks after, both tests came HIV Non Reactive! Also negative for Chlamydia and Gonorrhea.

This is the 5th week and am going back for another test maybe in a week or two. My doctor said that I should wait and get tested after 6 months, which I think it's not right, at least to my knowledge!
I didn't have any symptoms so far,no fever or rash, had dry mouth and dry throat(not sore) but it was due to my anxiety I believe.
I thought had swollen lymph nodes in neck area(on 4th week) but my doctor checked me and didn't find any.
How reassuring is a 7-8 weeks test in my case?
What are my chances?
Thank you for your time!

[Edward W Hook, MD]

Welcome to our Forum.  When all aspects of your story is considered, your risk of HIV from this exposure is now close to zero.  While HIV is more common among African Americans than whites, unless your partner was an IV drug user her likelihood of HIV is less than 1 in 1000.  In addition, the risk of getting HIV from a single unprotected act of intercourse with an infected partner, irrespective of the presence of menstrual blood, is also 1 in 1000.  Thus statistically before testing your risk was about 1 in a million.  At 4 weeks over 90% of HIV infections are detectable with standard HIV tests so this then brings your risk to about 1 in 10 million, not something to worry about (You are far more likely to be hit by lightening).

A test at 8 weeks will be definitive and will completely rule out infection.  With all due respect to your doctor, he is being more conservative than need be.  No further testing is needed after an 8 week test.

Bottom line, you are in good shape, with almost no risk of getting HIV from the exposure you describe.  I hope my comments are helpful and give you peace of mind.  EWH

[mickey55]

Dear Doctor Hook,
Thank you so much for your quick reply,your comments helped me understand the situation better!
The girl I had sex with, said that she never used drugs/needles.So I'll be waiting 3 more weeks to get tested again!
As I mentioned before, being uncircumcised,is it still the same risk of getting HIV from a single unprotected act of intercourse with an infected partner, irrespective of the presence of menstrual blood, also 1 in 1000?
Just wanted to clarify that, thanks again!

[Edward W Hook, MD]

The presence of menstual blood is not associated with change in risk, probably because HIV is also present in genital secretions.

Your are correct that, when looked at in isolation, cirumcision is associated with about a 50% reduction in risk of getting HIV but in a statistical sense, when risk of infection goes from 1 in 1000 to 1 in 1000, this is not a major difference becasue there are so many variables (more than there is room to recount or discuss) involved.  Your really have very little to worry about.  EWH

[mickey55]

Hi Doctor,
I just read your comment and was wondering maybe when you said: "1 in 1000 to 1 in 1000"  you meant 1 in 1000 to 1 in 10.000?
Thanks again for your time.

[Edward W Hook, MD]

Yes, I meant to say from 1 in 1,000 to 1 in 10,000.  EWH

[mickey55]

Hi Doctor EWH,

Yesterday I learned that the lab(St. Luke's-Roosevelt Hospital New York) I got tested for HIV uses Western Blot.

My question is, how accurate is Western Blot after 8 weeks compare to ELISA?
Most of the people here mention ELISA more than Western Blot.

Thank you

[Edward W Hook, MD]

Typically an ELISA test is done first and if this is positive, the Western blot is done later for purposes of confirmation.  The reason the ELISA is done first is because it is cheaper and easier to do than the Western Blot.   If your Western blot is negative however, you do not have HIV.  EWH

[mickey55]

Thank you Dr EWH!

I really appreciate your quick replies!

Today is my sixth week, am going to wait two more weeks and then get tested, and this time it's going to be Western Blot exactly on the 8 week mark!

Have a great day!

[mickey55]

Hi Dr EWH
Today I received my Western Blot test(after 8 weeks) and it is negative!
So I guess now it's time for me to move on!
Thank you for making it easy for me while I was going through hell!

[Edward W Hook, MD]

Glad to help. Take care.  EWH