Your expertise

Dear Dr.Handsfield

First of all I would like to thank you for this great job you are doing.

I will make my position quite clear.

SITUATION

Unprotected sex (vaginal and anal) with a sex worker with unknown HIV status. I have stress afterwards and find almost all symptoms (except constant fever) listed in WEB pages as ASR symptoms. They started 3 days after and disappeared after two or three weeks later.  But to tell you the truth I convinced my self so much that I am HIV+ that might be showing these symptoms and disappering after having first results of test which calm me down.

FACTS

Tests and results after the intercourse

1 Week Proviral DNA PCR Negative

2 Week HIV1/2 (EIA) and Antigen 24+IGG Negative

3 Week HIV1/2 (EIA) and Antigen 24+IGG and Proviral DNA PCR Negative

4 Week HIV1/2 (EIA) and Antigen 24+IGG Negative

5 Week Proviral DNA PCR Negative

7 Week HIV1/2 (EIA)   Negative


The doctor at the test center told me that these test are conclusive and as a rule of conservative side a test at week 12 or 24 is advised.

So here are my questions; whatever the risk and symptoms I had,

1) With your experience, how do you interpret this situation and my HIV situation?
2) Are these results really conclusive and do you still advise another test? (actually I do know I overdose the tests)

Thanks

[H. Hunter Handsfield, M.D.]

Indeed you have been grossly overtested, a big waste of time, money and energy.  If your partner had HIV, the risk you caught it probably was around 1 in 1000; and she probably isn't infected.  Your symptoms could not have been due to ARS, which cannot start as soon as 3 days after exposure.  The results are conclusive; you don't have HIV.

HHH, MD

[southernguy911]

Dr. HHH,

A simple "yes or no" answer will perfectly answer this question.  

Do you agree with this chart? http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp

[H. Hunter Handsfield, M.D.]

I don't have time to review the chart in detail.  From quick scan, I agree mostly, but disagree about chlamydia and oral sex (in either direction).  No data support significant risk of transmission.

HHH, MD