is it necessary?

[123466]

Hi Doctor. I recently had an unprotected sexual encounter with a stranger. I am female,28 years old and in good health. He seemed like just a regular heterosexual non-drug user. This is just from my assumption. Alot of alcohol was involved. I am terribly frightened and regretting it.
I am hiv negative(was tested last year) I have only had the same partner for 5 years and he is negative as well. Then i go and do this and now i am unsure.
It has been 36 days since the encounter. After about 5-7 days i had a sore throat and some fatigue and a flushed face. No fever or swollen lymph nodes or rash.
At 10 days i had a cbc to see what was up and everything came back normal. I am going for a complete on tuesday but don't want to ask for an hiv test due to fear and feelings it would just be unnessesary especially because my doctor knows me really well and knows i am married.
What are the chances I could have it from one unprotected heterosexual act?
I heard that my symptoms at 5-7 days were too soon for ARS and they weren't really indicitive of it? Is this true?
Would i not have swollen lymph nodes by now at 36 days?
Would my cbc on tuesday show some kind of increase or drop in white cell counts if something were wrong?
Is it necessary for me to test?
Thanks in advance for the reassurance doctor.

[Edward W Hook, MD]

you have understood what I recommend.  Getting tested in a confidential setting will relieve you of concnern and let you move forward.  EWH

[123466]

Thanks so much for your time doctor.

[123466]

So in other words, I guess it would be unessesary to tested based on my encounter?
You are saying just to get tested if it will ease my worry right,but statistically not necessary?

[Edward W Hook, MD]

Welcome to our Forum.  The risk of HIV from a single unprotected sexual encounter with another heterosexual person is low.  Presuming your partner did not use IV drugs or have sex with other men, his likelihood of having HIV is less than 1 in 1000 and probably closer to 1 in 10,000. If by some stroke of bad luck he had HIV, the risk of getting HIV from s single encounter is also about 1 infection for every 1000 to 2000 sexual encounters, thus mathematically your risk of infection is less than 1 in a million and probably lower.  Thus this is not something to worry about. On the other hand, your risk of other STDs such as gonorrhea or chlamydia is considerably higher.  My advice, given the nature of your exposure, is to go and get evaluated. If you do not feel you can do this with your own doctor, these services are offered at your local health department and are both inexpensive and highly confidential.  My sense from your post is that you feel badly about this encounter and if you choose not to seek evaluation I worry that you will spend a lot of unnecessary time worrying if every newly appreciated sensation might represent an STD of some sort (including HIV)/.

With regard to your specific questions:
1.  Your chances of infection are low, less than 1 in a million for HIV.
2.  Typically the ARS symptoms begin 2-3 weeks following exposure, not at one week.
3.  Not everyone who gets HIV gets swollen lymph nodes.  The only accurate was to ascertain risk for HIV is with an HIV test, not by trying to judge from non-specific symptoms.
4.  The CBC is not reliable for determining risk for HIV, particularly early HIV.
5.  See above, I worry that if you do not test you will continue to worry.


Hope these comments and advice are helpful.  EWH