HIV risk episode

[Steve888]

I have had one episode 6 weeks ago I deeply regret - I had insertive anal sex with another guy of unknown HIV status.

My question is - 1) what are my chances of HIV from this one incident, and 2) I have tested at 6 weeks, waiting for result now - how accurate is this likely to be?

I have not had fever but had a very bad cough and sore throat.

[H. Hunter Handsfield, M.D.]

Unprotected anal sex with someone at risk for HIV is one of the highest risk activities.  However, the risk for any single episode still is low, perhaps somewhere around 1 in 200, even if your partner has HIV.  Cough and sore throat without fever is unlikely to be due to primary HIV infection.  A negative HIV test result at 6 weeks will be highly reassuring (at least 95%); but in view of the high risk context, you should be tested again 3 months after the event.

Next time 1) always know and share HIV status with your partners and 2) use a condom.  Even if any particular exposure is low risk, if you continue occasional unprotected anal sex with other men of unknown HIV status, it is highly likely you will acquire HIV someday.

Good luck--  HHH, MD

[Lutheran122]

Did you wear a condom?

[Steve888]

No - forgot to mention that - it was unprotected insertive anal, for roughly 5 minutes. Never did this before, was under influence of alcohol, but no excuse for it.

[Lutheran122]

The doc usually says chances of getting hiv on any 1 incident is low odd's. I hope you will be ok my friend. Stop taking risks though , its not worth the mental anguish that comes afterwards.

[bigdaddy1992]

Hi Steve. I think you will find that the doc will say that a 6 week test is about 99% accurate but as you had one of the higher risk exposures you may want to test at 3 months to be 100%. Can you not get in touch with the guy to check his status? i have a feeling you will be fine though as a one time exposure still has good odds you will be ok.

[Steve888]

I hope so - no matter what the odds are this mental torture is not worth it for anything, and my behaviour for life will change because of this. I just hope I can get out of this one.

[Lutheran122]

I think you will , as the doctor says this isn't easy to get like a normal STD but taking risks is not worth the few minutes of pleasure. Its just not worth it , my health already was a bit shaky and now I have to worry about this too and no matter what anyone tells me until I see a few neg's in my upcoming tests I can't shake the doom feeling. I read about others living with hiv for a long time 10 , 15 years and they have no trace of the virus in them but thats a lifetime of medicine , side effects and I am sure a lot of anxiety for the monthly blood work. I'd rather not have sex anymore if I get past this , unless its with someone who loves me and I know has been tested. If I had already had that I wouldn't have went out that one damn night 11 days ago. I guess whats done is done though.

[dellnet354]

I have had unprotected vaginal sex 8 weeks ago with a man who I am unsure of his hiv status. He was penetrating deeply but I pulled out before he came. Got tested for STD's which came back negative. last week at week 7 got p24 antigen test which came back negative. The doctor who tested me said I am 99.8% clear.
I still cant be satisfied that I am ok, especially because I dont know the guy and his activities.
How sure can I be that Im in the clear so I can get on with my life?

[monkeyflower]

99.8% sounds like pretty good odds to me, but I guess you could wait and get retested later for your peace of mind. However, I think your worries about this are way over the top. The risks from any one encounter, even with a stranger, are astonishingly small. If you can't let this go, and it's preventing you from living your life, then I'd suggest seeking counseling.

[dellnet354]

Thanks for your comment. I guess the reason why Im so worried is because until this encounter and visiting doctor after I didnt realise that hiv could be contracted so easliy. The doctors and the clinic really panicked me and then I started reading up on hiv. Up until this encounter I was so paranoid about getting pregnant that I never slept around and avoided sex. I was really drunk with this guy and he took advantage. I guess you can say that I have learnt the hard way.

[TheFacts]

I don't get it.Either the tests are 99% accuarate at 6 weeks or they are not.Why from reading many posts by the good doc,he goes back and forth with the %? Many times he says 6 weeks is almost 100%,other times 95%,then other times 99%.It makes no sense.The accuaracy of tests also should not change ONE IOTA whether it is gay sex or hetero sex.Different risk ratios sure,but NOT accuaracy of a test.Makes no sense.

[TheFacts]

I made a post that asked a question and now it is gone?Why?All I asked was why the good doc,on many occasions,has stated that a test at 6 weeks is almost 100% accurate,then other times 95% or 99% accurate.Also,the type of sex,gay or hetero should have NO effect on the accuracy of the test.Have an effect on the odds of course,but NOT on testing ACCURACY at a given time.Am I missing something here?

[H. Hunter Handsfield, M.D.]

Yes, you are "missing something here".  Testing accuracy does not vary; the tests are what they are.  But the interpretation and significance of a test result varies depending on the likelihood of infection to begin with.  This has to do with what epidemiologists and diagnosticians call "predictive value".  I have explained it before, although I didn't use that term.  The bottom line is that the higher the risk of the exposure or the potentially infected person's lifestyle, the more important it is to test at times that maximize test performance.

The tests are what they are; standard HIV testing (current generation ELISA) will detect approximately 90-95% of infections by 4 weeks, 95-98% by 6 weeks, and 99%+ by 3 months.  Let's take 4 weeks and say the test will pick up 90% of infections.  Now consider someone whose risk of catching HIV was very low to start, say 1 in 100,000.That person's negative result at 4 weeks means there is only a 1 in a million chance he or she has HIV.  That's low enough that can be considered definite.   [In epidemiologic terms, the "negative predictive value" of the test, or NPV, is 0.9999999.]  Now consider Steve888, who might have had a 1 in 200 risk of catching HIV.  The 90% value at 4 weeks, reduces his risk to 1 in 2000, or NPV of 0.9995.  That's pretty good, but it's 500-fold less good than 1 in a million; and most people would not be happy with that level of certainty.  So Steve888 needs testing at 3 months, when the test detects 99% (probably 99.9%) of infections.

HHH, MD

[TheFacts]

Now I understand.It just gets so confusing.Do you know the accuracy of the tests including Oraquick Advance OMT at say 10 weeks?I heard Massachusetts uses 6 weeks as thier window,and NY State says at 4 weeks the tests are 95% accurate.I also read that a Dr.Mark Katz from Aegis Ask the Doc says at 8 weeks the tests are 99% accurate as well.

[MiamiLat]

Hello "Steve888",
From what I understand based on the research I've done, the odds of aquiring HIV from this type of exposure is 6.5 in 10,000 (0.06%) IF the receptive partner is pos. Also, most people will have detectable antibodies at 25 days on average. Therefore, a test at 6 weeks can be considered pretty reliable. Nevertheless, due to the risk involved, it is recommended that you re-test at 12/ 13 weeks (3 mos) for a definitive result. I was exposed on 12/05/05; unprotected insertive anal sex with someone who I later found out is pos. I tested at 6 weeks via OraQuick Rapid Advance: Negative! I am waiting to retest at 12 weeks (3mos). I know this is a VERY difficult time, feel free to contact me for support: ***@****

[Steve888]

Thanks to the doctor for his reply and to the others too for their support. I just got my test result and it is negative. Needless to say this is a big relief, but I realise I am not out of the woods yet and will have to re-test after 3 months to confirm it.

Nevertheless I feel like I have dodged a bullet here - there seem to be varying reports of risk for insertive unprotective anal as far as I can see, varying from 1 in 200 up to the 6.5 in 10,000 figure. But I am hoping that the 95% accuracy of the 6 week test added to this, and also the fact that I have not developed a fever (yet) which from what I can see happens in between 70%-90% of sero-convertors should increase these odds significantly in my favour?

This forum has been an invaluable support to me in this difficult time, and good luck to anyone else going through the same mental torture awaiting test results. This has been the scariest and toughest time of my life, and I am going to make sure I never have to go through this again. Good luck to all.

[Concerned5]

Steve,

Congrats on your negative test. I had the exact same exposure you did, and it was negative at 6 weeks also. Looking forward to 13 weeks.