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Possible HIV/STD Exposure
Dear Dr HHH
5 days ago I had a drunken sexual encounter with a white female in west Texas. From what my memory can recall she seemed to be the very promiscuous type (not a CSW). I can recall some light kissing, fingering of anus and vagina and breast licking. However I can not recall having sexual intercourse because of my memory, from stacking up what I can remember and asking friends my steps and what I had said to them after being in her room for a while that evening I am about 50% certain that I did not have sexual intercourse. There may have been some oral both ways (most likely just receive) and my worry being that the day before I had bitten my tounge badly and had a laceration on it.
My high anxiety arises when I recall that she was very hot and sweaty (as if she was unwell) and seemed as if she was on more than just alcohol. I dont think she would have been a IV drug user as she came from a wealthy background and we were in a fairly upmarket hotel but a mutual friend did mention she is addicted to prescrption drugs. When I profile her and combine that with the possibility that I had unprotected sex and/or oral with her I am extremely worried about HIV risk and other common STD's.
I myself am a circumcised male and not usually reckless like this. I keep thinking about the worst case scenario - if I did have unprotected sex/oral and she was HIV pos and she transmitted it to me.......The consequences of this stupid mistake to me is life ending as I have a long term partner. She will be visiting me soon and this is before most testing window periods for many std's. If I ensure that I have only protected sex with her will that keep her safe from anything that I could have caught? would you say that it is safe to do so if I have no symptoms at the moment. How would you assess my HIV risk here?
Also why is the ELISA western blot a 6 week window and some UK sites say a 4week window for a HIV duo test?
Thanks in advance for your thoughts on my situation and advise.
5 days ago I had a drunken sexual encounter with a white female in west Texas. From what my memory can recall she seemed to be the very promiscuous type (not a CSW). I can recall some light kissing, fingering of anus and vagina and breast licking. However I can not recall having sexual intercourse because of my memory, from stacking up what I can remember and asking friends my steps and what I had said to them after being in her room for a while that evening I am about 50% certain that I did not have sexual intercourse. There may have been some oral both ways (most likely just receive) and my worry being that the day before I had bitten my tounge badly and had a laceration on it.
My high anxiety arises when I recall that she was very hot and sweaty (as if she was unwell) and seemed as if she was on more than just alcohol. I dont think she would have been a IV drug user as she came from a wealthy background and we were in a fairly upmarket hotel but a mutual friend did mention she is addicted to prescrption drugs. When I profile her and combine that with the possibility that I had unprotected sex and/or oral with her I am extremely worried about HIV risk and other common STD's.
I myself am a circumcised male and not usually reckless like this. I keep thinking about the worst case scenario - if I did have unprotected sex/oral and she was HIV pos and she transmitted it to me.......The consequences of this stupid mistake to me is life ending as I have a long term partner. She will be visiting me soon and this is before most testing window periods for many std's. If I ensure that I have only protected sex with her will that keep her safe from anything that I could have caught? would you say that it is safe to do so if I have no symptoms at the moment. How would you assess my HIV risk here?
Also why is the ELISA western blot a 6 week window and some UK sites say a 4week window for a HIV duo test?
Thanks in advance for your thoughts on my situation and advise.
MEDICAL PROFESSIONAL
http://www.medhelp.org/posts/HIV-Prevention/what-is-the-window-period-for-hiv/show/1704700
Re-read my closing comment above. This thread is closed to additional comments.
Re-read my closing comment above. This thread is closed to additional comments.
doc, sorry for coming back once again. I'm trying to stay clear of googling things now because all the differing material out there is driving me crazy. I had to test at 4 weeks (31 days) because anxiety was killing me.
Had an 8 panel test which included bloods an urine. hiV was an ELISA - all came back negative. I know 3 months is the guide but given my once off encounter how accurate are these tests at 4 weeks.
Thanks
Had an 8 panel test which included bloods an urine. hiV was an ELISA - all came back negative. I know 3 months is the guide but given my once off encounter how accurate are these tests at 4 weeks.
Thanks
MEDICAL PROFESSIONAL
No, I don't recommend testing for HSV-2, which is not a possible explantion for the penile skin symptoms you describe.
You may not keep returning with every addtional question that comes to mind. This thread is definitely over.
You may not keep returning with every addtional question that comes to mind. This thread is definitely over.
Doc,
Really sorry for coming back on this one. My ghon and chlam tests were negative.
I will have to wait a few weeks for the bloods.
Would you advise testing for HSV2? What's the transmission risk of this fron a one off encounter? I have some dry, scaly and sometimes itchy skin at the base of the penis?
Would appreciate your thoughts on the hSV2 possibility and symptoms I describe.
Thank you.
Really sorry for coming back on this one. My ghon and chlam tests were negative.
I will have to wait a few weeks for the bloods.
Would you advise testing for HSV2? What's the transmission risk of this fron a one off encounter? I have some dry, scaly and sometimes itchy skin at the base of the penis?
Would appreciate your thoughts on the hSV2 possibility and symptoms I describe.
Thank you.
MEDICAL PROFESSIONAL
I already said gon/chl testing would be accurate at this time. I agree syphilis is rare in white women (rarer than HIV, even).
Anxiety may or may not actually cause symptoms, but it certainly can magnify otherwise trivial body sensations you might not otherwise notice.
That will have to wind up this thread. Try to relax about all this. Best wishes.
Anxiety may or may not actually cause symptoms, but it certainly can magnify otherwise trivial body sensations you might not otherwise notice.
That will have to wind up this thread. Try to relax about all this. Best wishes.
Thanks doc,
I have booked a chlam and ghon test for today which is 5 days post possible exposure. Just to clarify Would negative results for these two tests be conclusive at this stage?
Secondly, I have been looking at std stats for the region of Texas I was in :
http://www.dshs.state.tx.us/hivstd/reports/STDSurveillanceReport.pdf
It seems that Syphillis is rare amongst white hetrosexual females - am I correct in assuming this risk is also low?
Also in your experience can anxiety make you feel symptoms? Or amplify normal sensations to make you feel as if your suffering from something. I.e slight tingling sensation around scrotum, occasion slight itch at top/head of penis....?
I have booked a chlam and ghon test for today which is 5 days post possible exposure. Just to clarify Would negative results for these two tests be conclusive at this stage?
Secondly, I have been looking at std stats for the region of Texas I was in :
http://www.dshs.state.tx.us/hivstd/reports/STDSurveillanceReport.pdf
It seems that Syphillis is rare amongst white hetrosexual females - am I correct in assuming this risk is also low?
Also in your experience can anxiety make you feel symptoms? Or amplify normal sensations to make you feel as if your suffering from something. I.e slight tingling sensation around scrotum, occasion slight itch at top/head of penis....?
MEDICAL PROFESSIONAL
In the US, among sexually active women who do not have special risks (injection drug use, commercial sex, etc), somewhere around 1 in 1,000 are infected. The highest likely chance for a partner like this one (who apparently hooks up with guys at bars, right?) is around 1%, i.e. 1 in 100.
For unprotected vaginal sex, the HIV transmission rate, if the woman is infected, has been calculated to be around 1 in 2,000. (It would be double that if you had not been circumcised, i.e. 1 in 1,000.)
Combining those two figures, the odds you caught HIV could be calculated at somewhere around one in 200,000 to 2 million.
Perhaps it will also help settle your nerves to know that in the 8 years this and the HIV prevention forum have been going, with over 30,000 questions, nobody has reported they tested positive for HIV after an exposure they asked about.* You're not going to be the first!
*On two occasions, people reported they had tested positive but it quickly became apparent they were lying about it.
For unprotected vaginal sex, the HIV transmission rate, if the woman is infected, has been calculated to be around 1 in 2,000. (It would be double that if you had not been circumcised, i.e. 1 in 1,000.)
Combining those two figures, the odds you caught HIV could be calculated at somewhere around one in 200,000 to 2 million.
Perhaps it will also help settle your nerves to know that in the 8 years this and the HIV prevention forum have been going, with over 30,000 questions, nobody has reported they tested positive for HIV after an exposure they asked about.* You're not going to be the first!
*On two occasions, people reported they had tested positive but it quickly became apparent they were lying about it.
Thanks for your response. If we went on the assumption that I did have unprotected sex just to be prudent, what would you say the stats are like for me? for the possibility of a white female in Texas to have HIV and also the risk of transmission to a circumcised male from a one off encounter?
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
You don't give me very much to go on here. You're the only one who can judge whether or not there was penile-vaginal (or anal) penetration; and if so, whether a condom was used. You shouldn't be worried about the oral component. The overall STD risk is low for all STDs and zero (or very close to it) for some, including HIV. And even if you had oral contact with her genital area, your tongue bite makes no difference in risk -- still zero for all practical purposes.
I wouldn't assume your partner was in poor health. Being sweaty is more likely related to temperature, alcohol, sexual excitement, etc. And if she was sick, HIV is very unlikely to be the cause; and other STDs are even less likely to cause sweating or fever. Perhaps you could get more information both about the exposure and her health by contacting the lady. You may find she is just as concerned about STDs and HIV as you are; after all, on average women are at greater risk from their male partners than vice versa.
Given the uncertainties, I think it makes sense for you to be tested for common and dangerous STDs. There is no testing "window" for chlamydia and gonorrhea, which are the two most likely consequences; you can have an accurate urine test at any time. The only other tests I would recommend are for HIV and syphilis. Both of these blood tests are virtually 100% accurate by 6 weeks. The odds of either of these is too low for serious worry, so as long as your gon and chl tests are negative, you probably can safely resume unprotected sex with your regular partner. But if you want 100% certainty that sex with your partner will be safe, you'll just have to avoid sex with her for a few weeks. Alternatively, if you speak with your recent partner, perhaps she will agree to testing. If her HIV and syphilis results are negative, you're home free.
Finally, about the window period for HIV testing: Just a few days ago I wrote a blog-like response that explains this in detail. Take a look, then let me know if you have any remaining questions: http://www.medhelp.org/posts/show/1704700
I hope this helps. Best wishes-- HHH, MD
You don't give me very much to go on here. You're the only one who can judge whether or not there was penile-vaginal (or anal) penetration; and if so, whether a condom was used. You shouldn't be worried about the oral component. The overall STD risk is low for all STDs and zero (or very close to it) for some, including HIV. And even if you had oral contact with her genital area, your tongue bite makes no difference in risk -- still zero for all practical purposes.
I wouldn't assume your partner was in poor health. Being sweaty is more likely related to temperature, alcohol, sexual excitement, etc. And if she was sick, HIV is very unlikely to be the cause; and other STDs are even less likely to cause sweating or fever. Perhaps you could get more information both about the exposure and her health by contacting the lady. You may find she is just as concerned about STDs and HIV as you are; after all, on average women are at greater risk from their male partners than vice versa.
Given the uncertainties, I think it makes sense for you to be tested for common and dangerous STDs. There is no testing "window" for chlamydia and gonorrhea, which are the two most likely consequences; you can have an accurate urine test at any time. The only other tests I would recommend are for HIV and syphilis. Both of these blood tests are virtually 100% accurate by 6 weeks. The odds of either of these is too low for serious worry, so as long as your gon and chl tests are negative, you probably can safely resume unprotected sex with your regular partner. But if you want 100% certainty that sex with your partner will be safe, you'll just have to avoid sex with her for a few weeks. Alternatively, if you speak with your recent partner, perhaps she will agree to testing. If her HIV and syphilis results are negative, you're home free.
Finally, about the window period for HIV testing: Just a few days ago I wrote a blog-like response that explains this in detail. Take a look, then let me know if you have any remaining questions: http://www.medhelp.org/posts/show/1704700
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
