Suicidal- Need Help

[dave29]

On a heavily drunken night, I had sex with SW. It was my first time. I am a 29 years old uncircumcised male from Sydney. It occurred on 7th of July 2005. I had two episodes of sexual intercourses. On First episode, I asked her to put two condoms on, and she gave me oral sex for about a minute then I ended up having vaginal intercourse with both the condoms on. Couple of minutes later I ejaculated in her, I was on top. Few seconds after that I withdrew my penis  from her  and  saw  that the condom was still intact. She pulled the condoms off me .She threw those condoms in a bin and wiped my penis with a clean tissue paper. Immediately after drying me out she put another condom on and started giving me oral, after a while I asked her for a tit **** and she performed accordingly. I believe the condom was still on during this time. Then I had another vaginal intercourse, this time doggy style. This lasted for a minute or two and I withdrew from her (I did not ejaculated in her). She started giving oral again till I ***. This time I don’t remember her pulling the condom off my penis but I do remember my penis was dry when she gave me the tissue paper.  I did not see any fluid on my penis while I was wiping it with a paper. I went to the toilet and couldn’t pee for a second and felt bit burning sensation while peeing and never had burning sensation after that. All this happened in less than ten minutes. Next day I woke up with sore throat, short breathing, low grade fever, fatigue, all the ARS symptom It went worst day by day I got tested on the 25th (1st of August 2005) day of post exposure and on six week marks (18th of august) both tests came negative. My blood sample was analysed by Micro particle Enzyme Immunoassay (MEIA) for simultaneous qualitative detection of P24 antigen and HIV 1 and HIV 2.  1) What are my odds to get HIV transmission through the exposures described above considering the fact that I had 13 standard drinks with in ten hours. Use of two condoms is not considered as a safe practice and my second episode I can’t recall condom been intact. 2) I have heavily white coated tongue and it burns. Last couple of days my eyes started burning too. 3) you said once  you have not seen anybody who tested negative on Six week mark, tested positive later with the new testing technology, but my GP said he had.  How reassuring are they, how much can I rely on them especially the six week one.4) I have never taken drugs and had never been hospitalized. I am not in any prescribed medications. Taking all these factors in consideration will my body take more than six weeks to produce any detectable antibody if I was infected? 5) I am so sacred to go for test, my first sexual encounter after waiting that long (29 years).what an experience!.6) HIV needs repeated exposure; I had two sexual episodes, aren’t those enough exposures to infect me if she had HIV.
Sorry for being this long. I am relying on your words of advice.

[H. Hunter Handsfield, M.D.]

Relax; you don't have HIV.  You had an intense but apparently safe sexual encounter.  The negative test results, especially 6 weeks later, are close to 100% reliable despite what your GP says.  Your description that symptoms began the next day after the sexual encounter is proof they could not be due to HIV acquired during that episode; HIV symptoms never come on that rapidly, period.  As I have said before on this forum, symptoms are a poor indicator of primary HIV infection; the blood tests are much more reliable.

To answer your specific questions:

1) Risk of HIV during that exposure:  Close to zero; your alcohol intake is irrelevant, as are the details of sexual positions etc.

2) Many things more common than cause tongue coating.

3) There are exceptions to all generalizations.  But your GP probably has a lot less experience and knowledge about HIV testing than I do, and I stand by the comments I have made previously on this topic (search the STD forum for "time to positive HIV test").  If you want real expertise, visit the Sydney Sexual Health Centre, one of the best STD/HIV clinics in the world.  (And give my greetings to my colleagues and friends who work there.)

4) Whether or not you take drugs, HIV testing is not affected.

5) You have already had 2 negative tests and you're frightened to have another?  That's pretty irrational, don't you think?  You can be virtually 100% confident you don't have HIV, but if you will sleep better with additional reassurance, have another test 3 months after the exposure.

6) HIV is pretty hard to transmit.  IF your partner has HIV (you don't know that she does), and IF you hadn't used condoms (you did), the odds of HIV transmission probably were in the range of 1 chance in 1000.

I hope that helps.  Seriously consider a visit to the Sexual Health Centre if you decide to follow up with further HIV testing.

Best wishes--  HHH, MD

[Imdumb]

Please relax -  The Dr. will rspond shortly, but in the mean time, I can tell you your risk of HIV was zero.  Condoms are 100% effective if they do not break. Which it clearly did not in your case.  You would have known it.  The Dr. will tell you even IF the condom came off your chnaces of getting HIV from your episode are so low that it is statiscally irrelevent.

All of the knowledgeable HIV organizations (those that are on the front lines of this disease) say thay 3 months is 100%.  If your GP is not on the front lines, take his info with a grain of salt.  Most GP's don't know much about regular STD's let alone HIV.  

You do not have HIV, but for peace of mind find a place that does Oraquick and in 20 minutes you will have your negatibe result.

You are in the same boat as many many many on this forum (and others) You had a less than ideal sexual experience and have inappropriately focused your anxiety, guilt and regret on HIV and/or HIV.

[edc]

is the 3rd generation hiv test in in the classification of a "newer test?" an 11 weeks and 3 days negative enough?

is there such thing as false negative. i ask this because my blood was taken in a clinic and delivered in another clinic with a hiv laboratory.

question is sending the blood to a laboratory late or not put the blood right away to the testing equipment that the virus will die and not detect it?


does it need to be put on cooler/ice when delivered?

do mishandling of blood products produce false positive or false negative?

[Imdumb]

I don't care what generation test you had...it could have been 30 years old and not mattered.  You didn't need testing in the first place.

Your "expouser" did not put you at risk for HIV and you are getting compulsive and grasping at straws.  YOU DON'T HAVE HIV!!!

[dave29]

Dr.


My first test was on 25th day of post exposure and next one on the six weeks mark NOT six weeks later.  How reliable are these tests. I am going crazy here. I can’t sleep, I don't eat. I am not functioning properly. I am so scared to go for another test and find out that I am +.

[H. Hunter Handsfield, M.D.]

I understood the intervals; that's what I said.  You are being entirely illogical and, frankly, irresponsible.  If you cannot shake your conviction you are infected despite the facts you know, and if your irrational fear of testing, it likely is a sign of a significant emotional disorder that should be evaluated and treated by a mental health professional.  I suggest it out of compassion, not criticism.

I will have no further replies.

HHH, MD

[dave29]

Dr.
I talked to my pathologist the other day this is what he said to me about my test results.
Any test prior to three months window period does not have any meaning at all, he told me “its nothing to do with the accuracy and sensitivity and the generation of testing technology, its the human body that matters. As we all know every individual has different biological functionality.  While dealing with biological factors, statistics and approximation does not have any merit in medical science. I asked him again about my test results if they have any meaning at all. His answer was “you are not infected now and weren’t infected before that does not necessarily mean you are not going to” His reason was; my body has not yet produced any antibody to detect

Being a cutting age scientist what is your opinion on this.

[JohnnyV]

Hi,

Dave: Dr. H is going to repeat that the 6-week test, counting 6 weeks after exposure, is still highly reliable. And since you didn't do anything risky, the result combined with your near-zero risk factor should be enough to return you to a normal state of mind. If you choose to do the 3-month test, you should look at it as a formality which will confirm the negative results you have already. If, by some strange twist of fate, the 3-month test turns out positive and you defy the pattern seen by Dr. H and others, at least you'll know your status and you can intervene early to ensure a long life span with HIV. But the only way the 3-month test would turn up positive would be if

1) You were so drunk that you took off all the condoms and had vaginal sex for a long time without them, yet had no memory of unprotected sex whatsoever, which is highly unlikely since your initial post shows you remember everything about that night,

2) the woman had HIV herself and had a high viral load, which seems unlikely considering that she used 2 condoms with you and seemed to engage in generally less risky things, and

3) you were one of a small number of cases worldwide, out of the 40 million people who have HIV, to seroconvert after 42 days, which is also unlikely because the average time to seroconversion is 22 days.

When I add up 1-3, I can't understand where your suicidal urge is coming from. All information points to you not having HIV. Something else is going on. If you are feeling suicidal, please seek help immediately, because it would indicate that you have a mental health situation that is manifesting itself as a paranoia about HIV.

-----

Edc: Have you still not been able to ask the questions of the doc? I would like to answer them but my answers are just based on laymen's research, mostly paraphrasing Dr. H and throwing in a few morsels of common sense, developed from my "expertise" as a reformed tramp with a disgraceful sexual past. Whereas Dr. H is a professional, I only know so much about STDs because I spent 15 years constantly at risk of getting one (you name it, I've thought I had it but never did). Here's something that may make you feel better:

http://www.state.nj.us/health/aids/rapidtesting/documents/Paul_edit.pdf

Go to page 2 and you will see a graph illustrating the infection window of HIV. Even if you are being tested with old tests, you will see that still, in almost all cases people seroconvert in fewer than 6 weeks.

From what I understand, nothing about blood handling can change your test from positive or negative, or vice versa. The tests are looking for antibodies, not HIV itself, so no matter what happens to the blood, the antibodies will still be detectable in your sample. The only glitch would be if the lab confused two people's samples. Consider getting a rapid test to ease your mind; because you can sit there and watch the test results.

Best wishes to everyone!

J

[Neurotic Aussie]

Greetings fellow Sydneysider.

The statement that “statistics and approximation does not have any merit in medical science” is simply wrong.  

No test has an analytical sensitivity of 100%, rather it is something like 99.5 to 99.99%. What is important is the predictive value of the test. The predictive value of a negative test is higher than a positive test because most people who test for HIV don’t have it (this is why only positive tests are confirmed with WB) The issue of the window period boils down to what point the predictive value of the test reaches its optimum level of sensitivity. There is plenty of evidence to suggest that the difference in the predictive value between a test at 6 weeks and another at 12 weeks is negligible (perhaps no more than 1%).  If you want to know the reason why, take a look at the graph in the second page of Johnny V’s link.  You will notice that the line “ab” rises in a steep curve and then evens off. The notion that a test at 11 weeks have a predictive value of 0% but a test at 12 weeks is 100% is absurd. But that is the logical outcome of what your pathologist is saying.

Something which may bring some comfort to you is the fact that practically all tests in Sydney are done through the serology labs at Westmead or St Vincent’s. In both cases they use “fourth generation” tests which simultaneously detect both P24 antigen and HIV1/2 antibody. These tests are conclusive at 6 weeks in all but the most exceptional cases.

[dave29]

People at my local Clinic and Dr HH here clarify the fact that I was actually engaged in intense but protected sex. What will I risk if I rely on their risk assessment and the two negatives tests and don’t go for further testing?  

Thinking about going to test makes me sick. I am trying to convince my self, it was not a risky encounter even though I was heavily drunk and trying to move on.
Any suggestions

[freewilly]

Anxiety spawns anxiety. It sounds like you were wearing a suit of armor.

I wish i were as lucid as you after 13 drinks to be able to recall all those activities in such detail. You should be an author. That was some good stuff. You should maintain a journal and publish it some day. Seriously.