infection risk

[stressedout12]

Hello Doctor, i am a gay man and i engaged in protected anal sex/unprotected oral sex(brief giving on my side)/kissing with a man 30 days ago. During the anal sex, we heard a pop sound and i immediately withdrew(i was insertive). I inspected the condom but couldnt find anything broken then i noticed a stretchmark on the condom where the shaft is. This stretchmark ended in a hole(also on the shaft) which was less than 1 cm wide. I immediately removed the condom and went to the toilet to wash myself with soap and water. When i came back, i put on another condom and finished the deal. Before we had sex, i had asked if he practised safe sex and he mentioned always. The days after, i began to feel paranoid about the hole in the condom and asked the guy about his hiv status. However, he kept evading my question and insisted it didnt matter since we only had safe sex. At this moment, i realised that he is most probably positive and it freaked me out as i replayed the scenes in my mind. After doing some reading on the internet, i thought my chances of infection are low as it was protected anal and i presume the hole on the condom to be rather neglegible and i didnt have any sores or uclers or wounds that i know of then. I did a home test yesterday (4 week mark) and it was negative. I have not had any symptoms other than 10 days ago when i had diarrhea once and vomitted once, with rest and water, i was almost completely fine again the next day. I plan to do another test in 2 weeks but i am still very anxious and stressed out. I think part of it stems from the fact that i felt "deceieved" as i thought it was so irresponsible of this guy to cover his status by insisting he always have safe sex. But i know its my fault as well for sleeping with someone i hardly know. Had i known his status, i would have never engaged in intercourse with him. But based on these facts and my 4 week negative test, what are my risks? Thanks.

[H. Hunter Handsfield, M.D.]

First, you can almost certainly relax.  Despite an apparently small hole, it sounds like the condom remained mostly intact; and your negative HIV test at 4 weeks is strong reassurance.

But my main thoughts start with your own words:  "Had I known his status, I would have never engaged in intercourse with him."  I hope you now realize how irrational that statement is; you should have asked about HIV before sex, not after--and if he was evasive, it's sayonara buddy, I've got better things to do.  Exactly the same issue is raised in the thread immediately prior to yours, Slipped Condom.  Aside from avoiding sex altogether or permanent mutual monogamy with an uninfected partner, knowing and routinely sharing HIV status before anal sex--even if condom use is planned--is probably the single most important and effective HIV prevention strategy for gay men.  Please don't ever do it again.

Best wishes--  HHH, MD

[stressedout12]

I have also had a slight headache since yesterday and my eyes get tired from focusing. I would like to think that this is attributed to my stress and nervousness.

[tfe]

Hiya... 4 weeks is the time when many people seroconvert, but you may wish to refer to the forum archives for more specific data (that being that 6-8 is probably safer). Odds are you're OK, and I'm sure the doc will advise you in greater detail.

Doc... I have a thread a few days down ( http://www.medhelp.org/perl6/STD/messages/2274.html ) where we left off with your advice to follow up with an STD clinic, which I did. I apologize for commenting here in reference to that thread; but I have a follow up question regarding my visit posted in that thread. If you had some free time, would you mind taking a look?

[puccinitenor]

I think your risk of HIV is low.  The risk of HIV from any one single encounter is low, even if it is a high risk activity, which yours was not.  I am not sure about a home test, but the standard blood test is about 95% reliable at 4 weeks.

[stressedout12]

i used the rapid blood test kit from mirates.com , not sure which generation it is though.

[stressedout12]

thanks for answering,doctor. yes, i have realised how important it is to ask about hiv status now instead of just presuming that a positive guy will just admit it before sex. I have one more question: i was wondering if someone who was infected will test positive for antibodies once seroconversion has started. Thanks again.

[H. Hunter Handsfield, M.D.]

That question is sort of like asking whether someone with a high temperature has a fever.  Seroconversion and testing positive for antibody are the same thing; that is, once someone tests positive for antibody, s/he has seroconvered.

HHH, MD

[stressedout12]

mirates.com has replied my email about their bloodtest kit, they use the 3rd generation Elisa test which includes both Hiv 1 and 2.

[Mike300]

hey, how did your test come out?  Fine, I hope.  Was it anxiety?

[desperate_freaked]

Doctor I would be very appreciated if you answer my question too because I cannot afford $10 at this time.
I read million pages about HIV etc. but I am really freaked out..

I had a really "wrong" and out of my character encounter 22 days ago. I had sex with a gay male - unprotected oral sex and protected anal sex (both I was insertive).

I don't have even 22 days ago any sores, scratches on my penis.

I asked before and even one day after this encounter about his HIV status and he said he was negative and even he said he was tested 10 days ago. But I am so freaked out, that doesn'T make me relaxz and I cannot trust even if he says right.

So, we realize that he was lying... I used my condom right, so there was no abrasions etc. I didn't realize any blood after the anal sex on the condom but I don't remember that exactly or I couldn't see it even.

By unprotected oral sex I didn't ejaculate and there was no visible blood, too. I am not sure if his oral health is good.

After 2 days I had a little fever (37,5 Celcius) and some kinda flu that lasted 2-3 days and since 4th day I have a sore throat and even in my esophagus i feel burning. My stomach burns a lot but I think that could be perhaps bacuse of GERD or even anxiety and stress but I read that esophagitis could be a sign. I don't have any markable swollen lymph nodes but I have a white coating on my tongue all this time. I had 7 days ago one time diarrhea. I didn't last even one day.

So, are these any smyptoms of HIV and what is my risk to get infected?
I thought that you could help me doc, sorry that I couldn't pay but I like to pay because you make wonders here...

Thanks for your answers.