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Vaginal Receptive Sex with Uncircumcised Bi Guy

Will try to keep this as brief as possible.   Am currently living in the Middle East in a country where you have to test negative for HIV to be granted residency.  Drank too much at a bar on December 3rd and ended up having brief unprotected vaginal sex with a guy for approximately 1 minute - 2 minutes after he had spent a while performing oral sex and fingering me.  Here are the details I have since compiled on the guy.

1- From South Africa and visits a couple times a year
2- Moved to the ME in late 2009, (so he was at least negative at that point to enter the country), but has traveled significantly since then (including SA)
3- Uncircumcised
4- Bisexual with a preference for men

The past few days I have had cold like symptoms.  My throat is scratchy and I have slightly swollen glands in my groin.  I have had some overall muscle aches also and my breasts have felt swollen and tender.  I have definitely been doing extensive amounts of reading on HIV acute infection because, naturally, am terrified I have contracted it as I think this person fits the profile for "high risk" to a T.  So, I am aware that I could be creating/imagining these symptoms.  Am also aware that even if there were no symptoms, I could still be infected.

I guess I am just hoping for some solid assessment of the chances that I have contracted HIV, let's say if we are assuming that the guy is +.  Also, if I were to be experiencing symptoms of seroconversion, would they be really obvious?  Should I have to dig around to feel the glands? Or would they be prominent? Can it go both ways (mild or severe)?

Also, I am returning to the States next week and plan to have a PCR test AND blood test done. I know the blood test will not pick up on anything after only 4 weeks, but will the PCR at 4 weeks be a good start?  Where I currently live, I don't believe I will be able to be tested in 3 months time.

Any advice/council is greatly appreciated.

1 Responses
1024580 tn?1331577721
Thank you very much for your post and welcome to our forum.
I would not go as far as not having sex ever again as that is not a good option either.  I would suggest that safe sex is a very good alternative option and if you had used a condom, even for the brief penetration, you would not be having all these worries now.  Anyhow, we are all human and sometimes we all make mistakes like these.  
Any unprotected penetration, even without ejaculation, involves risks, including risks of HIV infection.  The risk is always higher for the person being penetrated.  Incidence of HIV is high in South Africa as well as higher among gay and bisexual men:  risk is higher for uncircumcised males.  Therefore if we assume that he is positive, the estimated risk for you is approximately 3% or 1 in 33, which is significant. This is probably lower because your penetration was quite brief and also we do not know his status.
Looking at symptoms is not usually the best approach because, even though most people would get symptoms of sero-conversion, many would have mild symptoms or no symptoms at all.  And the symptoms are non-specific, being consistent with hundreds of many other common conditions.  If you are able to have a PCR RNA test (or NAAT) for HIV-1 and 2 as soon as possible, that can be considered conclusive straight away.  However you could also have a simple antibody test, which, if negative, would at least exclude the symptoms you have been experiencing as related with HIV sero-conversion and would be reassuring, even though not conclusive.  Alternatively a HIV Duo test after 4 weeks would be totally final and conclusive.  Having said that, you could always have a Duo test now (testing for the antibodies and the p24 antigen) which would be highly reassuring as well as it can detect the p24 antigen already after 2 weeks.
I am giving you all these options because you need to have peace of mind as soon as possible.
Best wishes,
Dr José
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