HIV Odds?

[johnqw]

Dear Doctor,
7 weeks ago I traveled to a very large country in South America to visit a friend.  The last night I met one of his friends who is a female.   That night we had unprotected vaginal and anal sex. After having anal sex she was so embarrassed and she said it was her first time having it.   The vaginal sex lasted for like 15 minutes but the anal sex only lasted 3 or 4 minutes at the most.  Each time I did not release inside her.  The reason for my concern is 3 days after this I traveled back to the US and was sick for 7 days with fever, cough, and chronic tiredness.  After 7 days it got better and I felt ok until last Tuesday when I suddenly got a high fever, bad headache and had 3 straight nights of sweating, fever and chills.  A cough was also present. This time frame is about 7 weeks from my trip to South America.  It is now 7 days later and I still have a slight fever but my cough and sweats are gone.  The unusual part is that I have really horrible headaches... almost like migraines and cannot seem to get rid of them.  I do not have a history of headaches and I am very worried about my health. Please let me know if you think I should be worried and if I could have gotten the swine flu or something else?  I am extremely nervous about all this and need your guidance.
Thanks!  

[Edward W Hook, MD]

Please re-read my answer. The additional information about the timing does not change my answer or recommendations.  Your symptoms and their timing do not raise any concerns about being indicative of HIV- they are not useful for this purpose. Rapid tests for HIV are widely availble through many HIV tesitng sites and provide accurate results.  EWH

[Edward W Hook, MD]

Your risk for HIV from the exposure you describe is modest.   Risk for getting HIV is determined by two main factors - the likelihood that you partner has HIV and the sort of sexual exposure you have.  My guess is that the likelihood that your partner has HIV is low. You could find out more if you were to ask her or if she was willing to get tested if she has not been recently.  If she is HIV infected, the risk of a single episode of virginal sex is about 1 infection per 1000 exposures.  For rectal intercourse the risk is higher but still pretty low, about 1 infection per 100 exposures.

Your symptoms have nothing to do with HIV.  the onset of symptoms of acute HIV infection do not occur within a week of exposure and typically occur at 2-3 weeks following exposure. My guess is your symptoms are some other non-STD bug you picked up in your travels. the symptoms are certainly not due to HIV.

What to do?  Testing is always a reasonable idea, even though your absolute risk is rather low.  I would suggest getting tested at about 6 weeks following this encounter.  In your circumstance, when the result comes back negative as I am confident it will, you will know for sure that you did not get HIV.  Hope this helps.  EWH

[johnqw]

in my original message i said that i got sick 7 weeks after my trip to south america.  the time frame is actually exactly 40 days.  i am so worried about getting tested and if i do get tested i want a quick test that gives me the results asap.  Do you have suggestions and do you still feel my symptoms are not hiv related?  thanks

[Zhang255]

I think the girl that you met in S. America has more worrisome than you since she had both receptive vaginal and anal intercourse.  

1 or 2 unprotected sexual encounter won't put you at hiv risk if you are a healthy hetero male.