Need a professional view

[topidiot]

I have told no one about my exposure, and I am all bottled up with anxiety.  Exposure was with a female African American CSW in a suburban area of midwest U.S. (at her home) about 50 days ago.  Exposure was 2-3 minutes of non-rough anal sex where I was insertive, but condom broke...don't know when.  Strangely enough, when she turned on the lights, my ejaculate was on the floor (I know I ejaculated while in her).  Not sure what this means about when the condom actually broke (upon extraction?).  My penis was completely dry and there was no blood detectable upon inspection.  I asked her repeatedly if she had anything, she said no and that she gets tested all the time.  She also has a 1 year old daughter.  She wasn't panicking about the condom break, but she also wasn't excessively casual.

I had a full STD panel done at 10 days...all negative and non-reactive for HIV.  8 week test is next.  I know how much disdain you have for symptom-checkers regarding HIV, but it may be noteable that I have had no ARS-type symptoms (no fever, no fatigue, no muscle aches, no sore throat, no diarrhea) other than a recent congested chest, which could be from being around a lot of sick (cold/flu) people lately.  My lymph nodes and surrounding muscles in my neck are sore (but not swollen) with infrequent electrical-type shooting pains, but I have recently been poking around there while obsessing leading up to my 8-week test...I know, I will stop doing that.

I am going in for an 8 week test next week.  I am calm and committed to the test, but very nervous about results.  I just have this sense that my luck has run out...I've had plenty of successful protected sex to this point, and I just have a bad feeling about this event.  What are your thoughts about the risk in this type of situation?

[Edward W Hook, MD]

Thanks.  Take care.  EWH

[topidiot]

8-week test returned non-reactive.  Huge relief.  Though I don't know the generation of the anti-body test, Quest Diagnostics did the test, and I assume they are using the proper generation testing for USA standards.  I take your advice Dr. and consider it conclusive.

To all who come to this site to fret and worry...I've been there, and take comfort in the Dr.'s words.  My exposure as described above was probably higher risk than the majority of posts I have read: anal, African American partner, CSW, tatoos, etc... Perhaps not everyone will have their testing end favorably as mine has, but I think it supports what the Dr.'s say about one-time risk stats.  Use condoms everyone!  (regular, not UltraThin!...trust me)

[Edward W Hook, MD]

Your risk from the exposure you describe is not terribly high.  Certainly HIV is somewhat more common in African Americans and in CSWs but the odds are still hi that she did not have HIV.  She was certainly checked for HIV at the time she had her daughter- that is a routine part of prenatal care at the present time.  The odds of her being infected are no greater than 5% and probably closer to 1%.  Your risk from unprotected sex, IF she ha HIV is about 1 infection per 100 exposures.  Thus putting these numbers together, even before testing, your risk of HIV was mathematically no greater than 1 in 2000 and probably far lower.  

You already know what I think about symptoms checking.  The symptoms you describe are far more likely to reflect your anxiety over this exposure than anything else.  

I predict your 8 week test will be negative.  When it is, there is no need for further testing.  I would urge you however to continue to use condoms in future encounters.  

Take care.  EWH