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Avatar universal

Please assess my risk

Dr,

I had unprotected vaginal for about 1-2min (rest was with condom), outside of the US....fairly promiscuous Columbian girl (I have been living there for a year now)
Got tested several times and most recently at ~41 days.
I know it sounds excessive but i have my reasons. Should I be tested again? Is 41 days considered ~6 weeks and pretty conclusive? I know that you've said that you havent seen any one tested positive after 4-6 week test. If you dont mind me asking, how many cases have you studied/treated?
I also had some cold-like symptoms at ~week 5 (runny nose, sore throat for a day, didnt notice fever for more than half a day). Should i be worried about any of that.
Also, at weeks 3 and 4, I tested for all STDs and everything was normal. Does that lower my odds of anything serious here? What are my odds here?
Thank you.
9 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

Although I have no direct knowledge of HIV epidemiology in Colombia, I'll bet the chance your partner has HIV is quite low; and when a woman has HIV, the average risk of transmission by vaginal sex has been estimated at 1 in 2,000.  That's equivalent to having sex with infected women once daily for 5 years before transmission might be expected -- which is why many spouses of HIV infected persons never catch the virus.  Second, your symptoms do not suggest HIV, which does not cause runny nose and brief sore throat.  

Third and most important, a negative antibody test at 6 weeks is virtually 100% reliable (and 1 day short of 6 weeks makes no difference).  How many cases I have observed is irrelevant; my and Dr. Hook's advice has never been based only on our personal experience, but on published data and other solid science.  In case you are interested, here is a thread that explains the discrepancy between test reliability at 6-8 weeks compared with frequent official advice to wait 3 months:    http://www.medhelp.org/posts/show/1347755

As for other STDs, testing for gonorrhea and chlamydia is reliable any time more than a few days after exposure.  However, 3-4 weeks is too soon for all STD blood tests.  Six weeks is about right for syphilis, and 3-4 months for herpes.  However, in the absence of symptoms, your exposure does not warrant testing for any STDs other than gonorrhea, chlamydia, syphilis, and HIV.

Bottom line:  Almost certainly you caught no STD.  If you want a bit more certainty about syphilis, you should have another blood test.

Regards--  HHH, MD
Avatar universal
Forgot to mention. Tests were all in the US and standard ELISA I believe. All negative. Thanks doctor.
Avatar universal
thank you for your swift response doctor.
The thread you pointed me to mostly speaks of the duo test...is a 6 week antibody test equivalent to 4 week duo? Would you recommend I retest closer to 8 week of your."conclusive " range? sorry for the additional questions ahead of time.
239123 tn?1267647614
MEDICAL PROFESSIONAL
I think you saw only my initial response in the other thread; keep reading.

Odds your partner had HIV, let's make it a worst case scenario and say 1% (1 in 100).  If she had it, 1 chance in 2,000 you were infected.  That means the chance you caught HIV can be calculated at 0.01 x 0.0005 = 0.000005, or 1 chance in 200,000.  Reliability of a negative antibody test at 6 weeks say 99%.  Thus, the current odds you have HIV are 1 in 20 million, which should be sufficiently low to satisfy anybody; it means zero for all practical purposes.  And even this is an overestimate, since the chance your partner has HIV probably is a lot lower than 1%.  Accordingly, I see no need for additional testing at 8 weeks or any other time.
Avatar universal
Thank you doctot for your valuable input. Your voice of reason is much appreciated.
Avatar universal
As a quick follow-up, does random joint pain and some weight loss (4-5%) over the last few weeks indicative of anything? Really appreciate this doc
239123 tn?1267647614
MEDICAL PROFESSIONAL
Neither HIV nor any STD causes such symptoms, but they could be related to anxiety or other emotional response to a sexual exposure you regret.  Aside from that possibility, they are not related to your Colombian sexual adventures.  
Avatar universal
Hi doc,
Thank you for all of your advice. As an update, I got retested on ~6 weeks and 4 days since exposure (mainly for syphillis as per your recommendation but did for all as well) and was negative for all. I'm not sure why I recently started having prickly feelings around the body...comes and goes but getting a bit worse. The tests negative result calmed me down and I'm not an anxious kind of guy. This should be all unrelated, right? Sorry for bugging you.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Unrelated for sure.

That will end this thread.  I don't need to hear any more test results.  You can be sure that any symptoms from here on out are not due to any infection from the sexual exposure described.  Take care and stay safe.
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