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Please help with assessment...being tested soon
Hi Doctors! I have been with my husband for eight years now and we both would like to have a child. We have both been completely faithful to one another. Prior to our relationship, I was never with anyone, but my husband has past partners. The time period in question for my husband is 9-11 years ago. My husband said he had a couple of unprotected sexual experiences during that time (heterosexual contact only, no drug use, no immigrants). He is going to the doctor next week to ensure everything is okay (complete std/hiv panel).
He is very healthy and goes to the doctor annually. I have annual paps which have all been normal. I also have blood drawn every three months for my crohn's disease. I have tested negative for HPV with the HPV DNA test and my Chlamydia test was negative (routine part of my pap smear). My husband does not have any symptoms, but I tend to be a worry-wart that fixates on any ache or pain that I ever have (but I believe this is mostly due to my fear of hiv). The only symptoms I may be having would be the top of my feet itch (not all the time, but read this could be a symptom) and when I am stung by a mosquito I get big welts (read this could be a symptom also). One more piece of information which I don't know matters or not, but for the first several years of our relationship we used condoms as a form of birth control, but for the past several years we have used withdrawal.
My questions are as follows:
1. What are the chances that he or both of us have hiv?
2. What are the chances that my husband would be showing no symptoms 9 – 11 years later or me 8 years later?
3. With both of us seeing a doctor regularly, wouldn't the doctor suggest testing if he or she thought we needed it?
Every time I try to tell myself our chances are small, I keep thinking we'll be the "one" especially if people can go for 20 years without symptoms! Please help...
He is very healthy and goes to the doctor annually. I have annual paps which have all been normal. I also have blood drawn every three months for my crohn's disease. I have tested negative for HPV with the HPV DNA test and my Chlamydia test was negative (routine part of my pap smear). My husband does not have any symptoms, but I tend to be a worry-wart that fixates on any ache or pain that I ever have (but I believe this is mostly due to my fear of hiv). The only symptoms I may be having would be the top of my feet itch (not all the time, but read this could be a symptom) and when I am stung by a mosquito I get big welts (read this could be a symptom also). One more piece of information which I don't know matters or not, but for the first several years of our relationship we used condoms as a form of birth control, but for the past several years we have used withdrawal.
My questions are as follows:
1. What are the chances that he or both of us have hiv?
2. What are the chances that my husband would be showing no symptoms 9 – 11 years later or me 8 years later?
3. With both of us seeing a doctor regularly, wouldn't the doctor suggest testing if he or she thought we needed it?
Every time I try to tell myself our chances are small, I keep thinking we'll be the "one" especially if people can go for 20 years without symptoms! Please help...
MEDICAL PROFESSIONAL
You cannot learn anything about past STDs by CBC, chemistry panel, etc. Specific tests are necessary. The only ones worth doing, however, are syphilis, HIV, and maybe herpes. (The last is controversial in asymptomatic people at relatively low risk. Just scan the STD forum for innumerable discussions of problems interpreting and understanding HSV test results.) A urine test for chlamydia and gonorrhea also could be done, but these usually cause symptoms and go away on their own within a few months, so they likely would be a waste of money.
In the US, HIV still is heavily concentrated in men who have sex with men, injection drug users, and other traditonal high risk groups. Heterosexual transmission occurs, but mostly in regular partners of HIV infected persons, who themselves have obvious risk factors (even if they don't always admit it). Even these transmission events generally occur after months or even years of repeated unprotected sex; there are few HIV infections in the US due to single or occasional non-marital sexual exposures. Sure, technically anyone with nonmonogamous sex could be the rare unlucky one, and in theory your husband could have a deep, dark history that he doesn't acknowledge. (I'm not saying he does -- just that life is life and this sometimes happens.) This is why CDC recommends that every American have an HIV test somewhere along the line, and why all pregnant women are tested regardless of risk history. On that basis, testing is reasonable in your case (once). But not at all based on your and your husband's known sexual histories. If you or your husband are African American, statistically that raises the risk, but still very low if your sexual histories are accurate.)
Finally, as I said above, it is almost impossible that 2 people could be HIV infected for 8 years and both still be outwardly healthy. No chance.
I'll be happy to comment briefly one more time if and when you return to report your HIV test result -- but only then.
In the US, HIV still is heavily concentrated in men who have sex with men, injection drug users, and other traditonal high risk groups. Heterosexual transmission occurs, but mostly in regular partners of HIV infected persons, who themselves have obvious risk factors (even if they don't always admit it). Even these transmission events generally occur after months or even years of repeated unprotected sex; there are few HIV infections in the US due to single or occasional non-marital sexual exposures. Sure, technically anyone with nonmonogamous sex could be the rare unlucky one, and in theory your husband could have a deep, dark history that he doesn't acknowledge. (I'm not saying he does -- just that life is life and this sometimes happens.) This is why CDC recommends that every American have an HIV test somewhere along the line, and why all pregnant women are tested regardless of risk history. On that basis, testing is reasonable in your case (once). But not at all based on your and your husband's known sexual histories. If you or your husband are African American, statistically that raises the risk, but still very low if your sexual histories are accurate.)
Finally, as I said above, it is almost impossible that 2 people could be HIV infected for 8 years and both still be outwardly healthy. No chance.
I'll be happy to comment briefly one more time if and when you return to report your HIV test result -- but only then.
Quick follow-up and question:
My husband went to the doctor and explained we wanted to have kids and told him about his past and his need to be tested. Doctor said he understood and they would do thorough blood work that would check for everything. We had been worrying for a couple days waiting on the results, got the blood work back and it appears they didn't test for std's!!! He had a urinalysis, lipid profile, comprehensive metabolic panel, cbc with platelet and differential, and tsh 3rd generation. Am I missing something? Can these test be used for std testing? I didn't think so, but that's why I'm asking you. He and I are both irritated at this point which means more testing, waiting, and worrying.
Second question: I read a lot of the posts and you will state that individuals are "low risk", what exactly makes them low risk? For instance, you say that in my case we have a very low risk sexual history, but from all the sites I come across one of the"high" risk categories are people who have had multiple partners. What makes our situation "low risk"? By the way, we are in the United States. :)
Thanks for everything!
My husband went to the doctor and explained we wanted to have kids and told him about his past and his need to be tested. Doctor said he understood and they would do thorough blood work that would check for everything. We had been worrying for a couple days waiting on the results, got the blood work back and it appears they didn't test for std's!!! He had a urinalysis, lipid profile, comprehensive metabolic panel, cbc with platelet and differential, and tsh 3rd generation. Am I missing something? Can these test be used for std testing? I didn't think so, but that's why I'm asking you. He and I are both irritated at this point which means more testing, waiting, and worrying.
Second question: I read a lot of the posts and you will state that individuals are "low risk", what exactly makes them low risk? For instance, you say that in my case we have a very low risk sexual history, but from all the sites I come across one of the"high" risk categories are people who have had multiple partners. What makes our situation "low risk"? By the way, we are in the United States. :)
Thanks for everything!
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
You don't say where you are, which makes a difference in risk assessment -- but I'm going to assume the US or other industrialized country. Heterosexually transmitted HIV remains rare in most population groups in such countries, and you describe a very low risk sexual history.
1) It would be exceedingly surprising if you or your husband has HIV. If I were a betting man, I would be happy to go to Las Vegas and bet 100,000 to one (maybe a million to one) that you don't have it.
2) Almost everybody with HIV is very sick, often dead, with untreated infection more than 8 years.
3) This is a harder question. Most docs would not think of HIV in an outwardly healthy person unless the patient was known to be in a high risk group, like injection drug use, gay/bisexual, etc.
Almost certainly you will not be the "one". Go into your test with a light heart. It will be negative.
I hope this helps. Best wishes-- HHH, MD
You don't say where you are, which makes a difference in risk assessment -- but I'm going to assume the US or other industrialized country. Heterosexually transmitted HIV remains rare in most population groups in such countries, and you describe a very low risk sexual history.
1) It would be exceedingly surprising if you or your husband has HIV. If I were a betting man, I would be happy to go to Las Vegas and bet 100,000 to one (maybe a million to one) that you don't have it.
2) Almost everybody with HIV is very sick, often dead, with untreated infection more than 8 years.
3) This is a harder question. Most docs would not think of HIV in an outwardly healthy person unless the patient was known to be in a high risk group, like injection drug use, gay/bisexual, etc.
Almost certainly you will not be the "one". Go into your test with a light heart. It will be negative.
I hope this helps. Best wishes-- HHH, MD
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