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Timeline for HIV testing after unprotected sex
On Saturday morning (July 23) I had unprotected anal sex with two men. Alcohol was involved and at least one of the two entered me. My understanding is that he ejaculated. I also entered one of the two men, but did not ejaculate.
They both claim to have been tested withing the past three weeks, both negative, and claim previous regular negative tests every 3-6 months.
What is my risk and what is the best timeline for me to determine likely infection?
I have a long-term partner and we have until now had unprotected sex. I am willing to pay for a RNA test to expedite closing the window. Can you explain the pros/cons of this approach in my situation? Also, any recommendations of alternative methods and timelines would be most appreciated.
Thank you very much for your advice.
They both claim to have been tested withing the past three weeks, both negative, and claim previous regular negative tests every 3-6 months.
What is my risk and what is the best timeline for me to determine likely infection?
I have a long-term partner and we have until now had unprotected sex. I am willing to pay for a RNA test to expedite closing the window. Can you explain the pros/cons of this approach in my situation? Also, any recommendations of alternative methods and timelines would be most appreciated.
Thank you very much for your advice.
MEDICAL PROFESSIONAL
A negative antibooy test at 4 weeks is 90-95% reliable. Combing that result with the relatively low risk of the exposure, the chance you caught HIV is probably under 1 chance in 100,000 to a million. If you are comfortable with those odds, no more testing is needed. Otherwise, hace a combo test now, or another antibody test at 6-8 weeks.
I didn't read your last comment before being tested at exactly 4 weeks. I had a oral antigen swab at the health department. It was negative.
At this point, should I get another test at 6 or 8 weeks to verify?
I haven't resumed sexual contact with my regular partner since the July 23 episode with other partners. What degree of risk for my partner if I performed oral sex on him or receiving anal sex at this time?
Thank you for all of your assistance.
At this point, should I get another test at 6 or 8 weeks to verify?
I haven't resumed sexual contact with my regular partner since the July 23 episode with other partners. What degree of risk for my partner if I performed oral sex on him or receiving anal sex at this time?
Thank you for all of your assistance.
MEDICAL PROFESSIONAL
Friends usually don't mislead friends. So it does in fact make a difference; this makes it that much less likely either of your partners is infected. With this additional information, a PCR test really doesn't seem necessary. If you were my patient, I would advise visiting the health department or the AIDS clinic for a single combo test (HIV antibody with p24 antigen) 4 weeks after the event. And in the meantime, I would be confident you weren't infected and that sex with your regular partner would be safe. All things considered, the chance you caught HIV a few days ago is extremely small.
Dr. Handsfield,
Just to clarify, I do know both men involved. One has been a friend for seven years and the other is his former boyfriend. Not that it makes the situation better, but I do know who they are and have easy access to them. This was an isolated incident that I do not plan on repeating.
I've contacted my health department, local AIDS clinic, and walk-in labs and they only perform more basic HIV testing. I will likely have to go to a primary care physician for the PCR and Duo. Have you heard anything about whether they are generally covered by insurance? Do you recommend I go to any form of specialist? Perhaps I could ask my health department or local AIDS clinic if they're aware of a PCP that specializes in this treatment?
Since I don't have perfect knowledge of the sexual activity of both partners since their supposed last testing three weeks ago–assuming they've had some sex at all with other people–how do you feel about the level of assurance I could have from both of them having an antibody test? Also, just to clarify, by antibody test, which tests does this cover? I'm familiar with the standard two-week blood test, the oral swab and the finger prick.
Thank you very much for your assistance, I really appreciate your detailed response.
Just to clarify, I do know both men involved. One has been a friend for seven years and the other is his former boyfriend. Not that it makes the situation better, but I do know who they are and have easy access to them. This was an isolated incident that I do not plan on repeating.
I've contacted my health department, local AIDS clinic, and walk-in labs and they only perform more basic HIV testing. I will likely have to go to a primary care physician for the PCR and Duo. Have you heard anything about whether they are generally covered by insurance? Do you recommend I go to any form of specialist? Perhaps I could ask my health department or local AIDS clinic if they're aware of a PCP that specializes in this treatment?
Since I don't have perfect knowledge of the sexual activity of both partners since their supposed last testing three weeks ago–assuming they've had some sex at all with other people–how do you feel about the level of assurance I could have from both of them having an antibody test? Also, just to clarify, by antibody test, which tests does this cover? I'm familiar with the standard two-week blood test, the oral swab and the finger prick.
Thank you very much for your assistance, I really appreciate your detailed response.
MEDICAL PROFESSIONAL
Sorry; see above.
By the way, my comment above should be "...then you could be nearly 100% confident...." There would be a theoretical possibility one of them could be in a window period.
By the way, my comment above should be "...then you could be nearly 100% confident...." There would be a theoretical possibility one of them could be in a window period.
MEDICAL PROFESSIONAL
Welcome to the forum; sorry for the delayed reply.
This was a pretty high risk exposure, i.e. unprotected anal sex, both top and bottom, with men you don't know. I'm glad you asked about your partners' HIV status (and hope you did so before the exposures occurred), but of course it was a big mistake to not use condoms. That said, most people don't lie about HIV status when asked directly, so probably neither of your partners had HIV. On the other hand, there is at least a small chance that either of them could have a new infection, since their previous HIV tests.
A PCR test for HIV/RNA makes sense in this situation; a negative result at about 10 days (i.e. around August 2-3) would be very reassuring, but you would still need to have an HIV antibody test at 6 weeks -- or perhaps a combo test (for HIV antibody and p24 antigen) at 4 weeks) to be certain. In this situation, however, you should not rely on my online advice for the details. You should see a doctor or clinic with expertise in HIV prevention -- either a local community doctor very familiar with HIV/AIDS or your local health department would be good choices.
As for unprotected sex with your regular partner, if I were in your situation I wouldn't take the risk until the PCR test was done and negative. At that point, I would probably feel comfortable proceeding, but only after informing my partner and letting him participate in the decision. If he prefers that you wait until all testing was done and negative, you should of course respect his wish.
One other approach that could sort this out more quickly would be to speak with both the recent partners and ask them to be retested. If they remain antibody-negative, then you could be 100% confident you weren't exposed and wouldn't need to await your own negative test results.
I hope this helps -- and also hope this experience helps you have condoms handy and use them for similar exposures in the future.
Regards-- HHH, MD
This was a pretty high risk exposure, i.e. unprotected anal sex, both top and bottom, with men you don't know. I'm glad you asked about your partners' HIV status (and hope you did so before the exposures occurred), but of course it was a big mistake to not use condoms. That said, most people don't lie about HIV status when asked directly, so probably neither of your partners had HIV. On the other hand, there is at least a small chance that either of them could have a new infection, since their previous HIV tests.
A PCR test for HIV/RNA makes sense in this situation; a negative result at about 10 days (i.e. around August 2-3) would be very reassuring, but you would still need to have an HIV antibody test at 6 weeks -- or perhaps a combo test (for HIV antibody and p24 antigen) at 4 weeks) to be certain. In this situation, however, you should not rely on my online advice for the details. You should see a doctor or clinic with expertise in HIV prevention -- either a local community doctor very familiar with HIV/AIDS or your local health department would be good choices.
As for unprotected sex with your regular partner, if I were in your situation I wouldn't take the risk until the PCR test was done and negative. At that point, I would probably feel comfortable proceeding, but only after informing my partner and letting him participate in the decision. If he prefers that you wait until all testing was done and negative, you should of course respect his wish.
One other approach that could sort this out more quickly would be to speak with both the recent partners and ask them to be retested. If they remain antibody-negative, then you could be 100% confident you weren't exposed and wouldn't need to await your own negative test results.
I hope this helps -- and also hope this experience helps you have condoms handy and use them for similar exposures in the future.
Regards-- HHH, MD
Is my question too general to be answered, or is there another post that already answers my questions? I'm just checking because I noticed posts more recent than mine have been answered and mine has not.
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