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Avatar universal

Waiting for test results... Cannot take it any more!!!!!

Dear Doctors,
Please help me to assess my risk. I have had a pretty shaky past when it comes to my sexual behavior that I offer no excuse for because there isn’t any. I am a 27 AA woman. I haven’t been tested in about 3 years. In that time I had various relationships and a few unprotected sexual encounters with 4 different men. All f4 of the men are heterosexual men, AA,  28-31, no reason to believe they are MSM and pretty certain they aren’t IV drug users.
1.Knew him for over a year before first encounter very brief unprotected vaginal/oral maybe 2 more unprotected encounters never any ejaculation inside of me. I ended relationship because of his unwillingness to wear protection. This scared me.
2.Had a relationship with a  for about 6 months spent 1 evening together and had protected and some unprotected sex both vaginal & oral. no ejactulation. Before sex we discussed our status and he told me he tested pretty regularly and was negative
3. Had an on and off again relationship for over a year and had unprotected oral mostly but 4-5 unprotected vaginal sex.
4.1 time unpro vag with a man I was seeing for a few month. Later asked his status and he said he just tested and was negative for everything.
All the men with the exception of number 4 and I are still friends but have no sexual contact as we have all moved on.
I have been tested for all STDs except HIV and was found negative and have completely changed my sexual behavior. I have been diagnosed with crohns disease and recently sent for blood test and requested an HIV test. The results are taking forever to come back and I am worried sick for obvious reasons. I have read through the forum and found no one whose risk mimicked mines and I am asking for an assessment of my risk, and a better understanding of 1in 1000 men having HIV and 1 in 1000 chance of catching it. Am i being totally paranoid or is my worry warrented? Thank you in advance, for any consideration giving to my situation.

5 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the HIV forum.  I'll try to help, but not sure how much I can do.  Your fears are going to be resolved by the test result -- which probably will be negative, since the odds are strongly on your side -- more than by anything I can say.

If you don't mind, your question provides an opportunity for a blog-like response, in this case about higher HIV/STD rates in African Americans than in other population groups in the US -- the sort of response I can bookmark for future use.  So here come some general comments before I come to your specific questions.

The central issue in assessing your risk is that you, and presumably most of your partners, are African American.  It is an unfortunate that this fact alone denotes higher risk for HIV than among other heterosexual populations in the US.  Of course this isn't because of race per se.  It is because AAs, as a group, have higher rates of factors like injection drug use; imprisonment (often with opportunistic sex with other men); greater antipathy toward homosexuality, especially in men, which in turn contributes to deeply closeted gay men who also have sex with female partners (the down-low); a different male-female ratio in the community, due to higher mortality and imprisonment, effectively forcing women to share male partners, with or without their mutual knowledge; and much higher rates of HSV-2 and other STDs than whites, which in turn are partly due to many of these same factors.  These factors see their extremes in especially disadvantaged, ghetto-like settings, as in parts of Washington DC, where the rates of heterosexually transmitted HIV in AAs are as high as in some tropical African countries.

For these reasons, even among AAs who makes all the right sexual choices and is inherently safe in his or her partner selection, condom use, etc, the risks of HIV are substantially higher than in whites, Asian-Americans, or other racial/ethnic groups.  It's very unfair, and you will recognize that all this comes down to the legacies of race in our country.  You well know things are getting better, but the level playing field we all hope for remains in the future.

Now, having said all that, you describe a careful approach to sexuality and it is unlikely any of your partners had HIV.  And remember that when one person has HIV, the risk of transmission by unprotected vaginal sex averages once for every 1,000 exposures.  Most women who catch HIV sexually do so in the context of an ongoing relationship, often for many years, with a man who unknowingly has HIV.  For the reasons above, the chance you caught HIV are higher than if you and your partners were of other races, but still the odds are strongly in your favor:  not many people like you catch HIV.  

So the answers are that you definitely are not being "totally paranoid" -- the risks are real -- but they are low and it will be very surprising if your HIV test is positive.  Please try to be mellow about it, with the expectation of a negative result.  Feel free to return and let me know the test result.

Best wishes and good luck--  HHH, MD
Avatar universal
Thank you Doctor for responding so quickly. I will try to mellow out. REALLY :)
But after reading your response I have follow up questions. I hope this is ok.
1. I live in a state neighboring Washington DC. Does this increase my risk?
2. "more than by anything I can say" I am not trying to read into anything but i want to be clear what you meant by this statement.
I apologize and promise not to keep going on. Just need a little more clarity. Thank you.
239123 tn?1267647614
MEDICAL PROFESSIONAL
The state where you reside is less important than the specific community.  For example, if you're in suburban Maryland or Virginia, it would be a lower risk environment than, say, downtown Baltimore.  You're probably a better judge than I can be about whether your past sex partners, and their partners (i.e., your "sexual network") have links to communities like Anacostia or central Baltimore.

I just meant that your negative blood test probably will be more effective than my verbal reassurance in resolving your fear of having HIV.

Take care.
Avatar universal
I received my results today, and I am NEGATIVE!!!!!!! whewwwwwwwww feels wonderful! thank you for the services you all provide.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Not to gloat with "I told you so" -- but I told you so!  Congratulations.  Best wishes, and stay safe in the future -- most important, consistent condom use in the future until/unless you are assured of mutual monogamy with a partner who has been tested and negative for HIV.  While this advice is universal, it is an unfortunate but realistic fact that it is especially important for sexually active African Americans -- for the reasons we discussed.

Thanks for the kind words about the fourm.  I'm glad to have helped.

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