Any hope for me?

[foolishidiot]

Dear Doctor,

Thanks for your time. I can't tell you how stressed I have been these past 11 weeks.

I was (past tense because it is definitely over) in a relationship with another guy for the past 1 year. I was really naive and believed that he was HIV free (he claimed to be whenever we discussed the topic) and I think he was until we both decided to get tested. My result was negative while his came out to be positive (verified by a second test). He claims to have acquired the virus recently which makes the situation worse for me I believe. I have not had any other exposure.

We had several episodes of unprotected anal and oral sex. Kissing, frottage, rimming, etc. all included. I freaked out completely after the results and felt cheated. I have taken several tests since then.

All are negative / non-reactive / not detectable (Thank God for that)

3rd day after last exposure - HIV 1 DNA PCR Qualitative
8 weeks - Elisa (3rd gen) Antibodies
10 weeks - HIV DUO (for HIV 1 and 2), HIV Tridot Rapid (for HIV 1 and 2), HIV 1 RNA PCR Qualitative, Hepatitis B, Chlamydia (antibodies), HSV 1 and 2 (antibodies), VDRL
11 weeks - HIV Tridot Rapid (for HIV 1 and 2)
11 weeks 1 day - HIV 1 and 2 DNA PCR, Gonorrhoea PCR

The specific questions I have:

1) What further tests do I take and when (specifically for HIV)? The CDC recommends testing upto 6 months for high risk exposures like mine.
2) What are my odds at the moment - given the exposure and my tests?

As you can see, I am pretty stressed from the event and can't seem to get the thought out of my head. I haven't had any "significant" symptoms, but keep looking for signs of fever, sore throat and swollen lymph nodes and freak out at the slightest hint of a possible symptom.

3) Is it too late for symptoms anyway? Also, as you have guessed, I have spent a lot of my savings on these expensive tests.
4) Any other STD's I need to test for?

Thanks again. I have learnt a lot from this incident.

[H. Hunter Handsfield, M.D.]

When one partner has HIV, the virus is not transmitted with every sexual encounter.  Each episode of unprotected vaginal sex with an infected partner has about 1 chance in 1,000-2,000 the virus will be transmitted.  (Most wives and husbands of HIV infected people never catch the virus themselves.)

[yungndum]

Sorry Dr. I dont know if this is piggy backing the post if it is i apologize but, he said he had intercourse multiple times with his partner. How is it possible to have an encounter with a positive indivdual and come back negative. and i notice you and the other doctor mention "single encounters" as if it is a factor could you explain?

[foolishidiot]

Thanks for your patience Doctor. Really appreciate your help.

[H. Hunter Handsfield, M.D.]

HIV-2 is a) too rare to worry about and b) adequately covered by the tests you have had.

Don't look for nuance, i.e. don't go looking for reasons that you might actually be infected.  You're home free (a US baseball term) and can move on.  Deal with the relationship issues as you must, but if the additional STD tests are negative -- as almost certainly they will be -- you can stop worrying about any adverse health outcomes from this experience.  (But do consider strictly safe sex and/or pre-relationship HIV testing in your future relationships.) Best wishes.

[foolishidiot]

Thanks a lot Doctor for your time. Your comments have put my fears to rest (for the most part). The emotional healing will take time, but atleast the process can start now.

You are absolutely correct. I have been getting these tests without much professional advice. I will get the additional STD tests you mentioned. As per your comments, no further testing for HSV required (I did not get any symptoms as well).

The only follow-up question I have is about HIV 2. I know the tests I did cover HIV 1 and Group 0 as well. For HIV 2, I have the DUO, Rapid and Elisa tests as well as HIV 2 DNA PCR. However, I could not find a HIV 2 RNA PCR test at any of the 3 clinics I got these tests done. Can I assume I don't need that since I have it covered through the above tests?

Thanks again for your comments.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

I can certainly understand your shock and concern in these circumstances.  However, you should be having no worries at this point.  We have repeatedly pointed out -- you can find discussions in literally hundreds if not thousands of threads -- that test results ALWAYS trump exposure history and symptoms in determining whether or not someone has HIV, as long as testing is done sufficiently long after exposure.  Your test results prove that you didn't catch HIV.  At this point, you can ignore the level of risk, regardless of how alarming that information was when your partner first was tested.

1) The 6 month advice is for antibody testing alone and does not apply when p24 antigen (part of the Duo test) and HIV PCR tests also are done.  And even for antibody testing, 6 months is overly conservative, based on older antibody tests no longer in use.  Your results already prove you were not infected.  It is not possible to have HIV and have negative duo test and PCR 10-11 weeks after becoming infected.

2) Zero.

3) Yes, it is too late for symptoms; and if you do develop symptoms consistent with a new HIV infection, your test results have already proved that HIV in fact is not the cause.  It isn't possible.

4) The tests you list suggest you may have been relying on lab testing without professional advice, e.g. through an internet service.  (For example, no knowledgeable provider would have done a chlamydia blood test, which is useless in this situation.)  And probably not HSV testing, although a case can be made for it.  If my guess is correct, then you probably have had only urine testing for gonorrhea (and chlamydia), but not rectal testing for gonorrhea/chlamydia or a throat culture for gonorrhea.  These would be reasonable to do, but generally are not available without professional evaluation.  Your local STD clinic or NHS GUM clinic would be a good option.  (I'm guessing you're in the UK -- "learnt" instead of "learned".)

Bottom line:  For sure you didn't catch HIV.  Stop checking for symptoms and prodding for lymph nodes.  Stop freaking out.  Consider a GUM/STD visit to rule out those STDs not yet tested.

Good luck--  HHH, MD