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Chance of exposure / Appropriate test

Hi Doctor,

I am a healthy female who had single unprotected vaginal intercourse ( w/ ejaculation) preceeded by brief anal ( 10- 15 sec w/ no ejaculation ) with a Bronx Hispanic male of unknown status. This incident occured 24 days ago and i have had no ARS sympthoms since.  Would youp please advise on whether i should get PCR or OraQuick antibody test at this point?  Also, based on current statistics , what are my actual chances of having contracted HIV?  Thank you in advance.  
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239123 tn?1267647614
There are three parts to your question:  What is the chance you caught HIV, if your partner had it?  What are the odds he is infected?  And what HIV testing is recommended

First, the average transmission risk from male to female from a single episode of unprotected vaginal sex averages 1 in 1,000.  Anal sex to completion is riskier, but with such brief exposure without ejaculation, that part of the event doesn't make much difference.  So even if your partner had HIV, the likelihood you were infected is very low.

Second, what is the chance he had HIV?  You don't provide enough information.  We probably can assume he isn't gay, right?  Nationwide, the chance any particular straight male has HIV is less than 1 chance in 1,000.  On the other hand, parts of NYC -- including some neighborhoods in the Bronx -- have among the nation's highest HIV rates.  And Hispanics in NYC on average are probably at higher risk than the national average.  But these factors depends on things you don't mention, such as whether your partner has used drugs by injection or has ever been imprisoned.  You know him, whereas I have no way even to guess at these thigs.  Without such risk factors, it is very unlikely he has HIV.

As to the type and timing of testing for HIV:  At this point, standard antibody testing is all you need.   If you have reason to believe your partner was in fact at high risk (bisexual, drug use, etc) and if you were being tested earlier (e.g., at 10-14 days), then a PCR test might have picked up an infection earlier than OraQuick or other antibody tests.  By 3.5 weeks (24 days), around 90% of newly infected people have positive antibody tests, so a negative result would be very reassuring, although not perfect.  But since you have waited this long already, I recommend you just wait another 2 weeks then have an OraQuick or any other standard antibody test, then you will know for sure without needing to be tested once again later.

Many people on this forum ask about test type because they plan to be tested anonymously, often using an online service.  I recommend strongly that you not do that.  See your primary care provider, or visit your local health department, so that you get professional services (and the provider's advice) about the right tests to do.  While you're at it, please also get tested for syphilis, gonorrhea, and chlamydia.  The chance you caught one of those STDs is much higher than the chance of HIV.

Bottom line:  Assuming you have no reason to suspect your partner was at high risk for HIV, the chance you were infected is almost zero -- low enough that you dont' really need testing at all.  But of course better safe than sorry.  Don't forget the STD tests.  And please get into the habit of routine condom use!

I hope this helps.  Best wishes--   HHH, MD
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Avatar universal
Thank you Dr. Handsfield.

I will get all suggested STDs' tests asap and later, an HIV test.  Unfortunately, i have no reliable information about this person's past and out of all the risk factors you cited  his past imprisonment seems to be the most probable one.

Lesson learned here for sure - regardless of my future test results.
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