Follow-up to College Student HIV Risk

[espas247]

Hi Dr.,

I posted in the wrong section before and wanted to give you an update/more detailed analysis of my situation.  I am a 20yr old college student living in the US. I recently had a very brief relationship (1 month) with another man about my age (23)--he was an uncircumcised Asian American. Before we did anything sexual, we talked about our past sexual history. The only thing that scared me about his past was that he said he was continuously nagged to have unprotected sex with his ex until he complied (once). This in mind, I decided to use a condom when we first had sex about 4 weeks ago, but it broke. I immediately showered after this incident and thought nothing of my risks. About 2.5 weeks ago, my partner and I were doing some fore play when he unexpectedly inserted my penis anally, unprotected. After about a minute, we both decided this was a bad idea, and I immediately pulled out. I also immediately washed my penis thoroughly with soap and water. Since this incident, we broke up for unrelated reasons. I have been very anxious about this event to the point where all I do is think of the possibility I have HIV. I have talked to him about it, and he told me that about a month after his last unprotected incident he was tested and was negative--he "swears he's clean". Since this talk, he cut all communications with me, maybe because of my neurotic behavior.  Being completely anxious, I wanted to know my status, so last night I was tested for HIV, and it was negative. I know that this test would not cover the recent unprotected incident but I wanted to know my status. I read somewhere that washing after sex actually increases risk in UNCIRCUMCISED men; however, I am circumcised, but this still makes me nervous.

What is my risk? Should I be worried to the point that I am? How many people see a positive about 2.5-3 weeks after exposure? Thanks.

[Edward W Hook, MD]

You've already answered it yourself.  Some of the symptoms you describe are shared by the ARS however the odds that you have ARS are miniscule.  This is not ARS and you do not have HIV..  EWH

[espas247]

So Dr.,

It has been a little over 2.5 weeks since the risky behavior, and I am starting to feel like I am develop a sore throat. I am also getting a slight ear ache in my right ear. My body temp is normal--98.4. I have read your responses many time that symptoms are not a good indicator of HIV infection but is an earache one of the ARS symptoms? What do you think of my ailments?

[Edward W Hook, MD]

Sorry you needed to post a second time but the rules serve an important purpose of making sure that questions wind up in the right place for others to access them.  I think you are right, you are completely and, in my opinion, unnecessarily, anxious about this exposure.  It was very low risk.

I know of no scientific data that washing does anything to increase risk for HIV and in fact, have heard it suggested by some in the field that it could actually reduce risk.  I would not worry about it, nor do I see any reason for you to not do it in the future as long as you do so in a reasonable fashion (i.e. don't get carried away with your "scrubbing").

As far as the meaning of your most recent test results, at 2 weeks abut half of persons who are going to develop positive blood tests have done so.  While that is not enough to provide anyone with great assurance, in your case, it does further shift the odds towards being quite sure that you did not get HIV from the exposure you describe.

I hope this helps.  EWH