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One-night Stand Ends in Pregnancy, Chlamydia, Gonorrhea & now...HIV?
25 yo, married, white, married female here. Married 2y, with husband 4y. History of 15-20 sexual partners, most boyfriends/friends, never strangers. None minorities, none gay. Never tested prior to this situation. Sexually active at 14, annual gyn visits & birth control starting then. Irregular paps in 2004 caused by HPV. Early stage cervical displaysia, cone biopsy & leep cauterization. 3-rounds of Guardasil vaccinations & no more irregular paps after 1 year post initial irregularities. Generally healthy. Daily ultivitamins, fish oil & other nutritional supplements. Eat relatively healthy. Maintain low BMI. Good immunities. But, HIGH STRESS; intense marital strains & work strains. More stress brought on by guilt of having extramarital EMOTIONAL affair. On a trip in Jan, had unprotected sex with a stranger just met that night. He was white, not gay. I was blackout drunk. Had unprotected intercourse 2x. Woke up with a sore throat. 6 days post lost voice & had flu-like symptoms including extreme sinus congestion, drainage, & phlegm. Never had rash, lesions, fever or headaches, just head congestion from sinus pressure. Nutritionist tests me & indicates I have a virus. Went to regular doctor, got tested for mono (neg) & given 5-day Z-pak. Cleared it up immediately. 3 wks post affair, learned I was pregnant. Had D&C abortion 5 wks post one-night-stand at roughly 4.5 wks along. Had unprotected sex with husband 1wk post abortion, several times. Devloped pelvic pain and yellow discharge 2 days later. Got Rocephin injection & Z-pak at urgent care clinic. Cultures come back + for Chlam/Gonn & - for Trich. Never been tested for HIV before. Went for a follow-up visit at my GYN this week. Said I have very low chance of HIV. Checked me & said I looked normal &. Said antibiotics I was already given should handle STDs. Got blood test for HIV, Syphilis & Hep B. I’m COMPLETELY TERRIFIED that I now have HIV. What are the chances that I contracted it from my one night stand?
Great, thank you so much for your time and for sharing all your expertise!
MEDICAL PROFESSIONAL
The reply to everyone with that question is exactly the same. 8 weeks is fine. No further testing is needed. You are 100% in the clear with respect to HIV, not 99%. However, many health agencies continue to adhere to the now outmoded advice about testing at 3 months. So you could test yet one more time if you need the additional reassurance. But truly 8 weeks is fine.
I wanted to let you know that I got my test results today = ALL NEGATIVE!!!! They said my blood looked "perfect." :D
Thanks so much for your advice. Now that I know I AM OK, i'm ready to take on to the next battle, figuring out what to do with my husband! ;)
I know you've said it a million times, but I just want to make sure...if the blood test came back negative at 8 weeks post possible exposure, I can be pretty much 99% sure that I am in the clear, right? So, no further tests needed?
Thanks so much for your advice. Now that I know I AM OK, i'm ready to take on to the next battle, figuring out what to do with my husband! ;)
I know you've said it a million times, but I just want to make sure...if the blood test came back negative at 8 weeks post possible exposure, I can be pretty much 99% sure that I am in the clear, right? So, no further tests needed?
Dear Dr. Hansfield,
Thank you so much for your swift reply, you have no idea how reassuring the advice is to me. I have been an emotional basket case since this whole ordeal started and even more so since the HIV test.
Here's a little more data for you...
- The date of the HIV blood test was 3/15, a little over 8 weeks from the 1/15 encounter. I understand from your advice that tests taken that far from exposure are basically conclusive and can be relied on. I expect a result tomorrow or Friday and will keep you apprised.
- I had the same fear about my husband, regarding my z-pak for the sinus flu/cold I had. I think if I had no symptoms prior to intercourse with my husband and had taken the full course of Azithromiacin prior also, it would have been nearly impossible for symptoms to start after that. We have discussed the fact that I tested positive for gonn/chlam and he went to the dr. for a full battery of tests/blood work, including HIV this week also and was given a 1-dose antibiotic which is different than the Rocephin injection and Z-pack I received for the same thing.
- Lastly I forgot to add that at Planned Parenthood, they gave me a 7-day supply of Doxycycline which I took faithfully a week before I ever resumed having intercourse with my husband. Based on your experience and expertise, would you lean more towards the possibility of false positive results, or infidelity? I have asked him and he swears he hasn't (but then again, doesn't everyone).
Anyway, thanks again for your kind advice and reassurance during this difficult time for me. I always try to get as many professional opinions as possible but it appears to me you are a real expert in this area. I will surely keep you apprised as to the results of my blood work. Thanks again!
Thank you so much for your swift reply, you have no idea how reassuring the advice is to me. I have been an emotional basket case since this whole ordeal started and even more so since the HIV test.
Here's a little more data for you...
- The date of the HIV blood test was 3/15, a little over 8 weeks from the 1/15 encounter. I understand from your advice that tests taken that far from exposure are basically conclusive and can be relied on. I expect a result tomorrow or Friday and will keep you apprised.
- I had the same fear about my husband, regarding my z-pak for the sinus flu/cold I had. I think if I had no symptoms prior to intercourse with my husband and had taken the full course of Azithromiacin prior also, it would have been nearly impossible for symptoms to start after that. We have discussed the fact that I tested positive for gonn/chlam and he went to the dr. for a full battery of tests/blood work, including HIV this week also and was given a 1-dose antibiotic which is different than the Rocephin injection and Z-pack I received for the same thing.
- Lastly I forgot to add that at Planned Parenthood, they gave me a 7-day supply of Doxycycline which I took faithfully a week before I ever resumed having intercourse with my husband. Based on your experience and expertise, would you lean more towards the possibility of false positive results, or infidelity? I have asked him and he swears he hasn't (but then again, doesn't everyone).
Anyway, thanks again for your kind advice and reassurance during this difficult time for me. I always try to get as many professional opinions as possible but it appears to me you are a real expert in this area. I will surely keep you apprised as to the results of my blood work. Thanks again!
MEDICAL PROFESSIONAL
Welcome to the HIV forum. I'll try to help.
Even though your partner may have had both gonorrhea and chlamydia, the chance he also had HIV is very low. Not zero, but still the odds are strongly in your favor. And if he had it, the chance of transmission also was under 1 in a few hundred -- again, strongly in your favor. Your sore throat a few hours later and then cold symptoms in the next 6 days cannot possibly be due to HIV from that exposure. HIV symptoms cannot start sooner than 8-10 days after exposure. It sound like you caught a cold from the guy, not anything like HIV. Mono also cannot cause such symptoms so soon -- and neither mono nor HIV causes "sinus congestion".
I'm somewhat skeptical about your positive gonorrhea and chlamydia tests, by the way. If I understand correctly, you were given azithromycin (Z-Pak) early on, then had the positive tests a few weeks later. Azithromycin is highly reliable against chlamydia and pretty good against gonorrhea; it would be quite unusual for either one to persist after such treatment. It can happen, but you might discuss this with your doctor -- e.g. what kind of test was done, how reliabile s/he thinks the results are etc. However, I have to be concerned that your husband might also be having other sex partners. Are you very confident he could not have done that and brought the chlamydia and gonorrhea into your relationship?
Going back to HIV, you can expect your blood test to be negative. A negative result at 5 weeks will be highly reassuring, but not quite definitive. Your doctor might recommend a final test at 6-8 weeks.
Feel free to report back with your syphilis and HIV test results. Also, regardless of the possible source(s) of infection, your husband needs to be tested and treated for gonorrhea and chlamydia -- and you should consider a straightforward and sensitive discussion with him about his potential STD risks.
I hope this helps. Best wishes-- HHH, MD
Even though your partner may have had both gonorrhea and chlamydia, the chance he also had HIV is very low. Not zero, but still the odds are strongly in your favor. And if he had it, the chance of transmission also was under 1 in a few hundred -- again, strongly in your favor. Your sore throat a few hours later and then cold symptoms in the next 6 days cannot possibly be due to HIV from that exposure. HIV symptoms cannot start sooner than 8-10 days after exposure. It sound like you caught a cold from the guy, not anything like HIV. Mono also cannot cause such symptoms so soon -- and neither mono nor HIV causes "sinus congestion".
I'm somewhat skeptical about your positive gonorrhea and chlamydia tests, by the way. If I understand correctly, you were given azithromycin (Z-Pak) early on, then had the positive tests a few weeks later. Azithromycin is highly reliable against chlamydia and pretty good against gonorrhea; it would be quite unusual for either one to persist after such treatment. It can happen, but you might discuss this with your doctor -- e.g. what kind of test was done, how reliabile s/he thinks the results are etc. However, I have to be concerned that your husband might also be having other sex partners. Are you very confident he could not have done that and brought the chlamydia and gonorrhea into your relationship?
Going back to HIV, you can expect your blood test to be negative. A negative result at 5 weeks will be highly reassuring, but not quite definitive. Your doctor might recommend a final test at 6-8 weeks.
Feel free to report back with your syphilis and HIV test results. Also, regardless of the possible source(s) of infection, your husband needs to be tested and treated for gonorrhea and chlamydia -- and you should consider a straightforward and sensitive discussion with him about his potential STD risks.
I hope this helps. Best wishes-- HHH, MD
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