Risky Business - Male to Female Transmission fears - please help

[calmseeker]

Hi Doctors,

I keep trying to tell myself everything's going to be okay, but I'm so scared that I've ruined my life with one slip-up.  I'm literally terrified.

I'm a woman and I've been sexually inactive for the past 18 months, and my last test for HIV was negative. I've only ever had unprotected sex with one man - my long-term boyfriend at the time.

Then, 2 1/2  weeks ago, I had unprotected vaginal and oral sex (giving and recieving) with a man of undetermined HIV status. He didn't ejaculate, but there was pre-***. Also, I had been waxed that day, and had finished my period a few days earlier.

We are both of Western origin, but travel a lot for work around the world. He is known for being promiscuous with women, but not for i/v drug use, bisexuality or as far as I know, sex with prostitutes. I tried to slow things down to use a condom, but there was alcohol involved, and he didn't seem to care. I did manage to stop things, as I said above, before he came inside of me.

We know a lot of people in common, and I've heard nothing to indicate he is HIV positive. But his lack of concern about condom use, his rep as a ladies' man, and the fact that he lives in Asia and travels a lot have me convinced I might as well have slept with a bisexual drug user.

Also, I took Plan B as emergency contraception the day after the event, and got my period early a week after that. But then I also got a vaginal yeast infection towards the end of my period - compounding my fears.

He and I are both now working in different countries, and I haven't been able to/am scared to ask him about his status.

I know your answer won't change anything - but how at risk am I? And how early can I be tested with any degree of certainty? the idea of waiting 6 weeks, never mind 3 months seems like a lifetime.

Any help or advice would be greatly appreciated.

[Edward W Hook, MD]

At six weeks following your exposure, given the situation you described, your negative HIV test virtually guaranties that you do not have HIV.  There is little to be gained from further testing.  Time for you to move on with your life.  EWH

[byronsun]

Assume you are a young woman with a good healthy usually. Do you think you body will not have anti-HIV within 6 weeks? Come on, test for those people after 3 month, they are old people with bad healthy so within 6 weeks, their body do not have that ability to generate Anti-HIV.
Hope you understand what i am saying.

[calmseeker]

Dear Doctor,

Thank you for your reply, and for the service that you provide with this forum. I re-read your answer a few times, when I was really starting to freak out. I hope you don't mind a follow-up question. Today, 36 days after my possible exposure, I went to a clinic and got a full STD work-up. They gave me the Duo test - and it's just come back negative! I still have to wait for my other STD results - but would you consider this to be fairly definitive as far as HIV goes. I've been so anxious for the past few weeks - I really want to draw a line under this and NEVER have unsafe sex again - putting myself at risk, and through so much stress.

Thanks again.

[Edward W Hook, MD]

Please try to calm down. Your single exposure has not put you at great risk. Let’s review the situation.  In that you know people in common, if he was infected you might well know it.  Even if you would not know, odds are far and away that he isn’t HIV infected, even if he has had multiple partners or even had sex with same sex partners.  That is simple the fact - the odds are very low that he had HIV.

If he did, then what?  The odds of your getting HIV infection from a single exposure of vaginal intercourse are less than 1 in 1000.  The odds of getting HIV from oral sex, at least 10-fold lower - 1 in 10,000.  That you were at the end or your period and had been waxed that day do not increase your risk.  

What to do.  First, try not to worry.  Second, if you can contact him, ask him. It doesn't do you any good at all to allow yourself to suffer and there is no reason not to ask.  Finally, for your piece of mind, get tested.  A test at 6 weeks following your exposure would detect over 95% of infections that are going to occur, thus a negative test at that time should give you great piece of mind.  At 12 weeks virtually all tests that are going to be positive will be.

Hope this is helpful.  You will be OK.  EWH