HIV Risk and testing

[paris1966]

Good day doctors

I am a heterosexual man from Switzerland. From 15th august 2008 till 20th September 2008 i was together with a Swiss girl (no drug user). During this time we had always protected sex. On 18th September 2008 we were both tested negative for hiv antibody/p24antigen. Unfortunately on 20th September 2008 our relationship ended.

On 20th october 2008 we begun again our relationship but unfortunately it ended again on 14 november 2008. During this time we had one unprotected vaginal intercourse, this was on the 31th october 2008. 28 days after the unprotected vaginal intercourse, on 28 november 2008 i was tested negative for hiv antibody/p24antigen at a laboratory in Switzerland. They used a test called Axsym Combo HIV1/2 and HIV p24antigen.

My questions:
1. How high is the risk of the unprotected vaginal intercourse?
2. Do you think i can relax, is this test 28 days after the unprotected vaginal intercourse conclusive?
3. Do you think i have to test again in 3 months? Here in Switzerland they say 3 months,no matter what test.
4. I have no penile sores and no penile discharge. Do you recommend other STD tests?
5. On 8t november 2008 i performed cunnilingus on her, she was not on her period. What about this risk?

Thank you for your response! I really appreciate this service!
Greetings from Switzerland

[Edward W Hook, MD]

No, no change in my opinion or advcie.  EWH

[paris1966]

Just to be sure: My ex girl friend was not tested on 28th november 2008 (she was tested on 18th september 2008). Does this change your opinion?

Thank you very much and greetings.

[Edward W Hook, MD]

Thanks for your questions. Let's go directly to them.

1.  You risk is very, very low for several reasons.  Most importantly, your partner was not infected.  The rates of HIV in heterosexual women in Switzerland are very, very low and she (like you) had negative HIV tests on several recent occasions. The chances that she caught HIV between the tests and/or was in the window period for becoming HIV antibody positive are extraordinarily low.  In addition to the extremely small chance that she had HIV, even if she was, your risk for acquiring HIV are less than 1 per 1000 exposures or average.  Given the results of your 28 day test and these facts, you have no need to worry and do not need further testing for HIV.
2.  See above
3.  Again see above.  Your public health authorities are being very conservative.  In your case, knowing what you know and with multiple tests of both you and your partner, as I said, you do not need further testing.
4.  STD screening is always a good idea for persons who have had new partners or more than one partner in the past year. If you fall into these categories I would recommend at least a test ffor gonorrhea, chlamydia and nongonococcal urethritis.  I make these recommendations not because of anything that you have said which raises concern but because this is good health practice, just like getting your blood pressure and cholesterol measured from time to time.
5.  Taken in the context of your other exposures, performing oral sex on her does not increase your risk for HIV measurably.

Hope this helps.  EWH