Risk from infidelity

[CheatedOn32]

Dear Doctor-

My questions stem from my ex-fiancee's infidelities. I am a caucasian female, non IV drug user. My ex-fiancee is a caucasian, non-IV drug user who does not have sex with other men. Earlier this year he was given 3 months of temporary duty at a military base in another state. During this time he cheated on me with three different women. When he returned from temporary duty we had sex two times before he admitted that he had cheated.

I know for certain that before his infidelities both he and I did not have HIV or other STDs. As a member of the military he is screened often and has always tested negative. I was tested for HIV as part of my annual female physical exam in January (while he was away on temporary duty) which came back negative.

He returned home in March, and we parted ways after he told me about his affairs. I tested negative for HIV and many other STDs 5 weeks after our last sexual encounter. He maintains that he used condoms with the women he cheated with, but given his infidelities I am disinclined to trust him.

I am very concerned that the women he slept with gave him HIV and that he in turn passed it to me during our two sexual encounters that took place after he returned.

Do you think that I have HIV and should be tested again?

As a side note, part of my concern stems from sex education years ago in school, nightly news reports, and even statistics in the latest issue of Time magazine. It seems like HIV is everywhere.

[Edward W Hook, MD]

Sorry it was needed, take care. EWH

[CheatedOn32]

Thank you very much for your assessment of my risk and your advice. I appreciate it greatly!

[Edward W Hook, MD]

I'm sorry to hear of your problems and understand how media attention and "scare-based" "education" can promote such concerns.  I hope that I can provide some information that will be helpful to you.  The punch line to what I am about to say is that your risk is very, very low- so low that I do not recommend repeat HIV testing at this time.  Let me tell you why.

Let's start by trying to put this into perspective an overall.  There are over 300 million people living in the United Stated of whom 1 million have HIV.  Thus, on the basis of this fact alone your chances of having HIV are less than 3 in 1000.  Then, realizing that infections are more common among men who have sex with other men, drug users and minorities, the chances that your partner was infected are still lower.  Then, your odds of getting HIV, IF HE WAS INFECTED, are less than 1 in 1000 exposures.  Given that by being in the military, your ex is regularly tested for HIV, as well as the absence of other risk factors, his likelihood of being infected are far lower than average.  Thus, your odds of infection, based on his risk for infection are far lower than average.  Clearly, the odds are in your favor.  

Now add to that the fact that you had an HIV test five weeks after your last exposure and your likelihood of being infected approach zero.  I say this because at five weeks post exposure close to 90% of HIV tests that are going to be positive following exposure will already be.  When you combine this with your overall low probability that he is infected, you are far more likely to be hit by lightening in the next day or two than to have HIV from the situation you describe. For this reason I would argue that you do not need further HIV testing.

I hope this helps.  EWH