should I be worried?

[socalgal]

Hi Doctor,

  Thanks in advance for your help. Here is my situation. I dated someone from mid-January to mid-March this year, and stupidly, we had unprotected sex most of the time (probably 6-7 times, and he ejaculated in me twice). Whenever I suggested using protection, he always said he doesn't like condoms... stupid for both of us, I know. Anyways, the last time we had intercourse was on 3/14/06. I started to think about the possible HIV risk after we split up and was worried. He told me that he has never been tested before (!) but he regularly gives blood. He was in a 5-year relationship until sometime last year, although I don't know if he had slept with anyone else after his breakup. I read from somewhere that the chance of transmission is higher if a woman is menstruating. Well, we've had unprotected sex during my period on 3/10/06 and he ejaculated in me. I went to get a HIV test (negative) on 4/11/06 (less than 4 weeks after the last exposure). Was the result reliable at all? I read from your other posts that newer tests can detect antibodies at 4-6 weeks - but how do I know what kind of test I was given? I went to a county clinic which offers free HIV test. It scares me thinking that if he could be so trusting with me, he could be trusting with his past sexual partners as well. According to him, his reason for trusting me is that he believed I have good judgements since I am well-educated (apparently that doesn't prove anything). I'd like to know if that incident during my period put me at higher risk, and how reliable the previous test I had in April was. Thank you very much!

[H. Hunter Handsfield, M.D.]

sh00tamcgavin is right, to an extent:  I should have said something like the 4 week test is pretty good assurance socalgal wasn't infected during the exposure she described, but not perfect.

HHH, MD

[sh00tamcgavin]

"Your 4-week test is too soon to be valid," wait a sec...it's that rite cuz like in 30 other post you say is like 90-95% accurate

[H. Hunter Handsfield, M.D.]

I don't have anything to add to the comments to the same questions in your STD Forum thread.  In any case, those symptoms don't make me any more concerned about your HIV risk from your sexual exposures in March.

HHH, MD

[socalgal]

By the way, I've also had vaginal/urethra itching (internally, especially after/when I urinate) for unknown reasons. The symptoms persisted for about 2 months now. I've done all tests (STDs, UTI, yeast infection)..., was given antibiotics, medicine for yeast infection, etc. Nothing worked. I found out that I have HSV-1, but the doctor didn't think it's related. Anyway... I don't know if this info is relevant. Just thought that I'd mention it. Thanks.

[H. Hunter Handsfield, M.D.]

Assuming your partner isn't gay or bisexual, and that he doesn't inject drugs with sahred injection equipment, the chance he has HIV is very low.  Your 4-week test is too soon to be valid, but I believe you don't need HIV testing at all, at least not based on this particular exposure.  As I have said many times, people with average sexual lifestyles are wise to be tested for HIV and common STDs on a regular basis, say once a year (or more often if at particular high risk).  But it doesn't make sense to be tested after every particular exposure, unless it was especially high risk - for example, if you knew your partner had HIV. Sex during menstruation raises the HIV risk only a little, if at all.

However, if you remain nervous about this particular exposure, you can be tested again 6-12 weeks after your last sex with him.  Also, get tested for common STDs, such as chlamydia.  Your risk for such infections is far higher than for HIV.  (But perhaps this has been done recently, if you're the same socalgal who posted a question about vaginal infections and herpes on the STD forum a few weeks ago.)

Despite what you might assume, some people's judgment about their partners' risk is excellent.  Others admitted is lousy.  These differences partly explain why some people have very large numbers of partners, often without condoms, and never get chlamydia or gonorrhea, let alone HIV; and others change partners only every few months or years and get infected almost every time.

Good luck--  HHH, MD