testing

[help123375]

Hi doctors, I have been perusing this forum for some time and it has been helpful in allying many of my fears.  I was not planning on posting anything but I am just feeling confused.  I had a fling with a man I know a little but do not entirely trust, though he was willing to answer my questions about his sexual history.  He is in his early 30’s not an IV drug user, he told me he was tested 6 months ago and was negative, I am not sure how many people he has been with in that period but he did disclose one encounter that was protected and that he has only been with a handful of people unprotected, most of whom were long term girlfriends.  I asked him point blank if I should be worrying and he said no.  All in all we had unprotected vaginal sex 3 times, 9.5 weeks ago and 6.5 weeks ago.  I was screened for Chlamydia and Gonorrhea, which both came back negative but I was diagnosed with bacterial vaginosis.  I had a rapid oral test at 3 weeks since the last exposure and today I just went back at the 6.5 mark, both were negative.  At about 3 weeks after my last exposure I got pretty sick, though I felt as though I was fighting something for a while.  I had sinus pressure, my jaw, ears, and neck all hurt, no fever but chills and muscle aches and extreme fatigue.  I am writing because the clinic I went to mocked me for coming back so soon but then said in an offhand way in regards to my last exposure “well that’s going to take a while”.  Though they said nothing about me needing to come back, they implied that I needed to wait the three months.  My rational mind just wants to put this behind me, I was confident that today’s testing was going to help me do that one way or the other but the experience I had today just left me confused.  I apologize if  you are repeating yourself but my question is, is the 6.5 week test good enough based on what I have told you, would you recommend going back at 8 or 12 weeks and should I do a blood test not the rapid oral. Thanks in advance!

[help123375]

Thanks so much, your comments were very helpful!

[Edward W Hook, MD]

Welcome to the Forum. As a reader of our threads, I suspect you know what I am going to say, i.e. that your risk, even before testing was small and with the test results you have, it almost certain that you did not get HIV from the exposures you describe.  While I will comment on the facts contributing to my statements, I want to comment before that I am saddened to hear of the reaction and comments made at the clinic you went to.  It really was rather unprofessional and that is really too bad.

As for your risks, let's put things into perspective:
1.  Your partner, as a heterosexual male who does not have HIV is a rather low risk partner with no more than a 1 in 10,000 chance of having HIV.
2.  Furthermore, your partner told you he had been tested 6 months earlier and was not infected.  This too is in your favor. Most people do tell the truth about such things.
3.  The risk of getting HIV in the unlikely circumstance that your partner had HIV is less than 1 infection per thousand acts of intercourse.  thus, even before testing, using the numbers I have provided is somewhere in the neighborhood of 1 in 3 million.
4.  Then, at 6 weeks following exposure, your HIV test would detect over 95% of infections acquired 6 weeks earlier, making your numerical risk more like 1 in 30 million.  This is not something for you to spend a lot of time worrying about.

As for your symptoms, it is far more likely that you got some sort of community acquired viral infection.  If you' gotten HIV, it would be expected that your recent HIV test would have been positive as tests typically turn positive about a week to 10 days following the beginning of symptoms.

Thus, for all of the reason cited above, I really do not see a need for you to pursue further testing.  If you must, either a rapid test or a standard blood test will perform similarly.

Hope these comments are helpful.  EWH .