Risky???

[jay4691]

I am a 39 yo male. Married.  Have had a few affairs in the past. Had recent one nighter on biz trip.  I was at a resort on biz and i met 2 people who happened to be friends on vacation (not my friends but each others - they are female in their early 50s).  (My wife was along and in our room asleep)
I had a few drinks with them, and took the 54 yo to her room.  We had intercourse and kissed (no oral).
I used a condom which came off as we changed positions - the end was hanging out.  I put a fresh one on.  She even offered me one of her own, but I had a second one.  We changed positions a few more times and on one occasion the condom came off again - same as the first time.  I was very hard (recreational viagra) and simply opend the same condom up real wide (to avoid her "dna") and stuck my penis back in the condom.  We had sex for about another 5 minutes.  I finished.  I went to get dressed and the woman said you should shower before you go back to your room.  I did.  I went back to the room feeling really guilty.  (Since this is a past behavior, I have decided to see a counselor to try to stop this behavior in the future.) The 54 yo was had the end of her period happening - light blood.  I have a mildy sore throat - I think from my recurring allergies, and the nasel spray I use and the snoring at night since I am stuffy at night.
What is my risk here?
Should I get tested?
If I get tested how long do I have to wait?  
What type of test would I have?

[H. Hunter Handsfield, M.D.]

Again and again on this forum we have to stress that symptoms mean NOTHING in assessing HIV risk. All that you mention are due infinitely more often to garden variety viruses and other conditions than to HIV.  Anyway, thrush is a sign of advnaced
AIDS, not early HIV infecion.  Don't worry about it.

[H. Hunter Handsfield, M.D.]

You say nothing about your partner and her lifestyle, and you don't say where you are.  If you are in the US or other industrialized country and your partner is not a commercial sex worker, injection drug user, the partner of a bay/bi man, etc, there is no realistic chance she has HIV.  (Since you're worried, you could ask her, both about whether she has HIV or is at particular risk.)  Accordingly, it is unlikely there was any HIV risk, even if sex had been entirely unprotected.  In any case, your sex in fact was protected.  Even though it was not ideal to re-use the same condom, the chance of transmission -- even if she had HIV or an STD -- was near zero.

For these reasons, from as standpoint of medical considerations and risk assessment, you definitely do not need HIV testing.  However, the tone of your question suggests your anxiety and guilt will make it difficult for you to rely on my advice alone, i.e. you likely are going to want to be tested for the psychological support you will gain from the negative test result.  Also, every person who is sexually active outside a permanent, mutually monogamous relationship should be tested for HIV from time to time, like every 1-2 years.  Since that applies to you, this seems a good time to do it, since it's on your mind.  But not because of this particular event.

So go ahead and get tested about 6 weeks after the event.  (You'll find many sources that advise 3 months, but that is a conservative, somewhat outdated recommendation.  it really isn't necessary to wait that long with the current standard HIV tests.)  A standard HIV antibody test is all that is needed; your own doctor (or your local health department STD clinic) will know what test to do.  While you're at it, testing for other STDs (syphilis, gonorrhea, chlamydia) would be a good idea at the same time.

Also, have that conversation with your partner about her risks. You might find she is just as concerned as you are and will appreciate it when you reassure her about your generally low risk for HIV.

In the meantime, don't lose sleep over this.  The chance you caught HIV is zero for all practical purposes.

Regards---  HHH, MD

[H. Hunter Handsfield, M.D.]

You could request the "duo" test, which tests for both antibody and the p24 antigen of HIV (i.e., a test for the virus itself).  It's pretty reliable as soon as 10-14 days after exposure.  Or a standard antibody test as early as 4 weeks will pick up ~90% of infections, so would be reassuring although not proof.  Neither of these is as 100% reliable as a 6 week antibody test.

[jay4691]

Hi Doc -
I still have a nagging sore throat from about 5 days ago.  Scratchy, no swollen nodes.  I keep looking in my mouth for thrush (ocd...).  Tonight I noticed a little more white matter on my tongue, and a small (smaller than a thumbtack head) sized white patch on the inside of my mouth.  I over course looked at pics on the internet which made me think thrush.  No fever, no night sweats.  Any worries?  
Thanks for your support.

[jay4691]

Thanks.  I live in the US in a large city and this person lives in another large US city.  I am white, she is white.  We did not trade info - it was what it was - i was horny as was she.  She was not a csw, and was there on vacation.  I am sure the 39 yo coming on to her was flattering to her.  I had not cheated for the past three years... I have also purchased life insurance since that time.

You are right about my anxiety and that is why i decided to see a "therapist" - I really do not need to put my marriage at risk, or my health.  The hiv test will help with the anxiety, and the continuing therapy will work on the underlying guilt, and trying to not cheat again.

Thanks for your reassurance.

One last question - Is there a test that can be taken sooner than 6 weeks?