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Unprotected anal sex
16 days ago I had unprotected anal sex with a female SW.
I am 41 years old, circumcised, in good health. I was tested after 3 days for Chlamydia and Gonorrhea, both of which were negative.
The SW is in her 40s and usually provides massage services (no penetration). She is expensive for the services she provides. She says she has a few regular clients, men in their 50s, and I get the impression that she might have sex with them. I don't know if it is protected or unprotected. From what I could tell, she is not an IV drug user.
I have spoken with her a few times and she told me that she is clean. She said that she doesn't keep condoms around because it's not something she usually does.
I have seen her a few times before, but this was the first time we had any sort of risky sexual contact. There was some brief rubbing of my penis on her vagina, and I may have inserted it into her once or twice. I'm not worried too much about that. But the anal sex was unprotected. She used lube. The session did not last long. It was not very deep sex. I did not see any blood, and I did not ejaculate inside her.
After 5 days I had an appointment with my doctor. He performed a visual exam and didn't find anything wrong. He didn't perform any tests as he said that it was too early to tell if anything was going on. I am going to see him again this week to get tested. This will be 19 days post exposure.
I'm sick with worry. I'm having difficulty eating and sleeping. I try to think positively and not dwell on it, but it is difficult.
As far as I can tell, I have not had any symptoms. No fever, rashes, headaches, sore throat. I've had muscle soreness, but I don't think it's any different than my usual aches and pains.
At this point, what tests should I get and how reliable are they? The online testing center I used offers HIV Anti-body and HIV PCR. There is a local clinic which offers rapid testing too.
Thank you
I am 41 years old, circumcised, in good health. I was tested after 3 days for Chlamydia and Gonorrhea, both of which were negative.
The SW is in her 40s and usually provides massage services (no penetration). She is expensive for the services she provides. She says she has a few regular clients, men in their 50s, and I get the impression that she might have sex with them. I don't know if it is protected or unprotected. From what I could tell, she is not an IV drug user.
I have spoken with her a few times and she told me that she is clean. She said that she doesn't keep condoms around because it's not something she usually does.
I have seen her a few times before, but this was the first time we had any sort of risky sexual contact. There was some brief rubbing of my penis on her vagina, and I may have inserted it into her once or twice. I'm not worried too much about that. But the anal sex was unprotected. She used lube. The session did not last long. It was not very deep sex. I did not see any blood, and I did not ejaculate inside her.
After 5 days I had an appointment with my doctor. He performed a visual exam and didn't find anything wrong. He didn't perform any tests as he said that it was too early to tell if anything was going on. I am going to see him again this week to get tested. This will be 19 days post exposure.
I'm sick with worry. I'm having difficulty eating and sleeping. I try to think positively and not dwell on it, but it is difficult.
As far as I can tell, I have not had any symptoms. No fever, rashes, headaches, sore throat. I've had muscle soreness, but I don't think it's any different than my usual aches and pains.
At this point, what tests should I get and how reliable are they? The online testing center I used offers HIV Anti-body and HIV PCR. There is a local clinic which offers rapid testing too.
Thank you
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
Everyting you say in the first half of your post indicates there was no appreciable risk from the exposure described. Intellectually, you seem to understand that there is no basis for being "sick with worry". The issue now is to find a way to let that intellectual understanding translate into emotional acceptance and relaxation about it. (My guess is that the main problem here, from a psychological standpoint, is that you regret the sexual choice you made. But don't confuse that aspect with HIV risk, which is zero for practical purposes.)
My advice is for you to be tested for HIV, as you are planning -- not because I believe you really are at risk. I do not, and from a strictly medical standpoint you don't need to be tested at all. But it seems you need the reassurance of a negative test result.
Let your doctor guide you about specific tests and when to have them. One option is to wait until the 8 week mark and have a standard antibody test. (Despite common advice to wait 3 months, it is really not necessary to wait that long for a reliable result; 6-8 weeks is fine). Or you could have a duo test, for both HIV antibody and p24 antigen; that test is 100% reliable at 4 weeks. Finally, you could indeed have a PCR test at this time, plus an antibody test at 4 weeks; that combination will also be 100% reliable. But no more so than the duo test, which would be a lot cheaper; PCR is costly. (If you have any of these tests at the 19 day mark, the negative results will be moderately reassuring. But for 100% reliable results you're going to need testing at the times I just suggested.)
You should also have a syphilis blood test, but not before 6 weeks. I recommend against blood testing for any other STDs; the risks are too low. You have already had negative gonorrhea and chlamydia tests; those results (even at 3 days) are completely reliable.
You could print out this advice as a framework for discussion with your doctor. Whatever testing you have, feel free to return with a follow-up comment to tell me the results. But since there is no point in speculating, let's not have any more discussion until then. In the meantime, stay mellow. There is virtually no chance you have HIV and you shouldn't be at all worried about it.
I hope this helps. Best wishes-- HHH, MD
Everyting you say in the first half of your post indicates there was no appreciable risk from the exposure described. Intellectually, you seem to understand that there is no basis for being "sick with worry". The issue now is to find a way to let that intellectual understanding translate into emotional acceptance and relaxation about it. (My guess is that the main problem here, from a psychological standpoint, is that you regret the sexual choice you made. But don't confuse that aspect with HIV risk, which is zero for practical purposes.)
My advice is for you to be tested for HIV, as you are planning -- not because I believe you really are at risk. I do not, and from a strictly medical standpoint you don't need to be tested at all. But it seems you need the reassurance of a negative test result.
Let your doctor guide you about specific tests and when to have them. One option is to wait until the 8 week mark and have a standard antibody test. (Despite common advice to wait 3 months, it is really not necessary to wait that long for a reliable result; 6-8 weeks is fine). Or you could have a duo test, for both HIV antibody and p24 antigen; that test is 100% reliable at 4 weeks. Finally, you could indeed have a PCR test at this time, plus an antibody test at 4 weeks; that combination will also be 100% reliable. But no more so than the duo test, which would be a lot cheaper; PCR is costly. (If you have any of these tests at the 19 day mark, the negative results will be moderately reassuring. But for 100% reliable results you're going to need testing at the times I just suggested.)
You should also have a syphilis blood test, but not before 6 weeks. I recommend against blood testing for any other STDs; the risks are too low. You have already had negative gonorrhea and chlamydia tests; those results (even at 3 days) are completely reliable.
You could print out this advice as a framework for discussion with your doctor. Whatever testing you have, feel free to return with a follow-up comment to tell me the results. But since there is no point in speculating, let's not have any more discussion until then. In the meantime, stay mellow. There is virtually no chance you have HIV and you shouldn't be at all worried about it.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
No surprises, and no need for further testing at 6 weeks or any other time. Although the HIV antibody tests don't reach maximum performance until then, the combination of negative antibdoy at 4 weeks and negative PCR at 19 days is 100% proof positive that you were not infected with HIV. If you do any additional testing at all, a syphilis blood test at 6 weeks or later will meet the need.
Whatever you do, there is no need to post another round of negative results. That will be all for this thread. Take care and stay safe.
Whatever you do, there is no need to post another round of negative results. That will be all for this thread. Take care and stay safe.
Just a quick rundown of my tests and results.
3 Days - Chlamydia and Gonorrhea - NEGATIVE
19 Days - HIV Qualitative DNA PCR and HIV-1 Antibody - NEGATIVE
19 Days - Hepatitis B-C, Herpes, Syphilis - NEGATIVE
28 Days - HIV Antibody (Rapid) - NEGATIVE
As suggested above, I will take another round of tests at 6 weeks.
3 Days - Chlamydia and Gonorrhea - NEGATIVE
19 Days - HIV Qualitative DNA PCR and HIV-1 Antibody - NEGATIVE
19 Days - Hepatitis B-C, Herpes, Syphilis - NEGATIVE
28 Days - HIV Antibody (Rapid) - NEGATIVE
As suggested above, I will take another round of tests at 6 weeks.
MEDICAL PROFESSIONAL
So?
Fell free to report the test results here, If you wish. They will be negative.
Fell free to report the test results here, If you wish. They will be negative.
I also saw my primary doctor this week. He performed another physical exam and said I looked good so far. Since I had the PCR test the day before, he drew blood and is running the standard STD tests and is checking my white blood cells. I should have the results tomorrow.
On Day 19 I went and got an HIV Qualitative DNA PCR test, and an HIV-1 Antibody test. The results came back today - both NEGATIVE. I know it's not conclusive but I am very relieved.
I plan on having an HIV Antibody test at 4 weeks.
Then at 6 weeks I will check for the other STDs as suggested.
I plan on having an HIV Antibody test at 4 weeks.
Then at 6 weeks I will check for the other STDs as suggested.
Thank you. I will let you know when I get the results.
MEDICAL PROFESSIONAL
DUO is widely available in all parts of the country. If not done at a local lab, any doctor can always send a specimen to one of the major nationwide labs, such as Quest or LabCorp.
Thank you, Doctor, for taking the time to answer my questions. I very much appreciate the availability of a forum like this and the work you and the other doctors do. Over the past two weeks I've been pouring through the posts trying to gain some comfort. Your response has provided a great deal. If I had known this much about HIV transmission a few weeks ago I wouldn't be in this predicament. And you are correct, I very much regret this incident and that is not helping my mental state at all.
I neglected to mention that I'm in the US, the Boston area. Is the DUO test available in the US?
I neglected to mention that I'm in the US, the Boston area. Is the DUO test available in the US?
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