Can I move on?

[lookingforhelp1234]

Hi Dr's,

I've asked this question in the regular forum and Teak said to move on, I think I just need to hear it from you two.

Thanks for taking my question.  I m sending these questions from Vancouver Canada.  I'm went outside my marriage and had protected receptive anal sex with a man i met on the internet. He stated he was negative.  I m not 100% sure the condom worked.  I didn't notice any breaks or slippage.  

I developed flu like symptoms 1 week post exposure (i know this is early) as did my wife.  I've since had testing.

Since the possible exposure i was tested on the 4th week negative naat and antibody and std's.  Then was tested on 10th week, 11th week, 12th week (84 days) all negative rapid antibody tests

The two hiv councellers at the testing centers I've been too have told me to move on and I can have unprotected sex with my wife.  I just can't seem to get over my anxiety.  I'm sure my guilt has a lot to do with it.  But I want to confirm you guys that I can move on after my 12 week test.  Even if the condom didn't work which would increase the risk.

Thank you for you time on this matter.

[H. Hunter Handsfield, M.D.]

The level of risk is irrelevant to whether or not you are infected and my response should not cause any heightened anxiety about this particular event.  The test results prove you didn't catch HIV.

But to expand on the risk:  Call it a high risk situation (choosing to have anal sex with another male) with a zero risk event, assuming the condom was intact.  However, condoms fail, can easily forgotten in the heat of the moment (and the bottom partner sometimes can't feel whether a condom is being used), and some men do not accurately know their HIV status.  Therefore, if you continue to do this sort of thing with any regularity, even with intended consistent condom use your risk for HIV will be many times higher than for strictly heterosexual men, but a lot lower than for many gay men.

[lookingforhelp1234]

Hi Dr. H,

Thanks for your timely response.

I just had one last question.  You mentioned my exposure was high risk, but then went on to mention it was zero risk due to the condom use.  I'm assuming you meant that receptivie anal was high risk but that fact I was protected I was basically at zero risk.

Just made me anxious when I saw you consider my actions high risk, so wanted to clarify.

Thanks again on your response.  This will be my last question.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I can endorse the advice you had on the HIV community forum.

You had a relatively high risk exposure, but even in the highest risk situations -- including receptive anal sex -- most such exposures don't result in virus transmission, even unprotected, and if the top partner had HIV, which yours apparently did not.  Given the condom use, the risk was zero and you were significantly overtested given the circumstances.  However, a negative HIV test 12 weeks or more after the last possible exposure is always definitive, in everybody; there are no exceptions, regardless of exposure history or symptoms.

You don't have HIV.  You can safely resume unprotected sex with your wife.

I hope this helps.  Best wishes--  HHH, MD