Hiv Risk

[alwayscareful333]

Hi there,

I am a 39 year old woman who always practices safe sex and testing when starting a new relationship.
My newest partner was tested a month before we got together. I have known him for several years so I trusted him.
We have had 3 unprotected vaginal intercourse episodes. Now... he tells me a different story. It was many months ago he was tested and until 4 to 6 weeks ago, he was with a fairly promiscuous woman. My fear is that he could be newly infected. He did go six days ago for more testing but in the meantime I am worried sick.

1. I know the risk is 1 in 1000 but is that even if he is newly infected?
I keep reading that if your partner isnewly infected, your risk is high.

I should mention that he is 43, no IV Drugs or sex with men. He has had anal sex with women... does this make his risk higher?

Thanks

[H. Hunter Handsfield, M.D.]

It is not true that your test "really are not accurate".  As you seem to understand already, the statistical chance a heterosexual Canadian male has acquired HIV in the few weeks since last tested is almost zero, no matter how many partners he has had in the meantime.

If I were in your situation, I would not feel a need for additional testing and would continue unprotected sex with my wife without any fear of infecting her.  But I'm not you.  If you want absolutely defnitive proof, you'll have to wait a few weeks more and have another test.

That will end this thread.  Whatever choice you make about further testing, do your best to move on without further worry.

[alwayscareful333]

Hi Dr. Handsfield.

Everything of his came back negative but it turns out he has been sleeping with us both this past few weeks, so the results really are not accurate. He is probably fine I know, as he has been sleeping with her for months and it seems odd he would just catch it now. I know they are probably both fine. I was going to go donate blood in a week but not sure I should as I will only be two weeks from the last time I was with him, unprotected. Would you suggest putting that on hold? I know they test but I would be in the window period in the off chance I were infected. I promise this will be my last question. I should mention I  in Canada. Thanks.

[H. Hunter Handsfield, M.D.]

Thanks for clarifying.  This doesn't materially change my advice -- of course it increases the risk if your partner is infected, but I still think that's very unlikely.

[alwayscareful333]

Thanks Dr. Handsfield. This is helpful. The sex was not protected... it usually is but as I thought he was newly tested within the past month, I felt safe. Just thought I should clarify. I will try not to worry  Thanks.

[H. Hunter Handsfield, M.D.]

And no, your partner's anal sex with other women doesn't increase his risk for HIV.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

Congratulations for a common sense approach to your sexuality, i.e. consistently safe sex.

In the US and most industrialized countries, heterosexually transmitted HIV is less common than you might realize.  Even among those straight men with very large numbers of sex partners and frequent change of partners, HIV is rare if one of the other traditional risk factors is not present.  In other words, if your new partner doesn't have sex with men, is not an injection drug user, has not been imprisoned, and is not an immigrant from an AIDS-endemic area like southern Africa, then the chance he has HIV is very low -- certainly no higher than 1 chance in 1,000.

The 1 in 1,000 transmission risk you cite is for unprotected sex.  Since your sex was condom-protected, there was really no appreciable risk, even if your partner actually has HIV, and even if he is recently infected with a high viral load and increased infectiousness.  Given the condom use, I would still put your risk of having acquired HIV in the ballpark of 1 chance in a million.

You have done exactly the right thing by asking your partner to be retested.  If his result from a few days ago comes back negative, you'll be able to go forward with complete confidence he isn't infected and you were not at risk.  (Yes, there's a very slim chance he is in the window period, i.e. infected within the past 4 weeks with a negative blood test.  But statistically that's extremely unlikely -- and of course impossible if he hasn't had any other sex partner in the past few weeks.

All things considered, you really needn't be worried.  Almost certainly he isn't infected and neither are you.

I hope this has helped.  Best wishes--  HHH, MD