Possible Exposure or Paranoid?

[curious27501]

My partner and I (though not in a completely monomagous relationship) were both tested in late January and early April.  Results both returned negative.  We have been having unprotected sex since February.  Here lately, I have become anxious about the possibility of contracting HIV and haved discussed using protection from this point forward until such time as we enter an exclusive relationship and test negative again.  Our last encounters were April 21 and April 28th (3 and 4 weeks after our negative results).  Immediately after our last encouter, I experienced vaginal sorness (the same night) and vaginal itching the next day.  I purchased monistat and symptoms have since resolved.  I also experienced some back pain and a little burning during urination and have been diagnosed with a UTI and prescribed Cipro for that.  Then,  I developed persistent headaches about a week ago, with no other symptoms. (Temperature is normal, no chills, muscle aches, etc.) I know that testing is the only way I can be sure of my status but I would just like to know the chances that I have contracted HIV from my partner.  

Thanks

[Edward W Hook, MD]

Thanks for the clarification on several points.  Sorry I mis-understood about your relationships.  The rates of HIV among African American men is about 10-fold higher than among whites, thus rates for non-IV drug using AA men are about 1 in 1000. Still low but higher than for whites.  

Given your recent history of negative tests, I doubt that here is any need for repeat testing at this time.  

The so-called "normal" temperature of 98.6 is an approximation.  Some people tend to run a bit higher, others a bit lower.  In addition, in most people the temperature fluctuates with the lowest body temperaure of the day occurring early in the morning.  I would not worry about your temperature.  In the hosptial we rarely worry about temerature elavations until they exceed and stay above 101.  

Both a UTI and anxiety could give you a headache by elevating your BP or by themselves.  

the line between paranoia and prudence is sometimes hard to distinquish.  It sounds to be like you are interested in the facts and are thinking clearly about things.  I would not classify you as being high risk for HIV on the basis of what you have told me and would urge you not to worry. I hope my comment help. EWH

[Edward W Hook, MD]

Some people who have false positive ELISAs as you experienced will have them repeatedly.  In others this is a passing reaction to something the person has encountered in the course of living their normal lives.  That your test reverted to non-reactive suggests you will not experience again but does not guarantee it.  Sorry.

No, I think you can believe your test results.  Don't let this bad luck (and that's all a false positive test is) make you crazy.  EWH

[curious27501]

Last question/comment.

I get tested routinely along with my annual OB/GYN visit.  My last test (November 2010) yielded a weakly repeated reactive (ELISA) and indeterminate Western Blot. (First time this has EVER happened)  I followed my test for 3 months and they eventually resolved as negative.  (This may be the reason I'm so anxious about this situation).
If I do decide to test, what would be the likelihood that I receive the same results?  My friend and I have decided just to remain friends.  

Besides the two occasions mentioned in my earlier posts, we have not had unprotected sex.  Would you recommend testing if I decided later move on to pursue another relationship with another individual?  

Dr. , as you can tell, I am very anxious...

[Edward W Hook, MD]

Of course it is possible, just as it is possible you will be hit by a meteorite while reading this note.  Neither are very likely to happen however, hence my recommendation.  In most situations it simply is not practical to get tested every time one has sex.  EWH

[curious27501]

Thanks Dr. Hook!

But I do have to ask: I have read other posts where you see no need for repeat testing in cases where individuals had very recent negative results.  May I ask what your reasoning is behind this?  Isn't it possible to become infected the day after, or a week after a recent test?

Just curious.

Thanks again!!

[curious27501]

Just to clarify some things.  He is my only partner.  He says that I am his only partner and I believe him but cannot be 100% sure seeing as how we have not made our relationship official--which is the reason we've discussed using condoms from this point forward.  He is not an intravenous drug user, nor does he sleep with men--but this you can never be too sure of.  

You state that fewer than 1 in 10,000 'while' males who do not have male partners and who do not use IV drugs have HIV.  Do you mean "white" males?  In this instance, both my partner and I are African American.  Does your assessment change?

As far as STDs, I had my annual exam back in February and tested negative for STDs.  I have known my partner for well over 10 years--he's actually my ex (this probably would not change your assessment either).

Do you think this situation warrants testing see as how we both tested negative 2-3 months and 3-4weeks prior to our last exposures?

As far as temperature, right now it's 99.0--but I consider this normal because my temperature fluctuaes throughout the day, reaching 99.5 at times.

When I was diagnosed with the UTI, my blood pressure was a little high--which could be the reason for my headaches, plus this HIV anxiety could possibly be contribute to it--and at my last physical my cholestoral levels were slightly increased.  

Doctor, do you think I'm being paranoid?

Thanks!

[Edward W Hook, MD]

Welcome to the Forum.  Unless there is something about your or your partner's other partners which make them particularly risky (i.e. they are IV drug users or your interval male partners have had sex with other men), the risk of having HIV is quite low but, of course not zero.  A few figures might help to put this in perspective:

In the U.S.  fewer than 1 in 10,000 while males who do not have male partners and who do not use IV drugs have HIV.

The risk of getting HIV from a single encounter, if your sex partner is an untreated person with HIV is less than 1 infection per 1000 sex acts.

Finally and perhaps relevant to your questions, the sorts of symptoms and problems you describe have no particular relationship to HIV and are problems which can follow sexual activity but are not STDs, i.e. both yeast infections, genital soreness following sex and even urinary tract infections can be due to sexual activity without being due to STDs.   As for your headaches, this is non-specific and does not raise concerns about HIV, particularly if you do not have other signs of early HIV such as fever, muscle aches, etc.  

Obviously, there are risks to you of having sex with multiple partners which include STDs other than HIV which are far more common than HIV as well. For this reason, you do qualify for periodic STD "screening (testing in the absence of symptoms) because you have had multiple partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).


I hope this helps.  EWH