HIV and Family Planning

[Wiz83]

Hi Doctor,

Greetings from India, I’m a 30 year old married male. Recently I went to Pattaya(Thailand) for a conference and picked up a street Thai hooker from there. We had unprotected oral sex and then protected vaginal sex. She was on top of me. She got the condom and put it on me. After sex I removed the condom and threw it. I  Did not check the condom for breakage.
Few days later I started getting anxiety attacks and a mild fever. So I got tested for HIV, in a local hospital they use the HIV DUO VIDAS test(4th generation I think), I tested negative at 26 days. Then I again got tested at 36 days, exact same test and that too came back negative.

I’m going crazy with Anxiety and guilt and have a few questions for you:

1. Are my tests absolutely conclusive?
2. If not when should I get tested again?
3. I want to put this incident behind me and start a family, but I don’t want to infect my future kid and wife, that would be catastrophic
4. If any symptoms related to ARS show up, I should consult some other physician and not think about ARS
5. Can I move on with my life :(

Sorry If I’m asking too many questions, but for last 8 weeks my life has been in turmoil. I hope I haven’t spoiled your holiday mood. I want logical medical advice from a professional as I don’t want to end up wasting money if additional tests are not needed.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

You had a low risk exposure:  oral sex is safe sex and condoms work to protect against HIV from vaginal sex.  And statistically, it is unlikely your Thai sex worker was infected; the large majority are not.

But most important, you negative test results are conclusive.  The duo test accurately detects all HIV infections within 4 weeks of infection; with two negative results at 26 and 36 days are conclusive.

Those comments pretty well cover all your specific questions, but just so there is no possibility of misunderstanding:

1) Your negative tests indeed are "absolutely conclusive".

2) No further testing is necessary.

3) Yes, that would be catastrophic. But it won't happen.

4) Anybody with symptoms that concern them should of course be
professionally evaluated by a doctor or other health care provider.  But no matter what symptoms you might develop, you can be sure they will not be due to HIV from your sexual indiscretion in Thailand.

5) Yes, you can and should move on with your life, without worry.  Don't confuse guilt and shame over a regretted sexual decision with HIV risk from that decision.  They aren't the same.  Deal with the former as you need to, but you need not worry about HIV.

Happy holidays--  HHH, MD

[H. Hunter Handsfield, M.D.]

Your doctor is just being careful, conservative, and applying the official standards for definitive test results.  However, my advice above remains accurate.  Although official advice remains 3 months, in fact HIV test results are definitive at 4-8 weeks, depending on the specific test or combination of tests that are done.

http://www.medhelp.org/posts/show/1704700
http://www.medhelp.org/posts/show/1891685
http://www.medhelp.org/posts/show/1855891

In the past several years, there have been no known patients with negative results like yours who later turned positive.  Try to relax and not worry; your follow-up test results will be negative.

Happy new year!

[Wiz83]

Hi doctor,

I went to the gynecologist with my wife couple of days ago. I narrated this incident to her my wife was getting her tests done at that moment. She told me that conclusive test are done only at three months.

So I panicked and got another test done at the 60 day mark which was a HIV duo again and it came back non reactive. I visited a general physician (visited him for the first time) and showed him the report he said that this is a good indicator but don't plan baby yet. Wait for another 6 weeks which will be 100 days since possible exposure. I told him is it really necessary? Since I did use a condom he said yes. Since you are planning a baby be 100 % sure he even said that only 95 % cases are ruled out by a 3 month test and 6 month is conclusive.

I'm really scared and worried now. Is he right? Or do you think since he is not a specialist his advise should be taken with a pinch of salt. He did not even consider the fact that this was a Vidas duo test.

[Wiz83]

Thanks Doctor, I will go back to living my life. Can't believe the thoughts that were floating in my head.