HIV and other STDs

[555steelers]

I unwisely had unprotected oral (both ways), vaginal, and anal sex (insertive) with a 26 year old white women recently (I am a 25 year old heterosexual man). I don't know this women at all, but she is a college student and i would be very surprised if she was a drug user. I asked her before the exposure and she said she gets tested at her gynocology apt annually for STDs and never had anything. About 17 days after the exposure, due to my stress about the situation, I bought the "10 test panel by STD alert". Everything came back clear (negative). I was very relieved at this time, but then read some more information and the HIV test was for antibodies, not the virus. I really am not too concerned about the herpes bloodwork, which came back negative and is also prob too soon (no symptoms either), because frankly I don't think acquiring herpes is really that big of a deal, healthwise. I am worried about HIV mostly.

Can you please help me put my risk in perspective and how worried I should be? They offer early detection testing for another $175 which I can go back and get. I can also re-test for antibodies but I am very stressed and the wait is hard for a definitive answer of many months. Also, I read that about half of the people that have acquired HIV will show antibodies at about 2 weeks. Is this true? Does a 17 day negative test for antibodies have any value at all statistically? Thanks.

[Edward W Hook, MD]

Everyone who gets HIV produces antibodies.  Anything you have seen on the Internet about "delayed  seroconversion" or failure to make antibodies is wrong.  The timeline of antibody you list is reasonable.  EWH

[555steelers]

One final follow up - when do most healthy people produce antibodies that are detectable from the standard HIV antibody tests (I had "Panel 083824")? There seems to be some conflicting data out there online. I have seen figures like 50% at 2 weeks, 75% at 3, 90%+ at 4. Do these figures seem reasonable in your experiences?

Thanks again for providing your excellent service.

[Edward W Hook, MD]

National testing data sets.  EWH

[555steelers]

Thanks Dr. Hook. Just curious, where does the 1 in 10,000 figure for American women come from.  

[Edward W Hook, MD]

Welcome to our Forum.  Your risk for any STD from this encounter is low.  Most American women do not have STIs and of those who do, problems such as chlamydia or gonorrhea are most common.  The testing you've already had rules these out.  

Your risk for HIV from this encounter is tiny.  Fewer than1in 10,000 American women have HIV and the risk for your exposure even if she did is, almost, 1%.  Further, as you point out, a test more than two weeks after exposure would have detected over half of recent infections.

You certainly do not need another $175 test panel.  Your risk is tiny.  If you wish to test further, go to your local health department where testing is likely to be free.  Personally, having already tested as you did, I would not test further but, this of course is up to you. EWH