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When and what tests should be done to check for HIV?

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Practicing since : 2004
Answered : 2415 Questions
Hi, i had protected sex with a sex worker yesterday. She didnt have any obvious bleeding in her mouth or any sores. We kissed. I fingered her vagina and clits and she was wet. Her vaginal fluids could have been transmitted through hand on to my penis. There are no cuts or sores on my penis. She performed oral sex on me with a condom on but she kissed my shaft and scrotum before putting the condom. We then had penetrative vaginal sex with a condom. Her vaginal fluids came in contact with the part of my penis that was not covered with the condom. I want to know if i will get infected or if tests are necessary. When and what tests should i go for? Does hiv or any other std trnasmit through vaginal fluids touching the uncovered part of my penis? I am really worried for being such an idiot.
Posted Wed, 19 Feb 2014 in HIV and AIDS
Answered by Dr. Saumya Mittal 45 minutes later
Brief Answer: information given Detailed Answer: Hi, welcome to our site. I am Dr Saumya Mittal. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query I think what you need not worry about is HIV. In the event that the vaginal fluid has not been penetrating you, it is unlikely that the HIV would have spread. I would be more worried about conditions like treponema infection. I would frankly not worry too much since you have stated quite significantly that there were no breaks in the skin. So I would rest more peacefully I would suggest you get a blood test done for HIV in about a weeks time, and then again after a month. The reason for two tests is that sometimes the HIV virus is in window period and so it does not show on testing. I would have also suggested testing for hepatitis B and hepatitis C viruses. The other test you could have is VDRL test. This test will help detect most of the other STDs. And this test also I suggest in a weeks time. An FTA-ABS test would be helpful too Meanwhile watch for symptoms and development of ulcers. I am sorry to be of limited help as of now. But right now the best approach is to wait and watch. There is no point in getting too worried. Get the tests done as advised. And watch for symptoms. I had been working in this field briefly and so I would share with you something that I intend to get published on collection of further data. But it has been found that the sex workers who insist on using condoms are less prone to transmit infections. And since the lady in question seems to have asked for a condom too, as gathered from the query, I would say your chances of contracting a serious STD is low. I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)
Above answer was peer-reviewed by
Follow-up: When and what tests should be done to check for HIV? 3 hours later
Thank you Doctor. Really appreciate your quick response. 1. I would like to know what sort of symptoms should i watch out for and how soon are they likely to appear? Its been a day and i have not developed any ulcers or sores in my genital area. 2. I read that yellow/greenish secretions from the penis, painful urinations, iching et could result. Will these be severe or shoild i worry even if they are mild? 3. Should i wait till 12 weeks to get tested or shall i get these done immediately? 4. Where can i get these tests done? 5. Also, if i have understood correctly, hiv transmission is possible only when the vaginal fluids come in contact with the head of the penis where there is urethral opening given that there are no cuts on the part of the penis that is not covered by the condom. Is this correct? Thanks and please dont mind these questions. I am just a stupid, scared guy wanting regretting my decision.
Answered by Dr. Saumya Mittal 25 minutes later
Brief Answer: answers to specific queries Detailed Answer: Hi, Thank you for your confidence and response. The symptoms vary with the STD contracted e.g. HIV may not present with any symptom at all. I would say you need to watch out for the following constitutional symptoms that occur in a large variety of the STDs- fever, weight loss, genital ulcers, urinary tract infections, and any new unrelated infection which takes longer to heal than usual. Yes itching and pus etc may occur. But again, it depends on the type of infection you may have contracted. So i would suggest that you should watch out for any new symptom. As far as the tests are concerned, you see what happens is that some infections like HIV dont appear in the blood immediately. They take some time. So you may get them done now. But these tests may be falsely negative, because they have not yet presented to the blood. So I usually suggest my patients to repeat the test at 4 as well as 12 weeks. Usually if they are negative at 4 weeks, they remain negative. Any laboratory will do these tests. So you can choose any standard lab around you, or you can use nationalized labs like Lal path labs. You are also right that the fluids need to be in contact with the mucosa. Therefore the chances are less likely that you have contracted the infection as you used condoms. But you did mention the fingering, so one needs to be cautious. I will repeat the chances are less for the transmission to occur especially from female to male because the receptive area is less in males. In females the semen spreads to the entire vagina, and so the risk of them getting an infection is higher. And frankly, I wont call you stupid or scared. It takes guts to ask what one needs to ask. I have known patients who know their STD status and yet are scared and shy and do not tell their status putting a large number of people in the medical health services at risk. I am glad you had the good sense and the courage to ask what may put you at risk. My congratulations for that XXXXXXX Further questions are more than welcome. Dr Saumya Mittal MD
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Follow-up: When and what tests should be done to check for HIV? 9 hours later
Thanks for giving me hope and confidence doctor. I have few follow up question at this stage. 1. If suppose i test negative even after 12 weeks, what are the chances of testing positive again if my partner and i both remain faithful to each other. I want to know if there are chances of any of these STD bacterias and viruses remaining dormant or going undetected in these tests. 2. If no unusual symptoms in 12 weeks and if i test negative, can i conclude that i have not contracted any STD? 3. I go to the gym for weight reduction and oan average lose 1 kg a month. How drastic will weight loss due to STD be? I need to be able to tell if it is my exercise routine or the STD that is causing it. Will I?
Answered by Dr. Saumya Mittal 1 hour later
Brief Answer: answering further queries Detailed Answer: thanks for your confidence XXXXXXX the answer to the first two questions is the same. so i will answer them together. the symptoms usually should appear within 12 weeks or earlier. but there are diseases like HIV which remain dormant for a long time, and do not show any signs and symptoms for a long time. while others like syphilis usually show symptoms within a week to 10 days usually. sometimes the STD like HIV is diagnosed on diagnosing something else. say you have an infection like gastroenteritis, and the antibiotics are taking too long to act, then one may think and test for HIV. similarly, for the tests. I explained to you that the causing agent- virus/bacteria- should appear in the blood. then only it can be detected. and when it chooses to appear in the blood is not predicatable. however by 12 weeks, most of the STDs appear in blood, or show some signs or symptoms. As for weight loss. The idea is that the weight loss will be beyond the usual and expected weight loss. Say supposing you expect to loose 1 kg weight in gym, and thats what was regularly happening. suddenly you will notice a loss of 5 kgs. so its more than expected. that way you can think about it. a word of caution, and its your personal choice. till you are clear, i think your regular partner should be protected from seminal fluid. so you precautions. i would suggest you tell her, the partners usually can be very supportive after the first outburst. as i said its intensely your choice. Hoping to be of further assistance Dr Saumya Mittal MD
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Follow-up: When and what tests should be done to check for HIV? 1 hour later
Thanks Doctor. I definitely will protect my wife from this until i am clear. I will wait for my test results after 12 weeks before engaging in any unprotected intercourse with her. 1. We are planning a baby this year. Is it okay for us to have intercourse after a negative test result post 12 weeks. I am cursing myself for what i did. I have never had intercourse with anyone else in my life before this stray anf i wish i could turn back time by 2 days. 2. What about bleeding gums? I didnt notice any blood/sores in my mouth or in the sex worker's. Should there be visible blood/active bleeding at the time of the act for the virus to spread? 3. The sex worker did not experience any pain during intercourse. I read that a person with symptoms of STD like genital herpes/gonorrhoea usually will experince pain during the act. Is this true? Moreover there was no blood, neither in my hands while fingering nor in the condom after intercourse. Any lesions/sore that she might have had would usually lead to bleeding and hence i shd have noticed them in my fingers or on the condom isnt it? I understand that if she didnt have any symptoms, there is no way to tell. But if she did have symptoms like blisters/sores, she would have experineced pain right? 4. If between 2 successive negative tests say 6 months apart, my wife conceives a baby, what are the chances of my wife and my baby being affected? Lets say after i get a neg test result in the 13th week, i have intercourse with my wife and she conceives and 6 months later i take up another test just to be sure and if that also turns out negative, will my wife and child be safe?
Answered by Dr. Saumya Mittal 4 hours later
Brief Answer: Response to further queries Detailed Answer: I am glad to hear you are concerned about the well being of your wife and kids. And so I will start the answer with that. No, if you are negative, it is absolutely unlikely that your newborn child would have developed an STD. So you need not worry. As it is I am pretty confident that you will not have an STD. So do not worry about that. As I said, I think in the last response, that you can try for a child if the second set of tests at 4 weeks is negative. If you have a negative test, you need not worry at all about the children and wife. If you still want to be sure, have TORCH tests in your wife during her pregnancy. Any good obstretician does these tests anyways during pregnancy. And once born, the child can be directly tested for the same. In case of the child, there wont be any delay in the test. As for the sex worker, I don't think you should worry about that anymore, its too late to worry about that. The reason i say this is because even if the lesion is/was there, one cannot say for sure if the lesion is/was due to the infection. Alternatively, even if she did not have a lesion, maybe she doesn't have it because its an old infection and she is just a carrier now. A carrier is any person who does not have an infection but harbours the infecting organism in the body. Besides, she may be in a window period herself. XXXXXXX my genuine suggestion is that try to relax. Most of the STDs are treatable or controllable. And whats more, I am quite confident you dont have the problem. So just wait for the tests. Dr Saumya Mittal, MD
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