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Can HIV be contracted through protected sexual intercourse?

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Posted on Mon, 1 Jun 2015
Question: Dear Dr,

I have had protected oral and vaginal sex with some sex workers in the passing month. Do I need to concern about any kind of STDs or HIV? Also, today I got the test result for syphilis and it comes out the RPR to be 1:1 and another test to be positive(not sure what test it is, it is about reactivity) and my doctor told me that I got syphilis. I also did the oralquick test from the doctor today for the potential exposure about 6 weeks ago. Do I need to worry about HIV? Is oralquick conclusive at about 6 weeks?

doctor
Answered by Dr. Sandip Kabra (46 minutes later)
Brief Answer:
It is very unlikely to have any STDs following protected sex.

Detailed Answer:
Hi XXXX,
Welcome to health care magic,
I have read your query and understand your concern,

First of all,if you had done protected oral or vaginal sex then it is very unlikely to have any STD through that.

Now,The RPR is a screening test. A positive test with a titer of 1:1, without a positive additional conformational test could be a false positive result.

Most people with syphilis will have RPR titres of at least 1:8 or higher. We use this test to determine generally prognosis means the treatment response .

You should wait for the second test to come back before making any decision to treat, especially if the RPR is 1:1.So,you must go for confirmatory test further.

The incubation period or window period for syphilis is 9 to 90 days,so I would advice you to stop bother and wait for some time and then after 1 or 2 month you can go for VDRL or TPHA tests.

The incubation period or window period for HIV is 1 month to 6 months,so here I would again advice you to not bother about HIV specially when you had protected intercourse about a month ago.The oraquick test is also highly sensitive test which might also give false positive results.

So,you can wait for some time and then if you have any symptoms related to STD then you should consult infectious disease specialist.

If there is any query then feel free to ask.

Regards,

Dr.Sandipkabra

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (13 minutes later)
Dear Dr. Sandipkabra,

Thank you for your reply. However, today I just got the test result from my doctor and it comes back with two tests. The first one may be TPPA(not sure) and it comes back with reactive and the RPR is 1:1. So my doctor told me to get treatment in this case. She told me to take medicine and injections. So I am not sure what I can do.
Secondly, because I used condom and I still got syphilis so I am very afraid that I may also get HIV. Today the oral quick is for the potential exposure on April 4 (with condom for both oral sex and intercourse) and it was about 6 weeks. It comes back negative and can I just conclude that I do not get infection of HIV from that exposure?
It is so sorry to bother you but I am really anxious about that although I got a lot of reply from the forum that I do not have risk for HIV and very low risk for STDs.
Thank you for your patience. Looking forward to your reply.

Best wishes, XXXXXXX
doctor
Answered by Dr. Sandip Kabra (30 minutes later)
Brief Answer:
will be a requirement of confirmation tests like TPHA or FTA-Abs for syphil

Detailed Answer:
Hi Dear XXXX,
Thanks for your quick follow-up query,

As i said earlier,It is very unlikely to have any STDs following protected sex.
If your oraquick test has come negative then you do not need to worry about HIV.However you can go for ELISA testing to clear any remaining doubt for HIV infection.

Now,syphillis could be false positively came out with using Non-treponemal tests which include venereal disease research laboratory (VDRL) and rapid plasma reagin tests because both are very sensitive tests.

False positive results could come on the non-treponemal tests following some viral infections such as varicella or measles, as well as with lymphoma, tuberculosis or malaria.

There will be a requirement of confirmation tests like treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs) which are specific tests and could come positive after 5 or 6 weeks following unprotected sexual exposure.

so,here I would suggest you to see immediate an infectious disease (ID) specialist for clinical signs or symptoms checking and thoroughly clinical examination without bothering about earlier test results.

Regards,

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (10 minutes later)
Dear Dr. XXXXXXX

Thank you for your reply. I just took the test at the University Health Center and I think the other test is TPHA test and it comes back with reactive. And my doctor told me that it is because TPHA came back reactive that they also took the RPR test and get the result of 1:1. But from what you have stated, the oral quick test for the potential exposure about 6 weeks ago is conclusive and I don't need to worry too much about the current test for syphilis with low number of 1:1 right? So should I still follow what the doctor told me to get treatment and retest it after a month?

Best wishes, XXXXXXX
doctor
Answered by Dr. Sandip Kabra (6 hours later)
Brief Answer:
TPHA is reactive then it indicates presence of syphillis.

Detailed Answer:
Hi XXXXXXX
Thanks for the follow up.

If your TPHA test has come reactive which is a specific test as I answered earlier,then you must start treatment at earlier as per your doctor's advice.

About oraquick test, if it was positive for HIV earlier then I would advice you to do ELISA test which will be more accurate. However western blot test is a confirmatory test for HIV.

I think you must go with your doctor's opinion and start treatment further.

Thanks and regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sandip Kabra (13 hours later)
Dear Dr. XXXXXXX

Thank you for your advice. I will start the treatment for syphilis today. However, when I post the question about HIV in the forum, when they heard that I used condom during the sex, they all said that I do not have any risk exposure, is that true?


Best wishes, XXXXXXX
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Yes,HIV can not spread following a protected sex.

Detailed Answer:
Hi XXXX,
Thanks for your follow-up query,

Despite condom use, people might get STDs because of condom breaks or people report condom use but don't use it from beginning to the end.

Maybe they have unprotected sex a little before hand and then decide to put it on after a couple of "strokes".

Also there are a few STDs that don't require penetrative sex and some times the condom doesn't cover the entire genital region such are syphilis, herpes, and HPV but not for HIV.

So,when you post the question on the forum,doctor's replies are correct when we are talking about HIV infection following protected sex.

Regards,
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Sandip Kabra (2 hours later)
Dear Dr. XXXXXXX

Thank you for your patience. Today I received one dose of Penicillin for the WHOLE treatment for my syphilis. Is that because my RPR is 1:1 that is not high that I can take only one dose instead of three doses? OK, just to confirm, I used condom for the sex during the whole sex period including oral and intercourse and I saw a lot of sperm inside the condom after the sexual behaviors. Generally speaking I don't have penetrative sex so I don't have risk for HIV right? Concerning the test for HIV, for how long after the potential exposure should I take the test? Is oralquick ok?

Best wishes, XXXXXXX
doctor
Answered by Dr. Sandip Kabra (8 hours later)
Brief Answer:
I would answer all the queries one by one.

Detailed Answer:
Hi XXXX,

Thanks for your follow-up query,

1) It could be possible that you have been given single dose of benzathine penicillin as it is to be given in the early and uncomplicated cases of syphilis.

Your treating doctor must be knowing about it.

2) The oraquick HIV Test is a rapid self-administered over-the-counter (OTC) test. This test uses oral fluid to check for antibodies to HIV Type 1 and HIV Type 2, the viruses that cause AIDS.

A positive result with this test does not mean that an individual is definitely infected with HIV but rather that additional testing should be done in a medical setting to confirm the test result.

Here,Individual’s immune system takes some time to produce enough antibodies for the test to detect, and this time period can vary from person to person which is known as the “window period,” when a person is infected with HIV but antibodies to the virus cannot be detected.

3) It might take up to 3 months ( in 90% people) for this antibodies to get detected in blood following exposure but in few cases this time period may be extended up to 6 months. And yes, your risks of HIV is low based on your description.

If there is any query then feel free to ask me.

Regards,
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sandip Kabra (12 hours later)
Dear Dr XXXXXXX

Thank you so much. OK, then can I understand like this, after I pull out my penis, if I see a lot of semen(sperm) inside the condom and the condom did cover the head of my penis I can say that the condom works and it was a protected sex?

Best wishes, XXXXXXX
doctor
Answered by Dr. Sandip Kabra (41 minutes later)
Brief Answer:
Condoms act as a barrier to HIV and STDs infection.

Detailed Answer:
Hi XXXX,
Thanks for your follow-up query,

Yes,condoms prevent transmission by reducing the risk that an exposure to HIV or STDs occurs during sex.

The materials used to make most condoms such as latex, polyurethane and polyisoprene do not allow bacteria, viruses or other germs to pass through them.

Therefore condoms act as a barrier to HIV and STDs infection by preventing the mouth, vagina, penis and rectum from being exposed to bodily fluids such as semen, vaginal fluid and rectal fluid that can contain HIV and STDs.

Hope you will understand it completely now.

Still if you have any query then you can ask me.

Regards,
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Sandip Kabra

General & Family Physician

Practicing since :2009

Answered : 3078 Questions

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Can HIV be contracted through protected sexual intercourse?

Brief Answer: It is very unlikely to have any STDs following protected sex. Detailed Answer: Hi XXXX, Welcome to health care magic, I have read your query and understand your concern, First of all,if you had done protected oral or vaginal sex then it is very unlikely to have any STD through that. Now,The RPR is a screening test. A positive test with a titer of 1:1, without a positive additional conformational test could be a false positive result. Most people with syphilis will have RPR titres of at least 1:8 or higher. We use this test to determine generally prognosis means the treatment response . You should wait for the second test to come back before making any decision to treat, especially if the RPR is 1:1.So,you must go for confirmatory test further. The incubation period or window period for syphilis is 9 to 90 days,so I would advice you to stop bother and wait for some time and then after 1 or 2 month you can go for VDRL or TPHA tests. The incubation period or window period for HIV is 1 month to 6 months,so here I would again advice you to not bother about HIV specially when you had protected intercourse about a month ago.The oraquick test is also highly sensitive test which might also give false positive results. So,you can wait for some time and then if you have any symptoms related to STD then you should consult infectious disease specialist. If there is any query then feel free to ask. Regards, Dr.Sandipkabra