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Can HIV be contracted through sexual intercourse?

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Posted on Sat, 16 May 2015
Question: Hi. I made a mistake about two months back and had unprotected sex with a female of unknown HIV status. She says she is 100% clean and free of stds but you never know these days. I went to the emergency room because I started having little red dots on my penis that was diagnosed as a fungus and was given a anti fungal cream. I was also given a gonorrhea and chlamydia treatment just to be sure. At 33 days I went to the urologist to confirm the diagnosis given to me at the hospital and it was confirmed. The urologist also gave me a full panel of std testing including an HIV antibodies test. All these test came back negative.

Around 6 1/2 weeks I started freaking out again having stress, depression, and anxiety thinking that I might have HIV and I was having XXXXXXX hives that literally appeared on my legs and forearms and would disappear just as quickly. I also lost my appetite and dropped about 10 pounds almost in a week. I bought some additional HIV testing online. Those test were the HIV RNA 1 QL TMA (it say this test was performed using APTIMA (R) HIV-RNA Quantitive Assay Gen-Probe. What does that mean?) and the HIV 1/2 Antigen/Antibody, 4th generation W/RFL HIV AG/AB 4th Gen. I had both test done at 7 weeks after risk or 49 days to be exact and both test came back negative. I was told that the HIV RNA 1 QL TMA test is conclusive after 28 days and 99% accurate. The HIV 4th generation combo test is 97% to 99% accurate at 7 weeks and conclusive at 12 weeks. After I got the results back from those test I got my appetite back and was eating like a mad man. I don't if that was stress from this scare or not

I am still very stressed out with tons of depression over this always checking symptoms I think I have issues with my neck that believe have to do with this. I think I have become obsessed with this. I get the hive one or maybe two but not an enormous portion. Is this related to HIV? Am I sick or just stressed out about this situation? I am getting married by and I made a huge mistake. I hit the 12 week since my mistake in 3 weeks. Do pose any danger to her she wants to have kids right way? Can someone please help me. I really need it
doctor
Answered by Dr. S. Murugan (5 hours later)
Brief Answer:
HIV 1 ruled out. repeat test by 12 weeks rule out HIV 2

Detailed Answer:
Hi,
Welcome to HCM
Thanks for posting your query
Your RNA PCR and Combo tests by 7 weeks ruled out HIV 1 infection. It is conclusive. HIV 1 infection is 99.5% prevalent.
Hives may even be due to yeast infection. As you already crossed 12 weeks, repeat the 4th generation COMBO test. It will rule out HIV 2 infection also. Nothing to worry. You can get married and have children.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (5 hours later)
Could you please answer the following questions I would really appreciate it.

What is the sensitivity level of detecting HIV at 7 weeks when taking the 4th generation combo test and HIV-RNA test?

Is it too late to have ARS symptoms at 10 weeks?

Would my negative results from the RNA and Combo test change to positive 5 weeks after I took those test or is there zero chance that could happen?

I was treated for a fungal on my penis would that same yeast infection have spread to somewhere else? Where would it have spread to to cause hives? How do you treat a yeast infection?

What about the weight lose that I mentioned? This was going on a few days before I took the RNA and Combo test.

Are any of these symptoms I have mentioned anything to do with HIV or is it more fear, stress, and anxiety taking over? Can I put these feeling behind me?

In your opinion after everything I have told you do you think I have the HIV virus?
doctor
Answered by Dr. S. Murugan (5 hours later)
Brief Answer:
You are free from HIV 1 infection beyond any doubt.

Detailed Answer:
Hi,
Welcome back.

HIV RNA PCR by 7 weeks is 99% conclusive and the fourth generation combo test antigen part is conclusive by 7 weeks to an extent of 97-98%. When put together two test the reliability becomes 100%. No doubt that you are free from HIV 1 infection.
The term 'ARS' is obsolete. Possibilities of acute infection or Primary HIV infection after 7 weeks is remote.
There is no possibility for HIV 1 positive to occur after this date.
Yeast infection would not spread elsewhere from penis. Once after a total cure of this yeast infection Hives would be unlikely to appear. There are different good drugs are available to treat yeast infection and a total cure is possible. Your physician will guide you.

As far as weight loss is concerned, your local physician will be the right person to determine the cause for weight loss, if any by history, examination and investigations.(due to variety of reasons like anxiety, diet related etc).
No symptoms mentioned by you is specific for HIV.
I don't think that you have HIV infection.
Forget about that. Don't think odd possibilities.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S. Murugan (4 hours later)
The emergency room doctor prescribed nystatin cream for the fungal when i first went to the doctors. Would this work on a yeast infection? If it does than i used to 2 containers of it and the rash on my penis went away but i still get the hives on my arms and legs that disappear as quickly as they showed up.
doctor
Answered by Dr. S. Murugan (2 hours later)
Brief Answer:
Hives even after treatment for yeast, investigate for further cause.

Detailed Answer:
Hi,
Welcome back.
Rather than Nystatin, Clotrimazole or Micanazole are good options to treat yeast infection along with oral Flucanazole weekly once for 3-4 weeks . Your sexual partner has also to be treated to have a total cure for yeast infection.
If the hives are persistent or recur even after the treatment of yeast infection, consult your Dermatologist and investigate further to detect the cause of allergy. Hives is a condition sometimes poses great difficulty to treat. Get well soon.
DR S.Murugan
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. S. Murugan (23 hours later)
Can you tell me more about the HIV RNA 1 QL, TMA test and the differences between that and other PCR?

I had this yellow coating before on my tongue but it has gone away. Do you see anything that is alarming? Does it look like I need the medicine for oral yeast infection?

The hives or rashes that have had popped up look like this and they come and go. Anything look HIV related or seriously health related?

I don't have a rash anymore on my penis and I used both the Nystatin and Clotrimazole 1% the last 2 months. The hives are still coming. Again the come and the go really quickly. Any other ideas on the hive? I was also told it could stress related.

Can I seriously relax about the HIV and be sure that I don't have it?s
doctor
Answered by Dr. S. Murugan (29 minutes later)
Brief Answer:
HIV RNA 1 QL TMA test detects HIV 1 infection during the window period.

Detailed Answer:
Hi,
Welcome back.
I went through the pictures sent by you.
There is no oral thrush or any other evidence for STD/HIV.
Clotrimazole is a better drug for Yeast and now you are free from yeast infection. With regards to the skin rashes, get guidelines from your Dermatologist in person.
HIV RNA 1 QL TMA is a very sensitive and confirmatory test for HIV 1 infection before sero-conversion occurs (During the widow period-before antibodies develop). It would detect the infection as early as 1 week after the infection, if there is infection. DNA PCR also can detect HIV in early disease whereas the routine RNA PCR test is a quantitative test which would be useful to assess the severity of the disease and it response to treatment (prognosis). Quantitative RNA PCR would not be useful to rule out HIV.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (23 minutes later)
So the test i took is not the quantitative rna correct?
doctor
Answered by Dr. S. Murugan (3 minutes later)
Brief Answer:
HIV RNA 1 QL TMA test is not a quantitative test. more diagnostic.

Detailed Answer:
Hi,
Welcome back.
Yes, absolutely right. Your test is exactly qualitative and very much diagnostic and not a quantitative test.Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (22 hours later)
Hi. Had another hive pop up. Thought I would get your opinion on it. I add the photos

Started having a little bit of weird feeling in the right side of my neck, like a jammed feeling. How can you tell if your lymph nodes are swollen?

Started with a cough yesterday but I don't know if it's do to allergy season.

With all these test I took
3rd generation at 33 days (4weeks and 5days)
4th generation at 49 days (7 weeks)
HIV 1 RNA at 49 days (7 weeks)
Is it even possible to sneak by all 3 of these test? Am I at all a danger to my future wife?

Can you tell me more about the 4th generation test and sensitivity at 7 weeks, accuracy, specificity? Would this this test result change 5 weeks later?

Can I rest my fears? Am I over thinking this? I would appreciate any advise you have..
doctor
Answered by Dr. S. Murugan (35 minutes later)
Brief Answer:
HIV 1 infection is totally ruled out.

Detailed Answer:
Hi,
Welcome back.
Hive or Urticaria has a property for its recurrent appearance till the cause for allergy got alleviated.It seems certain lesions has an appearance of folliculitis or furuncles (skin infection). Anyhow you need to consult a Dermatologist as early as possible. But has nothing to do with the possibility of HIV.

All your tests were highly reliable and they were all put together had ruled out HIV 1 infection to an extent of 100%. There is no chance for you to become HIV 1 Reactive hereafter at anytime due to that exposure took place two months ago.
You had less than 0.5% chance for HIV 2 infection, it has to be ruled out by another Rapid test or ELISA or 4th generation COMBO test by 12 weeks.

4th generation HIV Combo test had two parts.
1. P24 antigen part it became conclusive by 4 weeks but can diagnose only HIV 1 infection as it incorporated with HIV 1 antigen only.
2.Ab 1/2 part can rule out both HIV and 2 ,but this part can detect antibody only after the widow period (after antibody formation in the body in presence of an infection- conclusive by 12 weeks).
So there is no chance for HIV 1 infection for you.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (14 hours later)
So what are the difference between rashes that I have been getting and HIV rashes? Everything look up on rashes sometime comes up with A hits on HIV. Its so annoying

Anything I should worry regarding my neck pain feeling or the cough messaged early? I know it's allergy season so I don't know if that triggered it.

I also mentioned if any serious health concern to my wife and or can I put those fears to rest?

So the chances of any HIV after the 3rd generation test, 4th generation combo test, and HIV 1 RNA test when I took at 7 weeks and all came back negative would not change 5 weeks later? .
doctor
Answered by Dr. S. Murugan (1 hour later)
Brief Answer:
No symptom is specific to HIV. You are free from HIV 1 infection.

Detailed Answer:
Hi,
Welcome back.
Your 4th generation Combo test and RNA PCR test 7 weeks after the risky exposure already had ruled out the possibility of HIV 1 infection. There is no chance for HIV 1 infection becomes positive anytime afterwards due to your past exposures.
There can be lot of different types of rashes can occur in the course of HIV disease due to various conditions like pappualar urticaria, seborrheic dermatitis, fungal infections, psoriasis, leprosy, Herpes Zoster etc. No rash is specific only to HIV infection. It is because of altered immune reactions during the course of disease various disease which could manifest or exacerbate. When there is no specific condition or illness, there is no necessity to disclose anything to your wife and making her also worry.Neck pain and cough might be due to throat infection.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (25 hours later)
Let me make sure I understand the combo test. If I was infected with HIV in the first few weeks the antigen portion of the test would come back positive correct?

Once the antigen starts to drop off the antibodies are detectable and that portion of the test would go positive correct?

From what up to what time are antigens detectable before they start to drop off 4 weeks, 5 weeks, 7 weeks?

The rashes I showed you would they also fit the description of stress or anxiety rashes and what would be a good medication for that kind of situation?

Am I correct in saying that when you look up HIV symptoms they are usually for people who have had the HIV virus for a while and the virus is now running it course?

And the acute infection stage where you have symptoms are for newly infect people?

I shouldn't say anything to my wife since there isn't any sign of an actual infection and all my test came back negative?

Anything else you would recommend doctor?
doctor
Answered by Dr. S. Murugan (5 hours later)
Brief Answer:
Acute infection manifest by 3-4 weeks

Detailed Answer:
Hi,
Welcome back.
There are many type of antigens present with HIV. Antigens could be identified through out the disease except few antigens like P24 antigens which could also lasts for more than 6 months in the body in presence of an infection. So a combo test by 12 weeks could confirm or rule out HIV 1 and 2 infection by both detecting the antigen and antibodies together and becomes doubly sure.

Your rashes can be treated with antihistamine drugs with the help of your Dermatologist.
Acute infection are manifestations could occur by 3-4 weeks after the infection with 50-70% of the infected individuals and not with all. Then after a long period of latency (5-7 years), once again florid manifestations start appearing in the course of HIV disease (once the individuals immunity goes down).
Nothing to worry.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (12 minutes later)
The HIV RNA 1 QL, TMA test detects a viral load or something else of the virus?
doctor
Answered by Dr. S. Murugan (7 minutes later)
Brief Answer:
This test would not detects viral load only the presence or absence of viru

Detailed Answer:
Welcome once again.
HIV RNA 1 QL TMA test once again either detects or rule out HIV 1 Infection as early as 1 week on wards and more diagnostic and not detects the amount of viral copies unlike that of a quantitative test.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (12 hours later)
I'm just wondering if someone had unprotected sex and that person was HIV 1 positive and took HIV combo and HIV RNA test at 7 weeks and both came back negative would they be HIV negative for the HIV 1 strain? I'm curious about how good the test is.

The window period is it 12 weeks from the time of unprotected sex? The next day would be day one and so on?

Is 12 weeks total 84 calendar days or 12 week of 30 days each month?

Would Feb 7 (encounter) to May 2 (3 months since) a total of 84 days be enough?

New rash any thoughts? It has gone away again

Could stress, anxiety, and depression over this HIV situation cause rashes/hives on my arms and legs (that disappear and reappear quickly), loss of appetite (I lost it for 4 days and I got my appetite back and I have been eating like a mad man), and some weight loss?

I have had at one rash or hive the past week maybe longer I can't 100% remember. Could this all be to stress, anxiety, and depression? What the chance of it being serious underlining condition?

i would think if it was a serious condition they would be a lot worse and wouldn't disappear and reappear so quickly. Would you agree?
doctor
Answered by Dr. S. Murugan (4 hours later)
Brief Answer:
Window period would not extend more than 84 days.

Detailed Answer:
Hi
Welcome back.
HIV infection can be caused either by HIV 1 or By HIV 2. HIV 1 INFECTION IS COMMON TO THE EXTENT OF 99.5%.
Medicine is not mathematics to have exact answer. So every resut has its own ranges. Window period is 6-8 weeks and may be extended to a maximum of 12 weeks (84 days) and never more than that.
Rashes might be due to some allergy. Whenever you have exposed to the allergen it may recur.
Anxiety and stress are not likely to cause rashes.
There is nothing serious .
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (48 hours later)
Is the hiv rna 1 ql tma considered a PCR or XXXXXXX and whats the difference between the two?

If i had an acute infection would the test have turned positive when i to them?

When does the P24 antigen not become detectable by the combo test?

Would 7 weeks still pick up the P24 on the combo test?

Do the rna test get false negatives at 7 weeks or is that only in the early stages?

Same question for the HIV combo test.
doctor
Answered by Dr. S. Murugan (7 hours later)
Brief Answer:
RNA QL TMA along with COMBO test 100% reliable

Detailed Answer:
Hi,
Welcome back.
HIV RNA 1QL TMA is neither a PCR nor XXXXXXX but detected the the presence of viral antigen through another technique called as Transcription-mediated Amplification method. More information can be got from a virologist than a clinician.
This test is very useful to diagnose HIV during acute infection. Very much reliable.
P24 Antigen may likely to start disappear after the appearance of antibodies. After 6 months the P24 antigen is unlikely to be present in side the body.
By seven weeks COMBO test can pick up P24 Antigen also.
RNA QL TMA at 7 weeks along with COMBO test becomes 100% reliable.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (18 hours later)
At 84 days could I take a 3rd generation or 4th generation test? Which would you recommend or it doesn't matter?

Can take the test exactly on the 84th day (12 weeks) and consider them conclusive?

Should I feel 100% confident in my earlier results and not fear the worst at 84 days?

Would the 3rd generation and combo test for HIV 2 be conclusive at 12 weeks?

For sure HIV 1 is completely ruled out?

Do I need to take another exam at 6 months or are 12 weeks enough?

Why are some reason that people I told to check back at 6 months? Are those 6 months obsolete rules?

If someone was infected would the RNA test always detect the virus throughout the person's life since it is a diagnostic test or would there be one point it no longer does detect? I would assume it would always find it correct?

Anything to worry or fear?
doctor
Answered by Dr. S. Murugan (5 hours later)
Brief Answer:
HIV 1 common up to 99.5%. ruled out 100%. not to worry.

Detailed Answer:
Hi,
Welcome back.

4th generation test is preferred than 3rd generation test as it is more sensitive.
Even though antibodies can appear as early as 6-8 weeks and it would never be delayed beyond 12 weeks (or 3 months- as some books says), you better take up the test after 90 days to have more confident results.
Your previous results were 100% sure with regards to HIV 1 infection and you can take up this test very confidently.
Yes any rapid test, ELISA or COMBO test are final and conclusive for HIV 2 by 12 weeks.
HIV 1 ruled out beyond any doubt in your case.
After this test by 3 months, you may not need any further test.
If anybody is on steroids or other immunosuppressive drugs or on ART as PEP,then there may be a delay in antibody formation up to six months and not beyond that.
RNA PCR tests are available as qualitative and it will be always reactive throughout the life of the individual , so it is used to assess the prognosis of the disease progress.
As you had ruled out HIV 1 infection already you need not worry.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. S. Murugan

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Can HIV be contracted through sexual intercourse?

Brief Answer: HIV 1 ruled out. repeat test by 12 weeks rule out HIV 2 Detailed Answer: Hi, Welcome to HCM Thanks for posting your query Your RNA PCR and Combo tests by 7 weeks ruled out HIV 1 infection. It is conclusive. HIV 1 infection is 99.5% prevalent. Hives may even be due to yeast infection. As you already crossed 12 weeks, repeat the 4th generation COMBO test. It will rule out HIV 2 infection also. Nothing to worry. You can get married and have children. Dr S Murugan