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What are my chances of getting HIV infection?

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Posted on Mon, 14 Apr 2014
Question: I have question regarding two encounters I had. For the first encounter, I have known a lady for almost 7 years now. She is married with 4 kids and is a house wife .Before engaging in sexual act, I got her tested for STI's for below and got the results on 22nd Feb’14. TPHA - Negative Anti HCV - Negative (Anti HCV is a chemiluminescent mictroparticle enzyme immunoassay for the qualitative detection of antibody to hepatitis C virus in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) Anti HIV - Negative (Anti HIV is a chemiluminescent mictroparticle enzyme immunoassay for the simultaneous qualitative detection of HIV p24 antigen and antibodies to human immunodeficiency virus type 1 and/or type 2 in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) HbsAg - Negative (HBsAg is a chemiluminescent mictroparticle enzyme immunoassay for the qualitative detection of hepatitis B surface antigen (HBsAg) in human serum. Test is performed on architect instrument employing chemiluminescent microparticle immunoassay (CMIA)) When we engaged in sexual encounter 2 days after getting the reports, she sucked me off for like a minute or so without condom, before penetrating her vagina with my penis, I inserted my finger inside her and felt some small hard bits. Upon removal of the finger I saw it was blood clots and blood. Later she told me she had done intentional miscarriage two weeks before as she and her husband were not planning to have another baby and she got pregnant unintentionally and that next day she got her monthly menstrual flow. I inserted my penis in her vagina by using condom but during intercourse I lost erection and became semi erect and continued to pump her in the same way. When I removed my penis, the condom was covered with blood and clots. As far as I remember, the condom didn't tear during the complete process. But when I removed the condom, I noticed some blood on the start point of my shaft, a few moments later I checked inside the condom to ensure whether the blood reached my tip but I couldn't find any traces. I washed my penis thoroughly with water and we called it a day. Regarding the second encounter. There is a friend of mine. She has told me that her last encounter with another person was in the end of Oct'13 which was unprotected oral sex both giving and receiving and protected anal sex, there was no vaginal sex. Before getting physical with her, I got her tested for the below on 11th Feb, 2014 Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive HbsAg - Non reactive V.D.R.L - Non reactive When we got physical on 28th Feb’14, her vagina got real wet and sloppy. I gave her head and sucked her for good 10 to 15 mins. I was having swollen gums and perhaps light bleeding. During the process, I did insert my tongue inside her vagina. Afterwards, I rubbed my penis on the outside of her vagina on her genitals while it was wet with her vaginal secretions for about 5 mins. After this, I inserted my penis inside her vagina for about 10 to 15 seconds but as she squirmed with pain, I removed it. After this nothing more was done. During all this, I didn't use condom at all. After this and due to my concern about being infected with HIV, we repeated her below tests again on 14th March’14 along with the below results. Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive Do I have anything to worry about for HIV infection? Should the tests be repeated for any of the above both partners I had keeping in view the details of encounter?
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Answered by Dr. Deepak Kishore Kaltari (1 hour later)
Brief Answer: There is no need for repeating tests Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear XXXX Regarding the encounter with married lady, as you had used the necessary precaution like wearing a condom while having invasive intercourse and there was no break in condom . There is unlikely to be any exposure. Also she had tested negative for the possible STD. Regarding your second exposure , if her story of having protected anal intercourse in October 2013 and no other exposure with any other person till 28th February with is to relied upon. Even though you did not use any protective method while having vaginal intercourse there seems to be no risk. As she had her intercourse 4 months after October 2013 and she tested negative on 11th February 2014 which is well beyond serological window period. There is no need for worrying about having contracted HIV. Also there is no need of repeating the test. I would also advise you to refrain from risky behaviour which will create anxiety of having contracted infection every time after exposure. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Deepak Kishore Kaltari (21 hours later)
Dear Doctor. Thanks a lot for your reply. Your reply has helped a lot to ease my tensions. As I mentioned in the initial question, after the second encounter and due to my concern about being infected with HIV, we repeated her below tests again on 14th March’14 along with the below results. Though her story of having protected anal intercourse in October 2013 and no other exposure with any other person till 28th February’14 is reliable, the only issue is that she is not sure if it was in Oct’13 or sometimes in the first half of Nov’13 and due to this we repeated her tests on 14th Mar’14. Before this, all his tests were done in Oct'13 start carried out by her employer to make her permanent which all came out negative. Below are the details of the tests done on 14th March, 2014. Anti HIV 1&2 - Non reactive - ( Method used - Fourth generation ELISA test to detect the p24 antigen and HIV 1 and HIV 2 Antibodies using Abbott Architect immunodiagnostic system using CHEMILUMINESCENCE Technology patented as CHEMIFLEX ) Anti HCV - Non reactive The main reason I became concerned is that after the encounter on 28th Feb’14, I got mild sore throat and mild fever on 5th Mar 2014 which went away after 4 or 5 days. Though I know this happens to me yearly when weather changes. Now I am experiencing body aches all over my body including in the axilla. It is not a constant pain,,,,,,,actually travels….sometimes in one place and then in another. I have read about ARS symptoms online and I continue searching them in my body. I try to feel my lymph nodes trying to palpate them thinking perhaps I have enlarged lymph nodes. I haven’t had rash or upset stomach. I have traveled to another part of the world 2 days after the encounter. Is any further testing required? Should I be looking for such symptoms in my body? Should I be concerned about HIV? Can these be due to anxiety? What is your opinion on all this?
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Answered by Dr. Deepak Kishore Kaltari (23 minutes later)
Brief Answer: No need for concern Detailed Answer: Dear XXXX What you are undergoing is acute stress syndrome. An individual looks for all possible signs and symptoms of the disease with mere thought of having acquired the symptom. There is definitely no need of repeating any investigation. Even if her encounter was in Nov 2013, test done in march which is more than 3 months are negative. Sore throat is normal infection which occurs. Just be relaxed. There is no cause for concern. Do write to me for any further query. Take care brother. Regards Deepak
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Deepak Kishore Kaltari (45 hours later)
Dear Doctor. Thanks a lot for your reply. It is really relaxing. I am experiencing below issues lately: • Intermittent pain in the ears. • Stiff neck • Pain in the left triceps which moves to biceps also. • Pain in the axillas and groin, seems like it’s superficial, not deep, when I examine the skin, nothing is seen and it’s not rashy. But does feel like its injured by rubbing together. • Muscle pain here and there all over the body. • One pimple in the groin. • Muscle pain in the pectorals. • The feeling of being low on energy as I keep on thinking of being infected to name some. Can these be symptoms of ARS? I really don’t know how to palpate and feel the lymph nodes so that I can give you an exact picture about them. This thing is really driving me crazy, the more I try not to think of it, the more it comes to my mind again and again. After reading your replies, I did get some peace of mind. Shall we repeat any tests for my partner with whom I had unprotected encounter in the end of May’14 to ease my mind? I do want to mention here that I was on vacation and have from about a week started going back to my job. I have office related job where all day I need to sit in front of the computer screen to work.
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Answered by Dr. Deepak Kishore Kaltari (12 hours later)
Brief Answer: There is no need for concern Detailed Answer: Dear XXXX There is absolutely no cause for concern. As the exposure was after using precautions and the tests are negative there is absolutely no cause for concern. The symptom which you are experiencing is likely to be due to anxiety neurosis. Anxiety can cause stiffness of muscle by increasing muscle tone and cause various psychosomatic manifestation which you ate experiencing. More you read about the literature of sero conversions on the Internet, more likely you will be looking for the presence of the symptoms consciously and subconsciously. The body starts manifesting these symptoms. I would suggest you to get your Blood test done including P24 antigen assay. That will be more reassuring to you. P24 antigen assay is quite sensitive and is elevated within 7 to 10 days after exposure. Being a Surgeon and knowing the level of exposure completely, if I was in your place I would be not worried at all. I do understand your concern and apprehension. Do let me know how can I guide you further. Take care Best Regards Dr Deepak Kishore Consultant Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3194 Questions

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What are my chances of getting HIV infection?

Brief Answer: There is no need for repeating tests Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear XXXX Regarding the encounter with married lady, as you had used the necessary precaution like wearing a condom while having invasive intercourse and there was no break in condom . There is unlikely to be any exposure. Also she had tested negative for the possible STD. Regarding your second exposure , if her story of having protected anal intercourse in October 2013 and no other exposure with any other person till 28th February with is to relied upon. Even though you did not use any protective method while having vaginal intercourse there seems to be no risk. As she had her intercourse 4 months after October 2013 and she tested negative on 11th February 2014 which is well beyond serological window period. There is no need for worrying about having contracted HIV. Also there is no need of repeating the test. I would also advise you to refrain from risky behaviour which will create anxiety of having contracted infection every time after exposure. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon