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Possible exposure and symptoms 2.5 months out from hetero contact?

Jun 22, 2007

Doctor Bob,

I hate to sound irrational, but I really am curious about your opinion on a possible HIV exposure. Please allow me to explain the scenario.

I am a married British military pilot who was recently in Reno, Nevada for work in March. One night, after far too much to drink, I met a woman and went to her place for a sexual encounter. I had a rather long and extremely drunken heterosexual contact with a female towards the end of March - hours of protected vaginal sex during a period that was the begining of her menstruation. This included unprotected receptive oral sex and some digital stimulation as well. I know some blood residue remained on my leg in the morning (gross), but I have little reason to think my condom failed, and any non-protected contact would be purely accidental and unnoticed. The point is, we were both absolutely wasted - a regrettable one night stand. Apparently, she was two months removed from a negative HIV test. I am an ohterwise monogamous partner and have not been exposed to HIV since my last negative test in April of 2006.

Four Days later, I woke up with a rather intense fever that lasted scarcely a night - followed by about 5 days of a general cold and sore throat. Some of my work colleagues reported similar symptoms, so I did not worry a terrible amount.

I had an AIDS test done for my flight physical roughly 50 days after this exposure. Given the sloth-like pace of the medical bureaucracy, I likely will not know the result for three more weeks. This Sunday, (80 days after my exposure), I developed a persistent dull headache that has lasted the past three days. I spent the weekend drinking excessively and flying at high altitudes, but I digress - I have never experienced such symptoms, and I drink hard and fly for a living.

My questions are as follows:

1. What is your assesment of my HIV exposure risk?

2. Might my "symptoms" be primary HIV exposre related?

3. My test was done 50 days after sexual contact - when should I get another one, if this one is indeed negative?

4. Might I be infected with a different type of STD? (I have no physical symptoms other than those listed).

Regardless of my predicament, I genuinely appreciate the good counsel and dedication you have shown to this forum. You are doing God's work, my friend, and I will donate accordingly. Thank you for your time.


Response from Dr. Frascino

Hello British Fly-Guy,

1. Protected sex is indeed "protected" if the latex condom was used properly and did not fail. Unprotected oral sex carries a very minimal risk for HIV transmission.

2. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. It is far more accurate to assess risk, rather than interpret symptoms.

3. HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. A negative test at 50 days would be encouraging, but not definitive. You'll still need a three-month test.

4. Unlikely, from what you describe.

I'll send my best good-luck/good-health karma that your definitive three-month HIV test is negative.

And Ron, one more thing. You mention "I drink hard and fly for a living." I must admit that's a bit worrisome to those of us seated in the back with our seatbacks and tray tables in their full upright and locked positions.

Stay well, Fly-Guy.

Good luck.

Dr. Bob

Broken condom
protected sex but vaginal fluids made contact with me!

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