Average time and maximum range b/w exposure and symptoms
Nov 16, 2007
Asexual partner began experiencing symptoms on 10/21. An oral quick test was performed on 10/27 and came out negative. A PCR test was performed on 11/7. This came back positive. unprotected oral and and sex with this person on the following: 10/4-10-6; 10/19-10/20; 11/3-11/5. On 11/3 he ejaculated inside me. On 11/12 he ejaculated in my mouth. My doctor started me on PEP today 11/16. Today 11/16 the PCN was drawn (results pending) and an Quick test was done and came back negative. My doctor was extreemly concerned about all the exposure but especially the anal receptive with ejaculation on 11/4 (right at the tail end of the conversion symptoms. The infected person states that I was the only person he had unprotected sex with during October (there were three safe sex enounters inlcuding oral without ejaculation). On Sepmpter 30th he said he had anal sex with a condom, oral sex without ejaculation with someone who said they were HIV pozitive. They also used shared an anal speculum and just "wiped" wihtout disinfecting. My doctor say he most likely was infected in the two weeks prior to 10/21 when he started hacing symptoms. I was the only person he had sex with during that time so it would follow that it had to be me that infected him (though I did not ejaculate in his rectum, but did severl times in his mouth. Prior to all of this I tested negative with a PCR test 7/27 and he tested negative in mid august. My only unsafe sex was oral, with several occasions in which I swallowed ejaculate. Could he have been infected by me in October and I still tested negative on the rapid test? If the PCR comes back negative,how many more or how long do i need to know 100% I'm not infected. Also, I do not recall feeling any conversion like symptoms over the last three months. I'm really confused and afraid. Thank you for whatever clarification or thoughts you might have about all of this.
Response from Dr. Frascino
Yes, I agree, you are indeed confused. You are wondering if you infected your partner; however, you've tested negative to date, had no symptoms suggestive of HIV and have been placed on PEP (beginning treatment far beyond the recommended 72-hour cutoff period). Yep, that is indeed confused and confusing! It seems that both you and your doctor are quite confused about what's going on and what should be done to sort it out.
Regarding your sexual partner, he had a negative oral rapid test. That's good news. If he placed himself at risk for HIV, he should have gotten another rapid test three months after his last potential exposure. PCR is not recommended for routine HIV screening, due to the rate of false-positives, other technical concerns and cost. Therefore, at this point we really don't know if your buddy is HIV positive or not (possible false-positive PCR with negative rapid test).
Next, you have placed yourself at risk for STDs, including HIV, by having unprotected sex. Consequently you need an HIV-antibody test now and again three months after your last potential exposure. PEP should only be prescribed for significant HIV exposures. It also should be started as soon as possible and no later than 72 hours after the exposure. PCR should not be drawn while on PEP, as the antiretroviral medication contained in the PEP regimen could drive the viral load to undetectable levels, resulting in a false-positive test.
My advice to both you and your barebacking buddy is that you see an HIV specialist to get this whole situation sorted out as quickly as possible. You should not be on PEP and he may not even be HIV positive! Finally, you both should also wise up and stop playing sexual Russian roulette with your lives.
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