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HIV Exposure, Test at 10 weeks and pregnant wife
Sep 2, 2008

Hi,

I'm a bi-sex male and at the beginning of Sep 07 I had protected sex with a professional sex worker (male) in Newark. During the exposure I kissed his penis but have not performed oral on him without protection. I then received anal sex from the person, again with protection. I did not penetrate him. The whole experience lasted less than 20mins.

At the end of this after he left I also checked the condom that was used and it was intact. There was no semen in the condom from him. This was my only experience with a male and actually the only non-faithfull experience outside marriage.

I have been feeling extremely bad about this and have been really stressed since that day. I had a complete sexual screening test done 2 weeks after the event (end Sep) and all was clear. During this test they tested for:

" HIV testing: HIV 1+2 antibodies and p24 antigen, Hepatitis B antigen and Syphilis test . Swabs or urine tests for STI/STD testing, chlamydia testing, gonorrhoea, mycoplasma, ureaplasma and candida (thrush). "

Knowing that HIV tests require 12 weeks to be 100% accurate. I had another HIV test done 10 weeks (November) after and that was negative as well. I did not test for other STDs at 10 weeks.

My wife is now pregnant with our first child and she had an HIV test done in April and that was negative. The test was done when she was 3 months pregnant.

The question is: Even though my test came back negative in November at 10 weeks, could I be HIV positive but not transmitted to my wife - even though I have obviously been having unprotected sex with my wife between Sep - April (as she is pregnant).

More details: > I have been having an extremely stressful time at work and in the last 4 months I have had Shingles - and of course I immediately associate this with my exposure in Sep 07.

> I have been having what I believe is "Globus Sensation" in the throat. I have visited my GP and they believe this is to do with acid in the stomach as I was also diagnosed and treated for "mild gastridis" in December 07.

Reading the facts above - what do you think - am I paranoid? should i have another HIV test? Does my test at 10weeks and my wife's test after that put me in the clear?

Response from Dr. Frascino

Hello,

Your first and only experience with another male and the only non-faithful experience outside your marriage was oral sex and receptive protected anal sex with a male professional sex worker. You are now feeling "extremely bad about this and have been really stressed since that day." Hmm . . . you are one of many married men who eventually act out on their innate sexual orientation (gay or "bi-curious"). This, of course, leads to intense feelings of guilt and anxiety. You can find many testimonials like yours in the archives of this forum.

Your HIV acquisition risk is essentially nonexistent, assuming the latex condom was used properly and did not fail (break). "Penis kissing" is not considered a risk for HIV transmission.

To respond to your specific hypothetical question could someone with a negative 10-week HIV-antibody test transmit HIV to someone else? yes, it's theoretically possible, because HIV-antibody tests performed prior to three months from the date of potential HIV exposure are not considered to be conclusive. As for your wife's negative HIV test despite your having unprotected sex, this also does not exclude the theoretical risk of you being HIV positive, because not every HIV exposure leads to HIV transmission. That said, it would certainly be extremely unlikely that you would have transmitted HIV to your wife, considering all the variables and circumstances you reported.

As for your shingles, "globus hystericus" and mild gastritis, these could all be related to stress.

Do I think you are paranoid? No, I think you are experiencing guilt-induced anxiety.

Should you have another HIV test? If you want a definitive test result, yes, you'll need to retest at the three-month mark.

My most important piece of advice to you is to level with your wife. It's not only the best way to confront your guilt, stress and anxiety; it's also the right thing to do. I'd also suggest you seek psychological counseling to explore issues of sexual orientation, irrational fears of HIV, guilt, anxiety and depression.

Good luck!

Dr. Bob



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