Thanks so much in advance for taking my question. I have been freaking out since an exposure to a risky situation 3 1/2 weeks ago. I had protected vaginal sex with a CSW. About 1 week and a half ago I started exhibiting really strong ARS symptoms (daily headaches, nausea, muscle and joint aches, painful throat and a yeast infection on my penis...I am uncircumcised). I was tested about 4 days ago and it came back negative. My questions to you are: 1) how accurate is a 3 week test? 2)If my symptoms have intensified in the past few days and I am in fact seroconverting, if I get tested at 4 weeks will this be accurate? I know I am suppose to wait at least 6 weeks and even 3 months, but I am going crazy. I am married and don't want to pass anything on to my wife. Any advice you can offer is much appreciated. Thanks!

Hi,

HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. If your walk on the wild side with the Naughty Lady of Shady Lane was "protected," your HIV-acquisition risk would be essentially nonexistent, assuming the latex condom was used properly and did not break. You're "going crazy" primarily due to guilt and fear. My advice is very straightforward:

1. Level with your wife. It's not only the best way to confront your guilt; it's also the right thing to do. Together you can decide to use latex condoms for penetrative sex until your HIV status has been confirmed to be negative.

2. Get a single HIV-antibody test at the three-month mark. The results will undoubtedly be negative; however, this is the most effective and efficient way for you to put your unwarranted fears permanently to rest.

3. Follow up with your general medical doctor regarding any intercurrent symptoms: headache, nausea, muscle pain, penis rash, etc. Many of these symptoms may well be anxiety related.

Good luck.

Dr. Bob