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Window Period, Viral Load and Chance of Transmission
May 15, 2009

I had unprotected anal intercourse (insertive) in the 20th jan 2009 with a person I found out later was HIV +. Other than that I did not engage in any risky behaviour. I was tested for HIV with an ABBOTT Architect antibody/ antigen in the 27th of april 2009 (approximately 97 days after exposure). In between that period I did not feel any of the Acute HIV Infection symptoms though I had a tonsillitis (which was treated with penicilin), muscular and joint pain followed the tonsillitis and after 3 weeks I had a viral infection which brought me diarrhea and a slight weight loss, which I quickly recovered (though no fever, skin rash or swollen lymph nodes appeared), and the doctor diagnosed it as a food poisoning associated with a cold and gave me some pretty usual medicine to help treat it and relieve the symptoms. My questions are: 1 - Can having been sick or taking any meds or any other activity increase or change my window period? 2 - If the person I had sex with was recently infected by HIV but already passed his window period and is nowhere near developing AIDS and having to take meds (for instance, he was infected with HIV one year ago) and was healthy at the time we had sex, does that mean his viral load was low and the chances he transmitted it to me are lower than average? 3 - Considering chances of getting HIV from insertive anal sex are 6,5 in 10000, the chance of developing Acute HIV infection 80% and the chance I would have seroconverted after 97 days of the exposure over 97% can I assume my chances of having contracted HIV are (6,5/10,000)*0,2*0,03 = 0,000004, that is saying 1 in 250,000 or virtually zero? What are the chances I have HIV and should I be tested again in 3 months? Or can I unwind? I've been feeling like shit since I knew I had sex with someone HIV + and even the 3 month test couldn't make me relax!

Thank you for all you hard work concerning HIV, it's a beautiful job you're doing and I hope you can continue to help people for many many years to come! Best wishes

Response from Dr. Frascino

Hi,

1. No. Not the medications you took.

2. No. You can not make that assumption, particularly if he was not on effective antiretroviral medications.

3. No. You can not use population statistics in this manner. Unprotected anal sex with an HIV-positive partner is extremely risky and it's possible to contract the virus with just a single exposure.

4. Your three-month negative test is extremely encouraging. However, since you had a significant exposure with a partner confirmed to be HIV positive, the CDC recommends you get a follow-up test at the six-month mark.

I'm continually amazed at folks who say: "I've been feeling like shit since I knew I had sex with someone HIV+ . . . ." If you never found out your partner was infected, would you be at any less risk??? No, of course not. Remember, 25% of the HIV-positive folks in America have absolutely no idea they are infected with the virus. Time to wise up and stop playing sexual Russian roulette! The consequences of losing that game can be catastrophic!

Good luck.

Dr. Bob



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