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Am I infected?
Jul 25, 2010

My partner and I (we're both men) have been together and mutually monogamous for over ten years. We have annual physicals that include HIV testing and have always tested negative (the last test for both of us was about four months ago). Twelve days ago we had a menage a trois with an acquaintance of ours (the first time we have ever done this or not been monogamous). My partner received fellatio from the acquaintance and I was the penetrative partner in protected anal intercourse with the acquaintance. I entered him wearing I condom. The condom I was wearing broke. The acquaintance I penetrated says he tested negative for HIV infection one month ago and that he always uses condoms in anal intercourse. We discovered the lube we used that he had at his house was oil-based, which probably explained the breakage. I have had symptoms in the last few days that definitely could be caused by initial HIV infection (specifically sore throat, some aches and pains, and a swollen lymph node in my neck). I have not noticed any other symptoms. My partner and I have been using condoms in both anal and oral sex since this incident. I have two questions - 1) Given the symptoms and the risk of the incident, how certain is it that I am infected? Can you quantify it? 2) At what date(s) should my partner and I be tested (e.g. 1 month, 3 months, 6 months?) Needless to say I am extremely upset about this situation.

Response from Dr. Frascino

Hi,

1. Your HIV-acquisition risk is low, but not nonexistent. Symptoms are unreliable in predicting who is and is not infected. There is no way to accurately "quantify" the risk for a specific encounter, as there are many potentially confounding variables involving the virus (viral strain, viral load, etc.), the host (immune integrity, concurrent infections, etc.) and the specific act (local trauma, etc.).

2. Three months. HIV-antibody tests taken prior to the three-month mark are not considered to be definitive.

One option would be to ask your "trois" in the menage to be retested. A rapid test will give an accurate answer in as few as 20 minutes. If he tests negative, you can breath a sigh of relief. At that point the only chance for HIV transmission would involve your acquaintance being recently infected and still in his window period. The odds of this would be remote at best. You'll still need your three-month test for a conclusive result and for peace of mind.

Good luck.

Dr. Bob



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