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Time to Seroconvert
May 23, 2011

I am worried to death. I am a gay black male. I was the insertive partner with a guy 18 days ago, on May 4, 2011. I did not use a condom. After the sex act, there was blood on my sheets, so I questioned him about his recent HIV status, and he said he last tested Negative in October, 2010. I pressured him to go with me to take an HIV test but he refused. After 2 weeks of pressuring him and threatening to report him to the authorities, he sent me a text and said that I should get tested, admitting that he is positive. He claims that he was tested on May 6th and found out that he is HIV+. That was the same day (2 days after the sex act) that I got tested with the Oralquick test and tested negative. Today (17 days after the sex act), I took a Clearview blood HIV rapid test and it is still negative. I have absolutely no symptoms. In fact, I feel super healthy and energetic more than usual, but the worrying is killing me. When the worrying starts, I have been taking Xanax just make it trough the day and night.

I had no blisters or noticeable cuts on my Penis or anywhere in the area. I took a shower immediately after the act and put soap in my urethra and squirted water in the area too.

I had some Acyclovir left over from an old prescription for a cold sore that I occasionally get on my nose, so I took a pill that same night. I took another one the next morning.

I have read that Seroconversion takes anywhere from 21 days to 6 months so my question is what are the chances that I do not have HIV? Is it 50/50, since I tested negative 18 days later and feels very healthy? I don't feel ill at all and I have no rash, absolutely no symptom. Please tell me something that makes me feel better because a 50/50 chance doesn't make me feel good at all.

Thank you very much.

Response from Dr. Frascino

Hi,

Why are you "worried to death" now only after finding out your bottom boy was positively charged? If he never disclosed his status (or didn't know he was infected), would you be at any less risk today? No, of course not. We must assume all our sexual partners could be HIV infected and take all the necessary precautions to prevent the transmission of HIV (and other STDs). Your decision to do an unsafe "dance with no pants" placed you at risk for STDs, including HIV. Yes, your partner should have disclosed his status before you hit the sheets, but remember, it takes two to do the unsafe mattress mambo!

Your risk is unprotected anal sex with a partner confirmed to be HIV positive. That you noticed "blood on the sheets" could increase your HIV-acquisition risk. The CDC's per-act statistical estimate for the risk of acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV infected is 6.5 per 10,000 exposures. Consequently, your odds are no where near 50-50. However, you are still at some degree of risk and testing is warranted. Because you had a significant HIV exposure, the CDC recommends HIV testing at the three- and six-month marks. Your negative HIV-antibody test at day 17 is encouraging, but far from conclusive. For future reference if you were to have another HIV exposure (such as a broken condom), post-exposure prophylaxis (PEP) would be warranted to help abort possible HIV transmission. PEP, however, needs to be started as soon as possible and no later than 72 hours after the exposure. Consequently it's not an option for you now. You can read more about PEP in the archives of this forum.

Good luck.

Dr. Bob



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