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Need advice about possible HIV infection and testing
Jun 3, 2011

I had sex in Seoul with a girl I met at a club for a one night stand. I was very drunk. During sex, the condom broke. She had blood coming out of her vagina which was most likely from menstruation. After sex, I was drunk and passed out. When I woke up, she was gone and I had some red spots on the head of my penis. They didn't hurt. I have had herpes prior to this but at the time of sex, there were no sores. I had been drinking several days in a row so my immune system might have been compromised. I was also getting sick often before I even went on vacation. Doctors also found a high level of protein in my urine so I don't know if my problems are related to that.

It has been 3 and a half weeks since exposure. I am worried that I am experiencing possible symptoms of HIV. I had a new small herpes outbreak. I have been having constant low fevers averaging 37 degrees. I have been tired and my muscles are fatigued. The tip of my penis (opening) has a burning sensation. I have been freaking out and very depressed.

I went to a hospital for a PCR test after 3 weeks. The doctor also tested for Hepatitis. 4 days later I got the results back as both negative. However, it turns out the doctor didn't do a PCR test but instead did some sort of antibody test. I specifically told him it had only been 3 weeks so I don't know why he used the other test, but he said there's still probably a 90% chance that I am HIV negative. I am very skeptical and still worried.

I want to go to a different doctor and get a PCR test done. Would this be recommended? I am in a serious relationship and can't hold off having sex for 3 months with my fiance. I feel very guilty and don't want her to get suspicious but at the same time don't want to put her at risk. Any advice? Does this sound like it could be HIV or possibly something else?

Response from Dr. Frascino

Hi,

Your HIV-acquisition risk is broken-condom insertive vaginal sex with a bar-gal from Seoul who also was menstruating. The CDC's estimated per-act risk statistic for acquisition of HIV via unprotected (or broken-condom) insertive vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. Your estimated statistical risk would be less, as we don't know the HIV status of your gal-pal.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected. That said, your specific symptoms are not worrisome for HIV. However, I would recommend you have a more complete STD screen.

PCR testing is generally not recommended for routine HIV screening. The FDA has approved only one RNA test for HIV screening: the APTIMA HIV-1 RNA Qualitative Assay.

My advice is that you level with your fiancee. Use latex condoms with her until your definitive three-month HIV-antibody test. This is not only the best way to confront your guilt; it's also the right thing to do.

Good luck.

Dr. Bob



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