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Very worried after positive exposure
Nov 22, 2012

Hello Dr.

7 weeks ago, I had protected sex with a prostitute in West Africa. No oral of any sort but there was mutual hand to genital contact and deep kissing. The condom stayed intact but I am still extremely worried as about 6 days after the incident, the lady tested positive for the -1 strain via a rapid test and 4th generation Elisa (DUO). She is not on any medication and I don't know what her viral load is.

The last few weeks have been very tough but I have tested negative with the very same rapid and DUO test every week since the exposure, with the latest tests being after 48 days. I have also tested negative with an RNA PCR after 9, 16, and 30 days. I also have had a CD4/CD8 done after 30 days and it was 1166/420.

I have not yet had any of the classic ARS symptoms and CBC has been very normal. I know that diagnosing symptoms can be a waste of time but I'd rather not be sick than be sick, especially in this early stage.

1. I've been told I had no risk, I've been told that I'm safe after the tests that I've had, and I've been told I need to keep testing. What do you think?

2. I'm worried about the PCR not picking up some of the rarer subtypes. It seems that all research, medication and test kits were carried out/designed with subtype B primarily in mind as this is the dominant subtype in the western world i.e. where the money is. Should I be worried about this?

3. What are the chances of the virus remaining dormant at this stage i.e. no virus or antibody being detectable?

Thanks for your time and I apologise for the length of my post.

Response from Mr. Glenn

You had no risk for HIV from the protected sex that you had.

Your job right now is working to believe that. You have been told multiple times that you had no risk but you're having trouble moving past this.

At this point, you must find a way to manage your anxiety. This can come from talking to a trusted person like a friend or family member. This can more easily come from talking to a knowledgeable counselor who can help you deal with your anxiety.

Unfortunately, I'm not familiar with the resources in your part of the world. But if you're able to get online to find out website, then there may be other mental health resources you can find online.

Hope this helps!

Erik



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