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Unprotected Anal Sex and Acute HIV Infection
Sep 21, 2013

DR Wohl

About 3 weeks ago I had unprotected anal sex with a person whose HIV Status remains unknown. I was the top. There was no blood on my penis. A week later, I developed a number of symptoms which I attributed to the flu. These included, sore throat ( negative strip culture), muscle aches, pain in my ears and throat, and extreme fatigue. The symptoms have continued to worsen over the two weeks that I've had them. I went to my doctor and informed him of my symptoms. His straight-out response was that it was one of two things, acute/primary hiv infection or mono. The mono test and HIV test were both negative. He informed me that at this stage, HIV antibodies would not be detected in a standard HIV test. His treatment recommendation was to wait 3 weeks and test again. He said that the HIV test at this point would be conclusive.

I have three questions

Are the symptoms I have presented only indicative or HIV or mono?

Would a standard HIV test in the next 3 weeks be conclusive?

What about measuring Viral Loads in the next 3 weeks as a means to determine HIV infection.

I anxiously await your response

Response from Dr. Wohl

This was a risky exposure if a condom was not used. Your doc should perform either a 4th generation HIV test that looks for p24 antigen along with HIV antibodies OR a plasma HIV RNA PCR test. Waiting wastes an opportunity to detect acute/early HIV and possibly start treatment to preserve immune function.

Waiting until antibodies develop follow a paradigm that is no longer followed given these newer tests.

DW



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