high risk for hiv?

Question

I am a 34 year old female who has had 4 sexual partners (since age 21). This includes my fiancee and boyfriend of 4 years. We have both been tested (negative) and have been in a monogamous relationship. My previous partner I know was negative. The 2 prior to that were in '89 and '92. Despite negative test results I am anxious. My risks have included only possible exposure to pre-cum (I don't think I knew that this was risky when I was younger and have always thought that I was being cautious). Does exposure to pre-cum pose a significant risk, and could I still have HIV even though I have tested negative? Clearly I would benefit from some counseling, but maybe knowing the facts and getting some perspective would also help me. I have thought everything from my test being a false negative, to a mixup of blood samples, to thinking that I have a rare form of HIV (such as HIV 2 or 0) or an odd subtype of HIV 1 that is not detected by conventional tests. I began to investigate "rare" forms of HIV I suppose because my fiancee is from Egypt and I had heard of different strains being endemic to certain parts of Africa. Any insight you can offer into this dilemma would be welcome. I am miserable and sometimes cannot even function. I should add that I have these thoughts even though I am a licensed health professional. Thank you so much for your time.

Answer

I think the anxiety you experience about HIV infection is quite common, especially among people who visit this website. Please refer to my response to Undetectable Strain...Please Help for more information on strains of HIV and anxiety.

Exposure to pre-cum is generally low-risk, but within that low-risk category there will be some variation depending on what part of your body came into contact with the pre-cum. It is also extremely unlikely that you were infected with a strain that went undetected by your tests. All of the circumstances that you imagine contributed to a false negative result are so unlikely to have actually happened. Beyond that, there is little I can do to convince you that you are very likely to be HIV negative. I suggest that you seek out some other form of help if you find the anxiety to be unmanageable.

RMK