Insertive Vaginal Sex - Did you say 1 in 500 with infected partner


Dear Mr. Kull:

Approximately two months ago I had unprotected sex (insertive vaginal intercourse)with a lady who's HIV status was not known. Of course my imagination has convnced me that I have aids. I had two nights of night sweats about 6 weeks after this occured, I appear to have blod sploches on the inner sides of my mouth, (almost like i have bitten the side of my mouth). No flu like symptoms or swollen nodes,(of course I convinced my self and went to the docator and he wasn't concerned)No sore throat or fever. Was tested 12 days after incident (negative)Dr. did a (cbc) at 45 days it was normal. I have not had sex with wife due to this in a while, we practice safe sex always use rubber. I need your help badly, does this sound like I'm HIV or just parnoid!! Is it true that if she was positive that there would be a 1 in 500 chance of exposure? Please help !!



That figure, 1 in 500 chance of transmission per unprotected penile-vaginal intercourse with an HIV infected partner, is based on ONE study conducted in Africa (see my response to "Recent Study of Per Contact Risk" The odds of transmission in that study approximate the odds in other studies. However, some studies have estimated that the odds of transmission to the insertive partner are much lower (see

Basically, the odds are against transmission happening in one episode of unprotected sex (especially if your partner is low-risk!). However, that's a gamble many people are unwilling to take.

Your HIV test 12 days after exposure is not that significant. There is no real reason to believe at this point that your symptoms are related to HIV infection, but you should continue to monitor them and see a doctor as needed.

You must be under a lot of stress about this situation, which can play a big role in your physical health and emotions. It's important to not only look at the medical side of things, but the psychological, emotional and behavioral elements. How did you arrive at the situation you are in (you had unprotected sex with a person of unknown status and use condoms with your wife)? What is your understanding of the dynamics underlying the circumstances?