Expert: Terry B - 7/24/2007

Question
Hi Sir,
I had unprotected high risky vaginal intercourse 5 weeks ago , what makes it
high risky is that there was menstrual blood , suddenly the girl's period
started ..

I can't describe how horrible my feeling was , I panicked , and started thinking
about being infected with HIV since the blood increases the risk massively !
I went through all the STDs tests , I found out that I've got Gonorrhea , I've
been taking antibiotics and I feel much better now , but I still have annoying
sore throat that started 12 hours after exposure and today it will be around the
35th day and it is still persistent , Beside swollen glands in my neck and groin
area , they are swollen a bit ..

I had P24 Antigen test at 14 days after exposure and it came back negative , I
took the Duo test ( ELISA antibodies and P24 Antigen ) at day 28th ( after 4
weeks ), Both came back negative ..
I asked the girl about her HIV status she told that she's fine ..
What do you think ? Do you think is there any possibility
that if i would go for antibodies test after 6 weeks , It would turn back
positive ? I am much worried and scared to death , and Lesson learned ( NEVER
practice sex out of your marriage ) ..
and what do you suggest in my case and for my high risk behavior ?
I am sorry for bothering but your answer will help me a lot ..

one more thing ..

I just want to know your opinion about the two tests that I've already taken ?
Negative P24 Antigen after 2 weeks and Negative Duo test ( ELISA antibodies and
P24 Antigen) after 4 weeks , Are they encouraging ? since P24 test can detect
the presence of the virus protein early post-exposure ?
thanks again .  

Answer
Dear Regret:

Peace.  Your question is not a bother at all, your perception of increased risk in the presence of blood AND vaginal secretions was well founded.  

You have used reliable testing in what seems the context of a relationship with your doctor - as noted in disclaimer, anything here is not meant to replace that relationship.  

I would offer my opinion on p-24 antigen testing in general, based on what I have read; the chances of a false negative test (meaning you are infected but it does not show up with the test) is miniscule, and the risk of anxiety due to false positive (indicating infection when none actually exists) can be as high as ten percent (10%).

A dual test that incorporates ELISA with p-24 antigen testing after six weeks supports the data you have from the initial test; as you were told, all evidence suggests that you are NOT infected with HIV.

A larger question I would encourage you to pursue is whether you have realistic expectations for yourself in sexual behavior.  I am aware of people with a similar resolve to have sex only within the context of marriage, who place themselves at risk by not carrying barrier protection.  While I encourage you to set high standards for yourself, and do your best to maintain them, your behavior in the past indicates at least a chance that you will fall short of your good intentions.  Whatever your resolve, I suggest strongly that you speak with a counselor at a STD testing center to be knowledgeable and prepared to protect yourself and others should you fall short of your goals.

I hope this answers your questions, please continue to take your medications as prescribed.  I wish you and yours the very best of health.

Terry