Concerns About HIV and Hepatitis B After Unsafe Sexual Encounters

Concerns regarding HIV and Hepatitis B?

I have been staying up late until 3 AM since the beginning of the year.
Between late February and mid-April, I had several instances of unprotected sexual intercourse with the same person (I am unaware of his medical history; I only know that he often has nosebleeds, and we have since cut off contact, making it impossible to inquire about his medical history).
Starting in July, I frequently experienced pain in the upper left and lower abdomen, as well as swelling in the lower abdomen (my menstrual periods were normal from February to July, and I have taken three pregnancy tests, all showing negative results, confirming that the swelling is not due to pregnancy, but I do have adenomyosis and an enlarged uterus).
On July 23, a urine test indicated a urinary tract infection.
After taking antibiotics, a follow-up test showed no bacteria, but the lower abdomen remains swollen (I am unsure if taking antibiotics could affect the test results).
On August 1 (more than 12 weeks later), I had a blood test for Hepatitis B, and the results showed negative for Hepatitis B surface antigen and negative for Hepatitis B antibodies.

On August 5 (more than 12 weeks later), I began to experience sores on the sides of my tongue, a small bald spot at the back of my tongue resembling a ligament, and a sore throat (there was no oral thrush, but the oral mucosa appeared pale pink with some areas showing noticeable blood streaks; I have an untreated cavity where the gums have been bleeding continuously and sometimes swell).
On August 6 (more than 12 weeks later), I coughed up blood-tinged sputum in the morning, but that was the only instance.
On August 8 (more than 12 weeks later), I underwent rapid testing for HIV and syphilis, which returned negative results.
On August 10 (more than 12 weeks later), during very hot weather, I ate ginger duck and drank some milk wine, and upon returning home, I discovered widespread folliculitis on my chest (I tend to have many acne breakouts and suffer from seborrheic dermatitis), and my throat pain worsened, with persistent pain in the affected areas of my tongue.
Based on the above symptoms, do I need to retest for HIV, syphilis, and Hepatitis B? Additionally, the rapid testing personnel reused gloves without changing them; is it possible that if the previous person tested positive for HIV, they could have used the same gloves to draw my blood, potentially contaminating my wound and raising concerns about infection? I apologize for the lengthy message, but I am very worried and regretful about the actions I took due to emotional manipulation, and I am extremely fearful of causing lifelong harm.
Thank you for your patience in reading this.

Niming, 20~29 year old female. Ask Date: 2018/08/13

Dr. Hong Yuanbin reply Internal Medicine

Hello, theoretically, the average window period for HIV is 3 months.
If you have not engaged in sexual activity since April, then you should have surpassed the window period.
Testing in August would likely yield a negative result, and the chances of infection should be very low.
The symptoms you described are not common symptoms of HIV.
As for the use of gloves, it should not lead to infection.
In summary, your risk of infection is almost nonexistent.
If you are still concerned, you can consider getting tested again around November for confirmation.
Thank you for your question.

Reply Date: 2018/08/13

More Info

It's understandable to have concerns about HIV and Hepatitis B after engaging in unsafe sexual practices, especially when you are unsure about your partner's health history. Let's break down your situation and address your concerns systematically.

Understanding HIV and Hepatitis B Transmission
HIV (Human Immunodeficiency Virus) is primarily transmitted through unprotected sexual contact, sharing needles, or from mother to child during childbirth or breastfeeding. Hepatitis B (HBV) is also transmitted through sexual contact, sharing needles, and from mother to child. Both viruses can be present in bodily fluids, and the risk of transmission increases with the presence of cuts, sores, or other forms of trauma.

Symptoms and Testing
You mentioned experiencing various symptoms, including abdominal pain, throat issues, and oral lesions. While these symptoms can be concerning, they are not specific to HIV or Hepatitis B. Many conditions can cause similar symptoms, including infections, stress, or other health issues.
You have already undergone testing for Hepatitis B, which returned negative for both the antigen and antibody, indicating that you are not currently infected with Hepatitis B. The timeline of your sexual encounters and the subsequent testing for HIV is crucial. The window period for HIV testing can vary, but generally, the following guidelines apply:
1. Initial Testing: An HIV test can be performed as early as 10-14 days after exposure, but results may not be conclusive.

2. Follow-Up Testing: It is recommended to retest at 6 weeks, 3 months, and sometimes at 6 months for a conclusive result.

Since you mentioned that you tested negative for HIV after 12 weeks, this is a strong indication that you are not infected, as the majority of people will develop detectable antibodies within this timeframe.

Concerns About Testing Procedures
Regarding your concern about the reuse of gloves during testing, while it is generally not standard practice to reuse gloves, the risk of HIV transmission in this manner is extremely low. HIV does not survive long outside the human body, and the likelihood of transmission through contact with a glove that may have been contaminated is minimal. However, if you have specific concerns about the testing facility's practices, it may be worth discussing with a healthcare provider or seeking testing at a different facility.

Recommendations
1. Follow-Up Testing: Given your history of unsafe sexual encounters, it is prudent to continue monitoring your health. If you have any new symptoms or if you remain concerned, consider retesting for HIV and other sexually transmitted infections (STIs) after a few months, even if your previous tests were negative.

2. Consult a Healthcare Provider: If your symptoms persist or worsen, it is essential to consult a healthcare provider. They can conduct a thorough evaluation and may recommend additional tests to rule out other infections or conditions.

3. Mental Health Support: The anxiety and stress stemming from your experiences are valid. Consider seeking support from a mental health professional or a support group for individuals dealing with similar concerns.

4. Preventive Measures: Moving forward, consider using protection consistently during sexual encounters to reduce the risk of STIs, including HIV and Hepatitis B. Additionally, discussing sexual health openly with partners can help mitigate risks.

In conclusion, while your concerns are understandable, the evidence suggests a low risk of HIV and Hepatitis B infection based on your testing results and timeline. However, ongoing vigilance regarding your health and regular check-ups are advisable.

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