HIV Risks and Blood Tests After Unprotected Sex

Q: HIV Risks and Blood Tests After Unprotected Sex

Hello： Hypothetical questions are difficult to answer and usually require confirmation. <br>It is generally recommended to get tested again after three months. <br>For safe sexual practices during the window period, you can refer to https：//www.tygh.mohw.gov.tw/?aid=52&pid=150&pa

HIV and Blood Testing

About three weeks ago, I had unprotected sexual intercourse.
Two weeks ago, I had a sore in my mouth (self-inflicted) and performed oral sex on my partner.
Last week, I experienced a fever and mouth sores (unexplained ulcers), but after a week, the symptoms disappeared, and only the mouth sores are still healing.
I am concerned about HIV.
I heard that a combo test can detect it by the third week, so I asked my partner to get tested, and the result was negative.
I tested negative last week (but it was only two weeks post-exposure).
The partner from two weeks ago is currently abroad and cannot get tested; he claims he tested last month and is on PrEP.
This week, I went to a clinic for blood tests due to an unexplained fever.
The results showed elevated liver enzymes (SGOT 64; SGPT 96), but no hepatitis.
Other abnormal results included: platelet count (140-440): 136; neutrophils (40-75): 37; lymphocytes (20-45): 46.2; monocytes (2-10): 11.8.
The doctor mentioned that these results indicate a viral infection in the blood, so could this possibly be HIV? The symptoms are similar to HIV, with a fever lasting a week and mouth sores.
I am worried about HIV and plan to get tested again next week or the week after.
Can I be reassured that my partner's negative test three weeks post-exposure is reliable? Also, what is the risk of HIV transmission from performing oral sex on that partner (there was no semen, and I don't recall much pre-seminal fluid, possibly just a little)?

ABC, 20~29 year old female. Ask Date: 2020/03/19

Dr. Du Shixi reply Urology

Hello: Hypothetical questions are difficult to answer and usually require confirmation.
It is generally recommended to get tested again after three months.
For safe sexual practices during the window period, you can refer to https://www.tygh.mohw.gov.tw/?aid=52&pid=150&page_name=detail&iid=210.
As for oral sex, it is considered a medium-risk sexual behavior.
Low-risk sexual behaviors include mutual masturbation, mutual rubbing, deep kissing, bondage, protected deep foreplay, oral sex with condoms or dental dams, anal intercourse, and vaginal intercourse.
● Medium-risk sexual behaviors include withdrawal (pulling out), sharing sex toys, unprotected deep foreplay, oral sex before ejaculation, and oral sex during menstruation.
● High-risk sexual behaviors include unprotected anal intercourse, vaginal intercourse, oral sex during menstruation, retaining semen in the mouth, sharing needles, syringes, and bleeding during sexual activity.

Reply Date: 2020/03/19

More Info

Understanding HIV risks and interpreting test results after potential exposure is crucial for peace of mind and health management. Based on your situation, let's break down the key points regarding HIV transmission, testing, and your specific concerns.

HIV Transmission Risks
1. Unprotected Sex: Engaging in unprotected sexual intercourse is a known risk factor for HIV transmission. The likelihood of transmission depends on various factors, including the HIV status of your partner, the presence of any sexually transmitted infections (STIs), and the type of sexual activity.

2. Oral Sex: While oral sex is generally considered to be a lower-risk activity compared to vaginal or anal sex, it is not without risk. If you had a cut or sore in your mouth, this could increase the likelihood of HIV transmission, especially if your partner is HIV-positive. The presence of blood, even in small amounts, can elevate this risk.

3. Pre-Exposure Prophylaxis (PrEP): If your partner is on PrEP and adheres to the regimen, this significantly reduces their risk of transmitting HIV. However, it is important to confirm their HIV status and adherence to the medication.

Testing and Interpretation
1. Combo Tests: The HIV Ag/Ab combo test is effective at detecting HIV infection earlier than antibody-only tests. It can typically identify an infection within 2-4 weeks after exposure. Since you tested negative at two weeks, it is still within the window period, and you may want to retest after the recommended time frame (usually 4-6 weeks post-exposure) for more conclusive results.

2. Partner Testing: Your partner's negative result three weeks after exposure is reassuring, especially if they are on PrEP. However, it is essential for them to continue regular testing as recommended by healthcare providers.

3. Symptoms and Other Infections: Symptoms like fever and mouth sores can be indicative of various infections, not just HIV. The elevated liver enzymes (SGOT and SGPT) could suggest a viral infection or other health issues, but they are not specific to HIV. It is crucial to follow up with your healthcare provider regarding these findings.

Risk Assessment
1. Infection Probability: The risk of HIV transmission through oral sex, especially without ejaculation, is lower compared to vaginal or anal sex. However, the presence of open sores or cuts can increase this risk. If you had minimal exposure to pre-ejaculate fluid, the risk remains low, but not negligible.

2. Follow-Up Testing: Given your concerns and symptoms, it is wise to retest for HIV after the recommended window period. This will provide you with more accurate information regarding your HIV status. Additionally, consider discussing your symptoms with a healthcare provider to rule out other infections or conditions.

3. Mental Health: The anxiety surrounding potential HIV exposure is common. It is important to address these feelings and seek support if needed. Counseling or speaking with a healthcare professional can help alleviate concerns and provide guidance on next steps.

Conclusion
In summary, while your risk of HIV transmission from the described activities is present, it is relatively low, especially considering your partner's negative test and PrEP usage. Continue to monitor your health, follow up with testing, and consult with healthcare professionals regarding any symptoms or concerns. Remember, early detection and treatment are key in managing HIV and maintaining overall health.

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