Am I at Risk for HIV After Unprotected Sex? Symptoms and Testing

Am I infected with HIV?

Hello doctor, I have a question: On October 28, 2023, I went for a massage and had unprotected sexual intercourse with the attendant, although it was only for 5 thrusts.
After that, I used a condom.
However, I had a fever for one day from November 26 to 27.
I later researched HIV symptoms and found that I had about four of them.
On the morning of the 27th, I went to see a doctor who diagnosed me with tonsillitis.
I also found online that tonsillitis could be related to HIV infection.
Subsequently, I went to a clinic for an HIV combo test, and the result was negative.
However, I read that tests conducted within six months may yield false negatives.
In addition, my fingernail beds have been painful recently, and I found online that this could also be related to HIV infection.
I would like to ask if it is very likely that I could convert from negative to positive? I am very worried.

Zhang, 30~39 year old female. Ask Date: 2023/12/12

Dr. Liao Zhongxin reply Internal Medicine

1.
The transmission routes of HIV include sexual intercourse, sharing needles for drug use, and improper blood transfusions, among others.

2.
As for the symptoms of acute HIV syndrome, they can vary widely; if you have engaged in any of the aforementioned high-risk behaviors, please consider self-testing or consult a nearby medical facility for detailed advice and testing.

Reply Date: 2023/12/12

More Info

After engaging in unprotected sexual activity, it is natural to feel anxious about the possibility of HIV infection. Your concerns are valid, especially given the circumstances surrounding your encounter. However, it is essential to understand the risks, symptoms, and testing protocols related to HIV.

Firstly, the risk of HIV transmission through unprotected sex varies depending on several factors, including the HIV status of your partner, the type of sexual activity, and the presence of other sexually transmitted infections (STIs). In your case, since you mentioned that the encounter involved unprotected intercourse for a brief period, there is a potential risk. However, the fact that you used protection afterward significantly reduces the likelihood of transmission.

Regarding symptoms, it is important to note that many symptoms associated with HIV can also be related to other illnesses. For instance, fever, sore throat, and swollen lymph nodes can occur due to various infections, not just HIV. The symptoms you experienced on November 26-27, such as fever and sore throat, could be attributed to a different viral infection, especially if you were diagnosed with tonsillitis.
You mentioned that you underwent an HIV combo test shortly after your symptoms appeared, and the result was negative. The HIV combo test, which detects both HIV antigens and antibodies, is quite reliable. Generally, it is recommended to wait at least 2-4 weeks after potential exposure for accurate results, with most tests being conclusive by 6-8 weeks. However, the window period can extend up to 3 months for some individuals, particularly those with a delayed immune response.

Your concern about the possibility of a false negative result (i.e., being HIV positive but testing negative) is understandable. While it is possible for someone to test negative during the window period, the likelihood decreases significantly with time. If you tested negative at 4 weeks post-exposure, it is a good sign, but it is advisable to follow up with additional testing at the 3-month mark for complete peace of mind.

As for the pain in your fingernails, it is unlikely to be directly related to HIV. Nail pain can result from various causes, including trauma, fungal infections, or other dermatological conditions. It is essential to consult a healthcare professional for a proper evaluation of this symptom.

In summary, while there is a risk associated with unprotected sex, your negative HIV test result is reassuring. It is crucial to monitor your health and seek further testing if you remain concerned. If you experience any new symptoms or if your anxiety persists, consider reaching out to a healthcare provider or an HIV specialist for further evaluation and support. They can provide you with more personalized advice and help alleviate your fears. Remember, practicing safe sex and regular testing are key components of maintaining sexual health.

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