partner notification

[shellshocked]

On Oct 26, 2007 I was diagnosed with HIV from a very recent infection. The last several days have been the scariest and darkest of my life. I’m walking around in a daze. I still can't believe this is happening. With the exception of Chlamydia in the early 80s, I’ve never even had a sexually transmitted infection. I'm angry and disgusted at myself. I'm 44 years old. I should have known better. Since the 80s, I've consistently practiced safer sex, always using condoms for anal sex but rarely for oral. Unfortunately, that was not the case when I hooked up with a sex buddy on Aug 11 of this year. This was the third time that I'd hooked up with this person for sex. The first two times we used condoms for anal sex. On the third occasion, Aug 11, we did not. He assured me that he was HIV negative and always used condoms as well. Now I’m wondering if he is the person who infected me.

I'm writing this post with the hope that somebody can help me sort out the likelihood that the person with whom I had unprotected sex with on Aug 11 was the person who transmitted the virus to me. I’ve read other posts in this forum and realize that searching for the answer to who infected me is without much purpose or benefit. In the end, I accept responsibility for what happened to me. Now I have to find a way to live with that fact for the rest of my life. I’m mainly concerned about trying to determine who infected me in terms of partner notification.

Let me explain how my testing unfolded. On Aug 30, I had a full STI screening, including HIV testing. I was concerned about the high risk exposure on Aug 11. I realized that the window period was generally longer than just a few weeks, but I decided to go ahead with the testing since by Aug 30 almost twenty days had already passed. That first test result (i.e. from the blood drawn on Aug 30) was indeterminate (i.e. reactive on ELISA but not WB). On September 10, I was retested. That result also came back indeterminate. On October 9, I was tested for the third time. This time the result was positive (i.e. reactive on both ELISA and WB).
Given this time line, it seems likely to me that I was infected on Aug 11. I did go to two different bathhouses in July (on July 10 and July 14) but practiced safer sex on both occasions, using condoms for anal but not for oral. On July 20, I hooked up with a different sex buddy but we practiced safer sex, using condoms for anal. That was all the sex that I had in July. In August I had sex with an anonymous partner on August 5 but that was also safer sex, and we used condoms for anal. Since August 11, I have not had any high risk or unprotected sex. I’m not at risk from injecting drugs so it must have been sexual transmission.

I was just diagnosed, and I can’t imagine telling my closest friends, let alone people I don’t fully know or trust. Since privacy is a major issue for me at this point, I don’t want to needlessly notify people who were likely not at risk of exposure from sexual contact with me. (Unfortunately, there is still a great deal of stigma about HIV/AIDS in the gay community.) Some of my sex buddies are not people that I know very well or trust with my personal health information. I realize that I have an ethical responsibility to notify others that they may have been exposed to HIV.  At the same time, I’m not ready to disclose my status to people I don’t know very well, especially if I can rule out that they were at risk of infection from having sex with me.

Any thoughts would be appreciated. I realize that I’ll never know exactly how and when I was infected, but does it seem likely that I was infected on Aug 11?

[keyite]

Firstly, welcome to the forums. As sad as you are that you've tested positive but glad you've found your way here. I can understand your reluctance to tell anybody but I'd nonetheless urge you to find sources of support, so you're not all alone in dealing with this. This place is obviously a great source, but in the days to come additional sources will be very useful as you work towards coming to terms with it and forgiving yourself for what has happened. Is there not one of those close friends you perhaps could trust with this information?

Secondly, the question of who infected you and when. Well, who knows? Speculation is likely to remain just that, speculation. What's done is done, cannot be undone, and as you point out, you accept responsibility for your part in it. Your energies are now going to be better spent focusing on the future.

I personally think the aim of partner notification should be to alert the person about the risk of infection they have been exposed to (if you believe there was a risk, of course). Whether they act on it by taking a test is then up to them and whether they tell you of the outcome of that test is also up to them. You've then done what you can.

I can understand why you might not be ready to do undertake notification so soon after being given the diagnosis. You don't mention where you live, but most countries offer a system whereby sexual health clinics or public health departments will do partner notification on your behalf. Your partners won't be told your identity. Perhaps ask where you were diagnosed?

I know it all seems very scary and dark right now. It will get better over the coming days and months...

[Ann]

Hi Shell,

Considering that protected intercourse is NOT a risk for hiv infection but UNprotected intercourse is, it's pretty safe to say you were infected when you had unprotected intercourse. Lots of people ASSUME they are hiv negative, despite not testing or engaging in risky behaviour since their last negative result or while in the waiting period for that result.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time for seroconversion being 22 days.

You tested indeterminate on day 19 and again on day 30 - four weeks. You tested positive on day sixty - eight and a half weeks. If you'd tested at six weeks, you most likely would have tested positive then. Your testing history is a textbook case from exposure/infection to seroconversion and testing positive.

What you don't know and might not ever know is if this guy actively lied or just assumed he was hiv negative. Lots of people do assume - lots of people think hiv is something that only happens to other people. Please don't put your energy into this issue right now - you need that for your own adjustment and health. You've got plenty of time ahead of you to come to terms with the circumstances of your infection and any of its implications.

I'm sorry you've ended up here with us - but welcome to the forums. Believe it or not, you will get through these initial dark days. Hang in there.

Ann

[next2u]

hey shellshocked,

dude, age ain't nothing but a number homie, trust me. i know i wanted to (and still want to) kick my own ass at catching the bug. but it happens, and i know i did the what if's a thousands times after infection. i know i feel as though i've lost something and i should have definitely known better. i may not have lived through the gay 80's, but i have a lot of friends who did. being black & gay should have been enough. i felt as though i dodged the bullet many times, but alas, it finally got me. anyhow, things are different now. not necessarily worse, but different. im fortunate enough to have had the number of years negative under my belt that i did. now ill be fortunate enough to have the poz years as well.

anyhow, i wanted to respond to your partner notification response. i have notified all of the people (3) i have had unsafe (anal unprotected) sex with. the others (oral only) i did not notify. if you want, you can use your public health dept. they can notify your partners anonymously. this gives them the information they need to make the next step and it is a win-win situation for people who do not want to disclose directly.

i am totally with ann on this one. i spent the first month or so wondering who i caught the virus from, wondering why i didnt use a condom, questioning if they lied, and in the end the only thing i knew was that i was still positive (and not pissed at the dude that shared it with me - after all, i hooked up with him in the first place for a number of reasons).  the unprotected anal partner was most likely the point of transmission. wasting time on figuring it out will only take you so far, please work on making yourself healthier and happier. also, if you can find someone to talk about this with you should. it will help out tremendously.

best of luck to you and welcome to our community. it's always a bittersweet welcome, but you are off to a great start.