Unprotected vaginal sex in Thailand

[allstarrr]

Hi all,

On the 4th of January (almost 7 weeks from today), I had unprotected vaginal sex with a girl of unknown status in Bangkok while I was on holiday. I met the girl on an online dating site (skout.com), and the influence of alcohol, and her rather flirtatious led to the encounter. I had sex with her unprotected twice, about one day apart. The first was a very brief encounter. I was wearing a condom for nearly the entire time, but after she suggested I take it off, (she said she wanted to know what it felt like without one) I stupidly decided to agree. On the second encounter, it was full on unprotected sex.

I suppose at the time I Wasn't thinking of HIV at all. I was only concerned with getting her pregnant and we took the right steps to get her on emergency birth control.

I started to get really worried two days after the encounter, when I asked her if she had any std's including hiv. She seemed to be really annoyed at the time, because the birth control pills were making her sick. So she told me, 'yes I have hiv'. She told me, 'I'm sorry, I cant speak to you anymore', and she said I should have used a condom. I then asked her why she didn't tell me earlier and she replied that she didn't care to tell me and I should have used a condom. I asked her how she got infected and she said she didn't know, but I should be find because her boyfriend didn't get it off her.

At this stage I totally freaked out and went to the nearest hospital and explained my story. They immediately gave me a blood test confirming that I was hiv negative and then gave me a prescription of pep pills which I started to take. However the first unprotected encounter was over 72 hrs ago (something like 90 hrs ago), so although I started to take them, I stopped after about 10 days as they were making me sick and I doubted they would do anything.

Anyway, at the hospital the girl then messaged me saying she didn't in fact have hiv and she said she did because she wanted me to feel the pain she was feeling through me forcing her to be on emergency birth control. She also blamed me for not reminding her to take the pills (i didnt actually have a phone number to call her), and was also upset that I would be leaving soon, so I deserved to be scared.

Our conversations went on and off about it, but in summary, due to her unstable emotions and the fact that I don't know her at all, I cannot say for sure whether or not she had HIV, but I consider the encounter to be very high risk.

As soon as I got back to Australia I got combined p24 antigen / antibody test at 2.5 weeks after the first exposure. This came back negative. I tested again at exactly 5 weeks after exposure (same test). This also came back negative. The 5 weeks test has really calmed me down a bit, although I'm still so worried.

I can't think of any noticeable symptoms, except for a fever and night sweats occuring a day after the first exposure. However due to it being so soon after the exposure, I don't account this to be from ARS. That fever went away about 4 days later, and since then, I believe I haven't had any noticeable symptoms.

Its now 7 weeks after exposure. I'm thinking of testing again now, but I might wait until the full 13 weeks and test one more time. If its negative it will be a big relief.

Based on my story, after testing negative for the combined p24 / antibody test (I believe this is a 4th generation test), do you think I should be worried about being infected? It's hard to reduce the anxiety I'm still feeling, which is impacting many areas of my life.

Thanks for listening.

[Andy Velez]

Let's keep this simple. Whatever the woman in Bangkok told you is all irrelevant. The main point is that you had unprotected intercourse which means you need to get tested.

As the insertive partner you are at lower risk than the receptive partner. And we're speaking of only a single incident which lowers the potential risk. It is significantly harder to transmit HIV from female to male than the other way round.

Nothing you are reporting symptomatically is in anyway HIV specific. But then neither the presence nor the absence of symptoms is ever the way to know about HIV status when there has been a risk. Only an HIV specific test at the right time can give you that answer.
 
If you get tested now and get a negative result it indicates a strong likelihood you will continue to test negative. The average time to seroconversion is 22 days. All but a very few who are going to seroconvert will have done so by 6 weeks after a risky incident.

You do need to test at 3 months for a conclusively negative result.

[allstarrr]

Hi Andy, thank you for your reply.
I suppose my question is how likely it is I would be infected after testing negative on a 4th generation combined test after 5 weeks from exposure. II've read that the testing window for these combined tests are shorter than the others?

Also what's got me really worried is that I've read Thailand have a different subtype or strand of hiv (subtype e) which is significantly more contagious in heterosexual sex than strands in western countries. I didn't link the article, but one article was putting the odds of transmission from female to male in heterosexual vaginal sex at 1 in 13!

Now nothing can take away my stupidity for having sex unprotected with an unknownpartner but iI guess now I'm really trying to reduce my anxiety. I can't test at least for the next week due to travelling due to my work. However, based on my negative 5 week result and lack of symptoms, are the odds in my favour?

Thanks for your reply.

[Ann]

all,

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

A six week negative must be confirmed at the three month point, but is highly unlikely to change. Your five week negative isn't likely to change either, but you do need to test out to three months to be certain.

Ann