Anxiety before HIV test

August 20, 2008 7:03 AM

How do I deal with HIV test window period anxiety? I had a risky encounter (unprotected sex) with a girl last week -- I trusted her when she said she'd been tested, which she told me on the way to the bedroom (had she not said anything I wouldn't have asked, and just used a condom). Before the encounter, I thought I knew her pretty well as she'd been a friend for a few months. Shortly afterwards she announces that she has a new boyfriend and cuts off all contact with me. I know I should get tested, but HIV tests aren't conclusive until after 3 months since it takes time for the antibodies to show up. I wouldn't be so worried if she'd still be talking to me. My question is ... how do I deal with the anxiety for the next three months?

I don't you to tell me I made a mistake, I know that, and it won't help. I know what I have to do, and that I just need to wait it out -- but in the meantime I've been driving myself crazy with nervousness.

For the next three months I just want to live my life normally and only worry about HIV if I actually test positive.

I also realize that it might be absurd of me to insinuate that this girl is going around deliberately infecting people with HIV ... It doesn't seem likely...

posted by anonymous to human relations (22 comments total)

You deal with the anxiety by using positive thinking: if the test results do return "positive" (ie, you have contracted HIV), it will be terrifying at first, but you have the inner resources to adjust, and then seek help.

At least you have a plan for dealing with the situation should it arise.

You also might want to analyze the overall risk of your encounter: you had one sexual encounter with this woman, and in order for you to even have a chance of contracting the virus, this woman would have to have already contracted the virus, and it's not like every woman out there has HIV.

Plus, aren't woman at higher risk for contracting HIV? It's transferred by bodily fluids, like semen. Shouldn't she be more worried about *you*?

You didn't use a condom. Are you worried that you got her pregnant? Shouldn't you be more worried about contracting a more run of the mill STD like herpes?

Your sexual activity is at a higher risk for unwanted pregnancy and contracting STDs than anything else, so think of that at night when the fear of contracting HIV is making you lose sleep.
posted by KokuRyu at 7:17 AM on August 20, 2008 [1 favorite]

The rational side of this is that you are very, very unlikely to have acquired HIV from one encounter. HIV is hard to pass from a woman to a man (much easier in the other direction, unfairly), and the rate of infection is pretty low nationally, and lower still in some demographics (eg white upperclass heterosexuals). You are far, far more likely to have picked up herpes, chlamydia, HPV, or another common STD than you were to have even been exposed to HIV.

Still, even though it's irrational, it's normal to worry. One thing that can help is to get two tests — get one at 30 days, which isn't going to be definitive but will at least be reassuring, and get another at 12 weeks.

There isn't some magic way to just instantly stop worrying. I've dealt with your exact situation by immersing myself so deeply into activities that I didn't have much time to worry, but the worries still wiggle their way to the surface. Still, sitting alone and brooding is exactly the wrong approach — this is a great time to get serious about exercise, or start a new thing you've been wanting to try.
posted by Forktine at 7:21 AM on August 20, 2008

Is there a reason to suspect you've been exposed? I mean it's always a possibility and getting tested is good, but maybe you weren't exposed. You've been friends for a short time, hooked up, and now she has a boyfriend. It could well all be on the up and up, perhaps she's really into the new guy and doesn't want to risk their relationship by introducing you as "this guy who I've been friends with for a few months, oh and we also hooked up". That will throw up a bunch of flags for many guys (which will probably come up in the future anyway).
posted by Science! at 7:29 AM on August 20, 2008

Use stats to make you feel better. According to wikipedia, *IF* she has HIV, your chances of getting it range from 5/10000 to 12.5/10000, depending on exactly what was inserted where. Worst case, that's just over 1/8th of a percent, and *only* if she has HIV.

Get yourself tested for all the other more run of the mill STDs as well, take a deep breath, and relax. The numbers are in your favour.
posted by cgg at 7:37 AM on August 20, 2008 [2 favorites]

One thing that can help is to get two tests — get one at 30 days, which isn't going to be definitive but will at least be reassuring, and get another at 12 weeks.

Err.. wrong. getting one at 30 days is pretty much pointless. It's only reassuring in the sense that you'll see the word 'negative'. It wouldn't be accurate in any sense of the word.

The best way to deal with the anxiety (in the future) is to just get tested every year, no matter what. I've been doing this since I was 14, and now no longer have any anxiety about results.

For now.. put it out of your mind. The bottom lines are: 1) F-to-M transmission through vaginal (I'm presuming it's only vaginal) intercourse has an incredibly low probability, and 2) assume for the moment you have contracted HIV. There is nothing whatsoever you can do to change that now. Worrying about things that you cannot change is a recipe for madness. And with the new therapies, it's not nearly as bad as it once was (and Christ, I remember saying the same thing to someone fifteen years ago. Plus ca change..)

What you need to be concerned about are other STI's: gonorrhea, chlamydia, herpes, syphilis, HPV. In about two weeks, maybe three, go to your local clinic and get a full STD screen (you need to cover incubation periods. And I have the feeling that syphilis may have a longer one--they'll be able to tell you). No sex between now and getting those results back, naturally. That means nothing. No sexual contact with another human being. Just in case.

And for the record... 'knowing someone pretty well' is a large, large factor in HIV transmission rates. Indeed, it's the reason cited by many gay men who bareback: "I only go bare with people I know". This isn't an attack, it's pointing out that until you're at the point where you have committed completely to each other, trusting someone with your life is a recipe (amongst high-risk populations, which unless the woman in question is African-American and in the lower levels of the income brackets, is not you) for disaster.
posted by dirtynumbangelboy at 7:38 AM on August 20, 2008

Errr... upon re-reading, I wasn't clear.

When I said 'assume for the moment', I really only meant for the time it takes you to read responses to this question. Assuming that you do, for a moment, will show you that it's pointless to worry about the result, as it's something you simply cannot change. That's all I meant.
posted by dirtynumbangelboy at 7:39 AM on August 20, 2008

Just relax. The odds of female to male transmission from a single sexual encounter (barring extremely high risk practices) are *vanishingly* small; the odds that she has HIV -- unless she's in some particular high risk group -- are almost equally small. You're having a classic anxiety reaction and fixating on the least likely possibility. Your odds of having acquired herpes or genital warts or something are a little better, but still -- despite all the fearmongering that will no doubt follow in this thread -- pretty damn small too. As in much smaller than your odds of being hit by lightning. Hell, the odds that you impregnated her -- even if she's on birth control -- are a good deal higher than the odds she passed on an HIV infection she likely does not have.

You are having a well known panic reaction. Doctors see it all the time and it's well described in the clinical literature and *far* more common than actual HIV infection. You feel guilty about having "unsafe" sex and hurt because she dumped you, and you're not thinking rationally about risk. You're panicking.

Also, the three month window is a very outside percentage. With modern tests, you're pretty sure if you're negative after a few weeks. Add all of it together and you are looking at a statistical risk that is *much* smaller than the one you take walking out the door of your house in the morning or driving your car to work. Much.

To be absolutely safe, refrain from having sex for a couple of months, and/or make sure you use a condom when you do. That makes your risk of passing anything on infinitesimally small, on top of the infinitesimally small risk you actually have acquired any infection to begin with.

(And dude, in the future, condoms are mandatory, right? One hopes you've learned that lesson, albeit the somewhat hard way.)
posted by fourcheesemac at 7:40 AM on August 20, 2008 [2 favorites]

Your likelihood, as a guy, of getting infected from one unprotected sexual encounter, are really low.

The first time I was tested, I was wicked nervous. But I kept my nerve by reminding myself that my behavior is incredibly low-risk (I'm a lesbian, and was getting tested because things were getting serious with woman I was seeing, and she wanted us both to get tested).

But you're going to get tested for other STDs, right? Because you don't want to pass herpes, chlamydia etc. on to your next partner. Though that would be less likely, because you're going to wear a condom next time, yeah?

CDC info

UCSF question/answer
posted by rtha at 7:42 AM on August 20, 2008

I know how you feel. I had an ex who admitted to lying about having been tested, months into our relationship (stupidly, I hadn't insisted on condoms). He'd had unprotected sex with men as well. So, I completely freaked out and went forthwith to get an HIV test. I was at much greater risk than you, having been on the "receiving end," as it were. I had to wait two weeks for the results; within that time I made sure to get tested for everything else under the sun. In that two weeks I concentrated on remaining strong and thinking that I would be able to handle anything that came my way. I got tested again at 3 and 6 months and by that time the terror had faded.

I know people who have lived with HIV for over a decade. A good friend has lived with it for literally 18 years. He's survived a triple bypass. He's perfectly functional and holds down a job. I don't mean to make it seem like no big deal - but it's not the HUGE SCARY MONSTER it used to be. (I've also seen friends die of AIDS, but this was back in the early 90s, when the treatment wasn't as advanced as it was now. Plus, they lived a really full and amazing life before they passed.)

I tested negative for everything. Chances are, you will too. Just be strong. You'll be OK no matter what.
posted by desjardins at 7:49 AM on August 20, 2008

Oh, and if you're still worried, call an AIDS hotline. They'll be able to calm you down. 1-800-CDC-INFO or 1-800-AIDS-NYC (the latter is run by a gay men's organization but will absolutely definitely help straight people).

Here's some more resources for people in certain locations or demographic groups.
posted by desjardins at 7:54 AM on August 20, 2008

There are tests for HIV that have shorter window periods. NAT (nucleic acid test), HIV PCR DNA, and "eclipse period" are search terms for Google. I know next to nothing about this so you should talk to someone who knows what they're talking about. I don't know if these tests are regarded as reliable tests for HIV in individuals.
posted by rdr at 8:13 AM on August 20, 2008

rr.. wrong. getting one at 30 days is pretty much pointless. It's only reassuring in the sense that you'll see the word 'negative'. It wouldn't be accurate in any sense of the word.

I based what I wrote on sources like this one:

Currently used antibody tests are more sensitive than those used in the past. Most people will develop detectable antibodies by 30 days after infection with HIV. Nearly everyone who is infected with HIV (99%) will have antibodies detected by 3 months after infection. Rarely do people take longer than 3 months, but it can happen.

This page has an interesting graphic of how test results can fade into positive over 30 days, illustrating that pushing your testing too early is not helpful.

This company (which is selling home HIV testing kits) claims that 95% of people will have seroconverted by six weeks after exposure.

So I'm still comfortable suggesting to get tested at 4-6 weeks and again at three months, while acknowledging front and center that the early test is not conclusive.
posted by Forktine at 8:37 AM on August 20, 2008

Shortly afterwards she announces that she has a new boyfriend and cuts off all contact with me.

I'd suggest that this is the heart of your anxiety. She seems to not be what was offered and that makes you worry about other things.

Focus on your feelings about her cutting off contact to see if that might be the real problem.
posted by Ironmouth at 9:47 AM on August 20, 2008

I wouldn't be so worried if she'd still be talking to me.

I don't get it. Why are you worried at all? Yes, you should have used a condom. No, she probably isn't some kind of black widow running around infecting people. She did say she'd been tested. I honestly don't see where you are getting this big worry from? Something about her getting a new boyfriend and not wanting to see you anymore seems to have tripped your radar, and I can't figure out why.

Just use a friggin condom next time.
posted by scarabic at 9:59 AM on August 20, 2008

First off, the odds for you being infected from vaginal sex as a male are extremely low, as has been well noted above, furthermore if you have been circumcised your risk is further diminished, so while you still need to get tested in a few months, you have no good reason to freak out yet.

Secondly, never ever take someone's word for it, it is stupid, and irresponsible. Using a condom is like eating candy with the wrapper on, but as a male it is your responsibility to make sure you and your partner are protected.
posted by BobbyDigital at 10:04 AM on August 20, 2008

I say, there is nothing wrong with feeling discomfort. It is how we learn to not make the same mistakes over and over again. Say it to yourself. "I feel uncomfortable." "That's normal and okay." "It will help me not make the same mistake again."
posted by vermontlife at 10:20 AM on August 20, 2008

you might have caught something -- the clap, chlamydia, herpes, etc. -- not AIDS.

calm down and next time just use a condom anyway since you're so anxious
posted by matteo at 10:21 AM on August 20, 2008

Man, I feel you, I really do. I did stuff WAY worse than you did and really scared myself horribly. I remember my first HIV test like it was yesterday, it's burned in my brain, I even remember most of the questions she asked. I knew I messed up and I knew I'd have to wait. But, the thing is, it's out of your hands. There is nothing you can do at this point about what has happened in the past. Learn from it and move on. For me, that lack of control is what saved me from worry, there isn't a thing I could do to undo what I did. The best you can do now is to take care of yourself and cope with your situation if something does come of it.

You'll get through it no matter what. Good Luck.
posted by Craig at 10:31 AM on August 20, 2008

Relax! She's not talking to you because you were a crappy lay and because she now has a boyfriend anyway - not because she knows/thinks that she may have given you HIV. Silly ;)

Oh and "I've been tested" is by it's very nature null and voided the moment you fuck somebody. Either you care or you don't. "At my last checkpoint I was all clear" ...Well you have fucked a bunch of people since then, but hey good for you there buddy.

But yeah, it is real scary huh... I like to always plan for the absolute worst, but that might not be your scene...? Nevermind, you'll be right.
posted by mu~ha~ha~ha~har at 11:28 AM on August 20, 2008

Oh and "I've been tested" is by it's very nature null and voided the moment you fuck somebody. [...] "At my last checkpoint I was all clear"

I think it's supposed to act as a "web of trust" - that is, I am a member of group A if I was negative for HIV when last tested, and since then I have only fucked members of group A.

Of course, the problem is obvious: people can simply lie about being members of group A.

The solution is obvious too: wear a condom.
posted by Mike1024 at 12:08 PM on August 20, 2008

It sounds like you're upset about how things went after this encounter, and you're kicking yourself for having unsafe sex, so you're projecting all of your feelings about all of this onto the small possibility that you might have HIV. Sometimes we regret things and feel that we're going to 'get what we deserve' because of it, but HIV just doesn't work that way. What happened isn't more risky just because you feel dumb about it now.

I'm not sure if that helps. TheBody.com (an HIV website) has a section in their forums for the 'worried well', and you can find similar stories there: http://www.thebody.com/Forums/AIDS/Labs/Archive/Messages/index.html
posted by heatherann at 2:02 PM on August 20, 2008

I went through something in the same ballpark as this. In my case, this fear derived in a big way from my need to demonize the dude -- who had angered me with his bad and dubiously legal (but pretty commonplace) behavior. I didn't want to have a disease, but I did want to build the guy up as a total piece of shit, and who is a bigger piece of shit than someone who carelessly spreads serious sexually transmitted illnesses?

I have since noticed others doing the same thing I did -- ascribing all sorts of catastrophically bad consequences to getting sexually involved with someone who treated them badly, and thus embarrassed or hurt them.

Also, what fourcheesemac said.
posted by Coatlicue at 2:22 PM on August 20, 2008