All I Want for Christmas is to be Negative
December 24, 2013 9:03 AM   Subscribe

I had an encounter with another man several weeks ago. I would normally wait for the end of the three month window to check my status, but I have recently gotten sick, which (given the vague symptoms listed for acute retroviral syndrome) has me spooked. I have made arrangements to get tested later in the week by DNA PCR (18 days after exposure, with the understanding that I will still get tested at 3 months), which should give me a decent degree of confidence whether I have HIV and whether these symptoms are ARS. However, I won't get these results until well into next week. In the meantime, it's the holidays, and I need to keep up my spirits and not cause chaos with 'what ifs.' Not that this is a conversation I'd ever feel comfortable having with my family. I'm feeling really isolated and am spending too much time inhabiting my own head. I could really use some external feedback about how high my risk is and whether I have any right to be this worried. Handwringing details inside.

- I had an encounter with a guy where I was on the bottom without protection.

- He pulled out before climaxing.

- We spoke about our status before/after the encounter, and I have seen his negative test results dated less than a week before the encounter. We didn't talk at any length about sexual history, so there remains the possibility he was sexually active/exposed within the test window.

- He said he tests every three months.

- [YANMD] I recently came down with a elevated temperature (max 99.6 degrees), sore throat (mild discomfort), running nose, slightly enlarged lymph nodes, sore muscles, and more recently my tongue has turned slightly white and tingling on the surface.

- [YANMD] I have not taken any medicine for these symptoms. So far these symptoms have persisted for a little under a week, and several seem to be subsiding (normal temperature today).

- [YANMD] Many of these symptoms are the same as ARS, but none approach what online resources commonly describe as "the worst flu ever."
posted by anonymous to Health & Fitness (16 answers total) 1 user marked this as a favorite
It sounds like you have a bad cold.
posted by mskyle at 9:05 AM on December 24, 2013 [15 favorites]

I know where you are: I have had the elevated temperature (max 99.6 degrees), sore throat (mild discomfort), running nose, slightly enlarged lymph nodes, sore muscles and whitish tongue before, and I have FREAKED, thinking I had HIV.

Spoiler alert: I did not. These symptoms are indeed common with ARS, but they also present with a variety of other minor illnesses, and the odds are really in your favor here.

It sounds statistically very unlikely that he had HIV. Even if he did, the chances of you catching HIV from this encounter are extremely low. Per the CDC, the risk of acquiring HIV from receptive anal intercourse is approximately 50 per 10,000 incidents (far less than 1%).

I get that you are worried. But try not to be! IANAD but I think you are very much in the clear. Try to enjoy the holidays! :)
posted by schroedingersgirl at 9:16 AM on December 24, 2013 [2 favorites]

Is there a chance you could have gotten HIV from this encounter? Sure. Is it far more likely given what you've said here and the fact that it's cold and flu season and seemingly everyone has a cold right now that you just have a cold or the flu? Yes.

I don't mean to discount that there was some risk involved here, but basically what schroedingersgirl said. (I typed out a whole similar answer.)
posted by bedhead at 9:18 AM on December 24, 2013 [4 favorites]

Based on what you've said, IANAD but IAAMSM, and it seems like your risk factors are very low.

Not ejaculating inside you is a good thing. Yes, HIV is present in precum. Not all guys precum much or at all; does he?

Seeing his neg test from a week before your encounter is all well and good. To properly evaluate your risk factors, as you know, you need to talk about his sexual history before (and after; many HIV infections are passed on before the infected party has even been diagnosed, if memory serves).

But your risk seems realllllllllllllllly low. That being said, I've been in the same boat (almost; I top) so I know exactly how you're feeling. MeMail me if you want some more 1-on-1 support over the holidays, I won't tell anyone who you are obvs.
posted by feckless fecal fear mongering at 10:58 AM on December 24, 2013 [3 favorites]

Try a home HIV test?
posted by Jason and Laszlo at 11:18 AM on December 24, 2013 [1 favorite]

I think the fact that you're getting better is a good sign that it was something less nefarious.

Please try not to worry yourself into feeling worse again.
posted by elizeh at 11:31 AM on December 24, 2013

Maybe I am remembering incorrectly, but from a purely science perspective - it seems HIGHLY unlikely that HIV would have progressed to compromise your immune system in such a short period of time. Great job getting on testing and try to use protection next time. I doubt this cold has any relation to your incident. Sorry it is causing you so much stress over your holiday.
posted by Kalmya at 11:33 AM on December 24, 2013

I think the fact that you're getting better is a good sign that it was something less nefarious.

Depends. I have a few friends who are poz, and their seroconversion reactions ran the gamut from being hospitalized for what he thought was flu to absolutely nothing out of the ordinary. (Not trying to add to your fears, OP, just trying to be accurate). Reactions really do range, and the fact that it's clearing up doesn't mean much at all.

Maybe I am remembering incorrectly, but from a purely science perspective - it seems HIGHLY unlikely that HIV would have progressed to compromise your immune system in such a short period of time.

Common symptoms of HIV infection--seroconversion--include unexplained, flu-like symptoms. Antibodies are detectable at 90 days post-exposure, and reactions can happen essentially anytime from the moment of initial infection.
posted by feckless fecal fear mongering at 12:08 PM on December 24, 2013 [2 favorites]

In terms of not letting your worry ruin the holidays for you... my dad once had a scary medical procedure looming, and when I asked him if he was worried he told me that denial is very underrated.

Distract yourself. Do stuff. Watch stuff. Listen to stuff. Throw yourself into the holidays, double down on the holiday cheer. Every time you start to worry, do something fun and distracting instead.
posted by Ursula Hitler at 12:11 PM on December 24, 2013 [1 favorite]

Chances of getting HIV though one single hookup are pretty low. (This source says 1.4% - that's assuming the insertive partner actually has HIV.) Chances that this guy has HIV are relatively low; most men who have sex with men don't have HIV (the highest estimates I've seen for an urban population are around 20%), and this man gets tested every three months and a recent test says he doesn't have it. Together, those things mean that the chances you contracted HIV from this person are pretty darn low; you could estimate them [0.2 * 0.014 = 0.0028] to be 0.28%. That's less than a third of a percent!

However, it IS flu season. Chances that you have the flu or something like it are pretty high, because unless you live in a bubble you've been around someone who's incubating it, and you can get the flu from being around someone who has it without even touching them.
posted by needs more cowbell at 2:11 PM on December 24, 2013

And I should add, 0.28% is a generous estimate - if this person has a recent negative HIV test and discussed HIV status with you before you had sex, I would imagine the probability that he's HIV+ is less than the estimated 20% I used above. So we're talking a very, very tiny chance.
posted by needs more cowbell at 2:19 PM on December 24, 2013

I really think the best answer anyone's going to be able to give you about your level of risk is "near zero, but not zero."
posted by treehorn+bunny at 8:14 PM on December 24, 2013

But definitely a hell of a lot closer to zero than to a hundred.
posted by feckless fecal fear mongering at 5:09 AM on December 25, 2013

It's a relatively low risk. It's higher than if you had been topping, but lower than if he hadn't pulled out. It's also lower because his recent test results were negative.

Even if you were 100% sure that he were HIV-positive and he weren't on meds and you didn't use protection and he came inside you, there still wouldn't be a 100% chance of transmission.

And whether you feel like you made the wrong decision or not has no impact on the odds of transmission. So if part of you is feeling like you must have become infected because "how could you be so stupid" or something like that, that is really common and you should take note of it but you should also know that it is anxiety talking and not biological facts. Okay?

Now about that anxiety, sure you're anxious. I would be too. I think what's important right now is to sit down and have a little chat with your brain about the anxiety. Brain is allowed to be anxious right now, and you can reassure brain that you hear that anxiety and it is scary and because of that you're doing all the right things: You got tested. You're not signing brain up for a Scary Conversation With The Family. You're not going to know for a week (unless you can get a rapid test, see below), so in the meantime give your brain something else to do. Distract it. Learn origami or something. Seriously. It'll help you spend the time without spinning your wheels in anxiety. Be gentle with yourself.

If you can you get a rapid HIV test, that could be helpful. If you're negative, they'll know in 5-10 minutes. If the rapid test is positive, they'll send it on for a more rigorous test which comes back in a week (like the one you've already done). The rapid HIV test is designed to have false positives (hence the extra testing) but not false negatives. Of course, there are still the usual caveats about the window period.

It may also help to know that the 3-month timeline is a cautious guideline:
"Across Canada, all labs use newer, more sensitive antibody tests (this includes rapid (point-of-care) HIV tests). Research shows us that with these new tests, as many as 95% of people who test positive will do so within 34 days of exposure to HIV. However, for the remaining 5%, the window period for these HIV antibody tests is generally accepted to be three months so as to ensure people who take longer to develop antibodies are not overlooked. This means that if someone tests negative for HIV antibodies during the window period, they should be re-tested three months after possible exposure, to fully rule out HIV infection." (from CATIE)
What does that mean for you? It means that while it's possible that your partner could have gotten infected sometime in the entire 3 months before testing negative, it's far more likely that the window of opportunity is much shorter than that — 5 weeks or less. And if he usually tops and usually pulls out, that lowers his risk too. Not as low as a condom would, but lower than otherwise.

If you are negative, you will be okay. If you are positive, you will be okay.

Hang in there. You will be okay.
posted by sadmadglad at 1:00 PM on December 25, 2013

If you can you get a rapid HIV test

Rapid HIV tests are antibody tests, not the PCR tests that look directly for presence of the virus. As such, they are useless within the window period before seroconversion.
posted by feckless fecal fear mongering at 1:14 PM on December 25, 2013

It's alright. Given what you describe, it seems extremely likely that you do not have HIV and do have a bad cold. Do what you can to calm your anxiety, until this is confirmed by your test.
posted by Drexen at 6:50 AM on December 27, 2013

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