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HomeAnswersHIV/AIDS specialistsexually transmitted diseasesI had unprotected sex. Am I at STD risk?

Can an unprotected sexual encounter increase the risk of a sexually transmitted disease?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At February 17, 2024
Reviewed AtFebruary 21, 2024

Patient's Query

Hi doctor,

I am circumcised and have no sexually transmitted disease. I had an unprotected penile to vaginal exposure. It took less than ten minutes; I had used a condom but it broke within the last two minutes. I did not ejaculate, but took a shower and urinated after the incident. She said she was fine when I asked about her health status and said not to worry. On the same day, after 16 hours, I started my post-exposure prophylaxis using Tenofovir, Lamivudine, and Dolutegravir (PEP TLD) and completed 28 days with perfect adherence and no further exposure. I did a fourth-generation HIV combo test, which came back negative three days post-exposure. My all other STDs are also negative. Today is 25 days post PEP and I do not have any symptoms, feeling fine except for severe anxiety.

What is your opinion about my risk and my test after 31 days post-exposure and three days post-PEP (fourth-generation combo test from the vein)? Also, I consulted some doctors who said there is no need to test again because the fourth generation is accurate and has not been affected by PEP. I know there is confusing information about testing after PEP, but what is your opinion from clinical practice? Are there any cases like mine, that tested negative (4th generation) after PEP completion and then turned positive later?

Thank you.

Hi,

I appreciate you signing up on icliniq.com.

You now have exclusive access to expert medical opinion.

The chances of transmission of HIV (human immunodeficiency virus) by single unprotected intercourse are low. Condom breaks can be considered almost as unprotected intercourse. In your scenario, the risk is even lesser and is almost nil. It is very good that the HIV fourth generation test is negative after the completion of PEP and three days later too. This is considered almost conclusive. The chances of HIV tests coming positive later are almost nil. But it would be better if you would please go for an HIV antibody test after 90 days post-exposure to be relieved of anxiety totally and have conclusive results.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Is there clear evidence that PEP affects fourth-generation tests? Is there any patient from your experience who tested negative after PEP using the fourth generation, and then, turned positive in the next tests? I want the answer from clinical practice because guidelines have more caution! Many doctors whom I consulted said PEP does not affect the fourth generation, while others said it may, according to guidelines. Please guide.

Thank you.

Hi,

Once more, thank you for allowing us to be of service to you.

We value the high level of confidence you have in us!

The test results after PEP (post-exposure prophylaxis) also depend on a few factors risk exposure, PEP initiation dates, and adherence to PEP. PEP is very effective if initiated and taken regularly. Then, the test results will be negative too. I have not seen a fourth-generation test coming positive later (after negative test results post PEP), with given exposure or PEP dates or test dates. Still, it would be better to go for an HIV (human immunodeficiency virus) antibody test 90 days after exposure to be relieved of anxiety totally and to get conclusive results.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra

Dermatology

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