Anonymous
On December 30th my boyfriend and I tried to have sex. The intercourse was protected, there was no oral/anal action at all. While he had his condom on he failed to achieve full erection, therefore, could not fully penetrate me (only for 10 sec or less). There was no ejaculation either. I did not know his HIV status though he claimed to be a virgin. 3 weeks later I have been experiencing cold like symptoms, low grade fever for a day, fatigue, joint pain and headaches. Are these signs of seroconversion? Should I get tested and what kind of test should I choose now? Antibody or Antigen?
Any input would be greatly appreciated.
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Anonymous
Thank you for contacting the AIDS Vancouver Helpline with your questions.

It sounds like you are concerned about transmission and would like some advice about your risk in this situation, as well as some testing information.

The simplest explanation of transmission is outlined in our Transmission Equation. It requires that the body fluid of one person has a direct entry point into the bloodstream of another:

HIV TRANSMISSION EQUATION


BODY FLUID
+
ACTIVITY
+
DIRECT ACCESS TO BLOODSTREAM
---------- -------- ----------------------------
• blood (including menstrual) • unprotected anal or vaginal intercourse • vagina
• semen • sharing needles • anus
• pre-cum • mother to child (in specific cases) • urethra in the penis
• rectal secretions • open cuts and sores (in theory)
• vaginal fluids • other mucosal membranes
• breast milk • points of needle injection

From the situation described, it sounds as though there was brief vaginal penetration and a condom was used. (It does not matter whether there was ejaculation because HIV can also be transferred through pre-cum.) So while it was likely that there was a body fluid, the condom significantly reduces the risk of exposure. We say that vaginal sex with a condom would be low risk for HIV. Condoms are also a great way to protect yourself from other STIs.

To help our clients assess their risk we have prepared a [Risk Assessment Chart](http://helpline.aidsvancouver.org/question/risk-assessment-chart) which lists some common activities and the risk involved. Many people also find this useful in planning their future encounters, because being aware of the risks and more comfortable in your choices can ensure a more fulfilling experience.

It's great that you're already thinking about testing. If you are continuing to engage in low risk activities, then regular HIV and STI testing will be fine. You do not need to take a test after every low risk encounter, every 3 - 6 months is perfectly acceptable.
I notice that this is your boyfriend, and if you are expecting to stay together, it might be sensible to have an open conversation about STIs. Many monogamous couples like to have testing together at the start of their relationship, so that if a condom breaks in the future, STIs are not the primary concern. [ Smart Sex Resource](http://smartsexresource.com/sex-talk/talk-about-sti-testing) offers some tips on how to start that conversation. If this is not an option for you, then it is even more important to continue your own routine testing.

There are many tests available, each slightly different. I think a good test for you to consider is the Rapid test, which is a 3rd Generation antibody test. As with all 3rd Generation tests, this can detect up to 95% of cases of new infection at 4-6 weeks. It's ideal for routine testing because you don't need a traditional blood draw, just a pin prick to the finger (or a cheek swab in the US). This test is particularly popular because it's inexpensive and your result is available in 20 minutes.

In relation to the symptoms you have been feeling, we cannot use these to diagnose HIV. HIV is a virus and so (for those who experience them) symptoms can mirror many other viruses. Equally, many people experience no symptoms at all. We always focus on the activity and risk factor to determine the likelihood of acquiring HIV, and the only way to be sure of our status is through testing. If you are feeling unwell, it is always best to partner with your healthcare provider to have your symptoms appropriately diagnosed and addressed.

Because you mention that your boyfriend said he was a virgin, I'm also including some links that he (and you) might find interesting.
[Smart Sex Resource](http://smartsexresource.com/sex-talk/pleasure)
[Avert - sex tips](http://www.avert.org/sex-stis/how-to-have-sex)

I hope this information gives you some reassurance regarding the risk of acquiring HIV in your encounters so far. Take care of yourself.

Best wishes

Wendy (Volunteer)

AIDS Vancouver Helpline/Online

Monday-Friday 9am-5pm (PST)

1 844 INFO-HIV (Toll free Canada & U.S.)

helpline@aidsvancouver.org

Private & Confidential**

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