[Question #10327] Hiv Test

23 months ago

So 4 years ago I had sex with an escort where the condom slipped a little but stayed on head. Few weeks later I got sick for like 2 days. 3 months later I took oraquik negative, took another at 6 months negative, took another at 9 months negative. Now I’m in a monogamous relationship with children and was recently seen for a routine checkup. Well he didn’t say he was going to give me a HIV test and I take a multivitamin with .03mg of biotin. That 4th gen test came back negative. I went on an took 3 more oraquik tests in the last 2 months all negative. Should I still be worried? And would that small amount of biotin in my supplements effect a 4th gen blood test 4 years post exposure?

H. Hunter Handsfield, MD

23 months ago

Welcome to the forum. Thanks for your question.

Probably there was little or no risk for your escort contact 4 years ago. Escorts (expensive female sex workers by appointment) have very low rates of HIV, and condom protection is complete against HIV when the penis head and meatus (urethral opening) are covered. The oral fluids test (Oraquick) misses a small percentage of HIV infections, but is at least 95% reliable; considering the exposure risk plus those tests results, it is completely certain you didn't catch HIV. In addition, after 4 years you probably would have been ill by this time if you had HIV; assuming you are outwardly healthy, it makes HIV even less likely.

In addition, you have now had a negative HIV AgAb (i.e. "4th generation") test, which is conclusive proof against HIV. The biotin made no difference. The biotin business has been discussed frequently on the forum; you can find info by using the search link for "biotin". The bottom line is that its supposed effect on HIV testing is mostly an urban myth. There definitely is no effect at the doses normally used in dietary and conditioning supplements; you would have to take far larger doses to have any effect. And if you remain nervous about it, all you have to do is hold off on taking the supplement for 2-3 days before testing.

So it is entirely certain you do not have HIV. If you remain nervous about it, feel free to have another AgAb after skipping your supplement for a couple of days. It really isn't necessary, but if you go that route, you can be sure the result will negative.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

---
---

23 months ago

So let’s just say hypothetically, I’ve developed AIDS would that negative 4th gen AGAB test be conclusive still

H. Hunter Handsfield, MD

23 months ago

Yes. Once positive, HIV antibody exists in the blood and is detected by all standard tests for the life of the infected person. Often but not always, p24 antigen also is present in the blood, depending on the viral replication rate, anti-HIV drugs, etc; and this is more likely in people with overt AIDS. Therefore the AgAb tests always are positive in people with AIDS.---

23 months ago

Thanks for answer doc, let me ask you this. I’ve heard advanced aids patients could test negative on HIV test for antibodies. Is that true? And what do they test positive for the P24 antigen?

H. Hunter Handsfield, MD

23 months ago

Answered in my last reply! The answer is no: it is definitely not true that people with AIDS test negative for HIV antibodies. It might have been true that with the first/earliest HIV antibody tests, i.e. 30-40 years ago, occasionally did not detect antibody in a few patients with advanced AIDS. However, that definitely has never been the case with the current, standard antibody tests. Re p24 antigen usually yes, sometimes no; re-read my last reply.

When searching online for such answers, I would suggest you limit your search to professionally run or at least professionally moderated sites; and for sure avoid those by and for people at risk or anxious about the problem you are researching (like Reddit). Anybody can write anything they want on the web!

That completes the two follow-up exchanges included with each initial question and so ends this thread. I hope the discussion has been helpful, in particular that you now have 100% confidence you do not have HIV from the sexual exposure 4 years ago that apparently is still on your mind. Best wishes and stay safe.

---