[Question #10518] Hiv 4th Gen

22 months ago

I had an exposure back August 2nd. It was with trans woman, mutual oral no ejac in mouth, under 2 minute anal unprotected "me as top", and bottom with condom for like 10 seconds. Don't think it ever really went in. Didn't continue with it. I took an std panel that came back negative for everything. This included the "HIV 1/2 AG/AB 4th Gen" test. This was on the 19th of August. I then took multiple ora quicks in the leading weeks, all negative. I then took another std panel with the same 4th gen hiv test at 50 days "spetember 21st". It was negative for everything as well. Anxiety has been killing me over accuracy. I took a 9 and 10 week ora quick as well, both negative. I have a sore throat now. Is there any reason to retest? The 10 week test was a couple days after sore throat started. The panel test included hsv1 and 2, syphillis, chlamydia, gonorrhea, and the 4th gen hiv test.

H. Hunter Handsfield, MD

22 months ago

Welcome to the forum. Thank you for your question.

Given the minimal if any anal penetration, both ways, this was a very low risk exposure for HIV and all STDs, even if your partner was infected at the time. Oral sex also is inherently low risk. You have been seriously over tested. The first AgAb (4th generation) HIV blood test, done only 17 days after exposure, was too soon -- but even that would have detected 80-90% of HIV infections. All the rest of all your negative test results were reliable at the times they were done. You have none of the infections for which you were tested. Your sore throat was not due to HIV or any other STD.

So all is well. Don't have any more tests!

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

HHH, MD

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22 months ago

The ora quicks were just the rapids saliva based ones. So I know they were earlier than the 12 weeks recommend window period. But at the end of the day, my 17 and 50 day 4th gen hiv negative test shows that I'm negative, correct? Good to move on with life? I've seen where you've said a negative test after 6 weeks basically trumps symptoms and even high risk exposure. Thanks for all of your help Dr. Also, they sent a picture where they did an ora quick 12 days after and it was neg.

H. Hunter Handsfield, MD

22 months ago

Yes, you correctly understand. I didn't say so, but I discounted your Oraquick test results, but your negative AgAb (4th gen) result at 50 days is conclusive. We have often commented on the forum that the oral fluids test misses up to 5% of HIV infections, even 3 months or more after exposure. They're fine for someone at relatively low risk, but not in truly high risk situations or when looking for reassurance following a particular exposure. However, you also correctly understand that a negative test trumps symptoms: even with the OF test, negative results confirm that any symptoms are not due to HIV. ---
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22 months ago

Thank you Dr. Handsfield with your quick and much appreciated response. I'm glad my response came from you. I did alot of searching online and can find some comfort in your opinion. Thank you again.

H. Hunter Handsfield, MD

22 months ago

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.---