[Question #1094] Another Exposure...

49 months ago
I have HIV-related questions about two recent exposures. First, I asked a question about a month ago related to performing oral sex on a female sex worker of unknown HIV status. Dr. Hook assured me that the HIV risk was only about 1 in 100,000. I was just tested this week, exactly 30 days after exposure. It was a 3rd generation INSTI test (the result came back in 60 seconds). I tested negative. I had never heard of the INSTI test. My first question is: how accurate are these INSTI tests at 30 days? How confident can I be in this result?

Second, and I know I need to act wiser... but I had another encounter 9 days ago. I received unprotected oral sex and engaged in deep kissing with a different female sex worker of unknown HIV status. I had a canker sore at the time. In terms of percentage risk, how risky are these two acts (receiving oral and deep kissing), particularly if she may have had a cut or sore in her mouth? Do you recommend testing? Thank you very much for this service and for your patience with me - confused
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
The INSTI test is an antibody-only rapid HIV test. Like all blood antibody tests, it detects at least 95% of all new HIV infections by 4 weeks, but requires 6-8 weeks for conclusive results. However, as Dr. Hook informed you in your previous recent threads, there has never been a proved case of HIV transmission by cunnlingus, i.e. vaginal to oral exposure (or oral to vaginal either). You're not going to be the first case. You did not need HIV testing after such an exposure.

There also has never been a proved case of HIV transmission by oral to penile exposure, or by kissing. This also was not a risky exposures, regardless of cuts in the mouth etc. Like your other exposure, this one does not warrant testing for HIV.

Thanks for the thanks. But we don't have as much patience as you might think. Repeated anxiety driven questions about low risk exposures are not permitted on this forum. This will have to be your last question along these lines. Any further ones will be deleted without reply, and without refund of the posting fee.  If and when you start having unprotected intercourse (vaginal or anal) with new, unknown, or otherwise high risk partners, you should be worried about HIV. But not until then.

HHH, MD
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