[Question #11490] HIV Testing Follow Up
14 months ago
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Hi,
I just wanted to follow up on my previous question. As a quick recap, on 4/30/24 I (male) received an unprotected blowjob from a female of unknown status. I fingered the same individual in the vagina as well. Exactly 26 days after the incident I came down with a sore throat, body aches, fatigue and some rash like dots on my arms.
I very much appreciate Dr. Hook’s advice to get a 4th generation test for peace of mind. I’m still attempting to schedule that (currently having some issues) but I decided to take a Oraquick test exactly 45 days after the incident. The result was negative.
Here is the issue. I started PrEP (Truvada) 6 days after the exposure (I incorrectly stated 8 days in my previous post) and I’ve been taking it every day since. I’ve read that PrEP can cause a false result for an Oraquick exam so I just wanted to see if this exam actually provided any helpful information or if it was just a waste of time? Thank you.
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H. Hunter Handsfield, MD
14 months ago
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Welcome back, but I'm sorry you found it necessary. I have reviewed your recent discussion with Dr. Hook and agree with all he said.
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You've got problems, all of your own making. I don't mean anything serious or dangerous: you were at zero risk for HIV and there is no chance you have it. There has never been a proved case of HIV transmitted oral to penis or by fingering, and you're not going to be the first in the world. You would not have been infected even without PEP or PrEP. By "problems" I mean that because of your inappropriately elevated fears, leading you to take unnecessary anti-HIV treatment, you have eliminated any chance of a reliably negative test result. Your negative Oraquick result is perhaps reassuring, but cannot be considered conclusive. This will continue as long as you continue to take your PrEP drugs. But the fact is that in the off chance that somehow you have HIV, or if you acquire it in the near future despite PrEP, a positive test result might be delayed until you are off treatment.
Don't get me wrong, i.e. do not try to read between these lines. I am NOT implying I believe there is even a remote chance you have HIV. I do not. But if our expert professional advice isn't sufficient to convince you -- i.e. if you need a negative test result in order to become unworried -- you'll need to stop PrEP and get tested a few weeks later. In any case, if your sexual lifestyle remains as described here -- female partners and only oral sex exposures -- you really shouldn't be on PrEP anyway. It's a prevention strategy advised only for people at truly significant risk for HIV.
Let me know if anything isn't clear.
HHH, MD
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