[Question #12549] HIV test

7 months ago

Hi Dr,

28 Oct - kissing, mutual masturbation. Her hands had vaginal fluids fluids when touching my penis

11 Nov - kissing, mutual masturbation

Her hands had vaginal fluids fluids when touching my penis

21 Nov - kissing, unprotected insertive oral sex

All 3 occasions were with same CSW

21 Nov - finger prick 4th gen hiv test - negative (CSW did the test)

09 dec - full urine analysis including chlamydia and gon, all negative (I did the test)

26 Dec - C and G urine test again. Vdrl test from vein for Syphillis. All negative (I did the test)

03 Jan (Day 43) - CSW did finger prick 4th gen alere HIV test and results were negative. She also did syphilis Vdrl test from vein and it was negative.

Also did a genexpert HIV-1 RNA Qualitative test and it was negative.

Blood test for HSV 1 and 2 and tested positive for HSV 2. All test perform on 03 Jan was done on CSW.

Do I need to do any other tests doctor?

Edward W. Hook M.D.

7 months ago

Welcome back to the Forum. When we last interacted 2 moths ago I indicated that the activities you took part in on 24 Oct were no risk. That has not changed. Those answers still apply to your 11 Nov encounter. Your 21 Nov encounter was also very, very low risk and no-risk for HIV. Since the tests performed on your CSE partner prove that she was not infected and could not have infected you. That she has a positive blood test for HSV-2 is irrelevant because there is virtually no risk for herpes from receipt of oral sex and because you have apparently not experienced a herpes outbreak which, if it were going to occur, would have within 10 days of your exposure. I see no reason for concern and no need for further testing. EWH---

7 months ago

Thanks for the reply doctor. I have a 3 more questions.

1. The finger prick 4th gen test done by the CSE on 03 Jan (day 43) - is this considered conclusive for all HIV purposes? Is the finger prick test accurate at day 43? If I recall correctly, in one of your post you said the finger prick test performs just as well as the lab test.

She also did a HIV-1 RNA Qualitative test and it was negative but this did not include HIV-2.

As in I would not have to do any HIV tests as this was my only exposure ?

2. VDRL (syph) lab test, Chlamydia and gonorrhoea test done on day 35 for myself. Can I say these negative results are conclusive ?

3. I have read that HSV-2 is not transmitted by oral sex. I did not have any lesions except for some slight irritation when urinating that comes and goes. Do you think I need to perform a HSV 2 test for myself

Thank you very much doctor.

Edward W. Hook M.D.

7 months ago

Your additional questions are repetitive as was much of your initial question. Straight to my replies:

1. Believe your finger prick test. The results are accurate and conclusive both for HIV-1 and HIV-2. As you point out, you really did not even need testing due to the no risk nature of your encounters. .

2. Yes, your results are conclusive

3. No, I recommend against testing for HSV-2. This test gives many falsely positive results.

I would not worry about the "slight irritation" you describe.

You have one follow-up remaining. EWH

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7 months ago

Thanks for the reply doctor. One last thing. Just abit edgy on the 4th gen testing. You mentioned that 6 weeks is conclusive for all 4th gen testing.

Would day 43, finger prick testing fall under this category? Is the performance of the finger prick testing just as good as the lab tests at day 43?

Thank you for all the replies doctor.

7 months ago

Also to add on, all the hiv tests were performed on the CSW and not me.

4th gen finger prick test on day 43

HIV - 1 RNA test on day 43

Edward W. Hook M.D.

7 months ago

Final response. Whether performed n a finger stick specimen or venous blood, 4th generation tests are conclusive at any time more than 6 weeks after an encounter. Your HIV PCR confirms you were not infected. Further, you have already been told that there was no risk for HIV from the encounter you described. Please accept the results. You have proven you did not get HIV.

There should be no need to return to the Forum regarding this encounter. EWH

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