[Question #12930] Testing - Insti HIV self test

3 months ago

Dear Doctors,

Risk: Three times Ive performed fellatio on CSW - trans, no ejaculation.

Questions:

a) Really anxious about testing, but will go with Insti HIV self test - Any reason to be concerned about false positive?(because of covid etc..).The risk events are 12+ months old.

b) Is IT true that fellatio on untreated HIV positive partner Has a lower than 1 in 10000 chance, WITHOUT EJACULATION? I understand the chance WITH EJACULATION is 1 in 10000.

c) Any reason to be worried i might infect other people in the meantime through GIVING oral sex(fellatio/cunnilingus)?

Edward W. Hook M.D.

3 months ago

Welcome to the Forum. Thanks for your questions. I'll be glad to comment. The risk of acquiring HIV from performing fellatio on an untreated, HIV infected person is estimated to be less than 1 infection per 10,000 encounters. Because it occurs so rarely, this is an estimate and the true rate could be even lower. Further, it is statistically unlikely that any of your partners had HIV (although in the future it would be good to ask- most people tell the truth). These were lo risk encounters. In response to your specific questions:

a) Really anxious about testing, but will go with Insti HIV self test - Any reason to be concerned about false positive?(because of covid etc..).The risk events are 12+ months old.

Self tests are very slightly lower sensitivity than lab based tests. With all tests, falsely positive results are quite rare. COVID and similar illnesses do NOT cause falsely positive results. At 12 months, your test results should be conclusive.

b) Is IT true that fellatio on untreated HIV positive partner Has a lower than 1 in 10000 chance, WITHOUT EJACULATION? I understand the chance WITH EJACULATION is 1 in 10000.

Again, because infection is rare, the contribution of ejaculation to risk is unknown. HIV is present in the pre-ejaculatory secretions of infected persons and it makes sense that with ejaculation the amount of virus one is exposed to might be greater but again, this is based on no data.

c) Any reason to be worried i might infect other people in the meantime through GIVING oral sex(fellatio/cunnilingus)?

I would not be worried about infection if I were you. I anticipate that your test results will show that you were not infected. I would not hesitate to have sex with others because of HIV concerns related to the encounters you describe above.

I hope this information is helpful. You have up to 2 follow ups if anything is unclear. EWH

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3 months ago

Dear Dr. Hook,

Thank you - based on your responses, do you see any medical need to get tested in the first place, apart from the reassurance the negative test will provide?

Edward W. Hook M.D.

3 months ago

Personally, I would probably not even bother to test, although testing is always a personal choice. EWH---

3 months ago

Dear Dr. Hook,

Thank you.

Seems like I have one more follow up - will spend it on symptoms:

- The events(three times), as I said are 12 months old(the last one) and 29 months (the first two).

-My questions:

a) Any reason to suspect muscle twitches would be indicative of potential infection? They started around 3 months ago, no other neurological symptoms.

b) Any evidence available/what is your view on whether RECENT infection (e.g. until three months of the infection) causes nasal congestion, occasional cough and mild sore throat?

Many thanks.

Edward W. Hook M.D.

3 months ago

As you know, this will be my final response as part of this thread. After the response, the thread will be closed. There should b no need for further questions on this matter.

Muscle "twitches" of the sort you describe are not suggestive of any STI, including HIV. Typically they are not something to worry about although if they become more frequent or intense, you may want to mention them to your doctor.

Interestingly, while HIV can be associated with pneumonia, it is NOT associated with non-productive cough or nasal congestion. The sore throat of the ARS, which occurs within 30 days of acquistion of HIV if it occurs at all is typically quite severe and associated with high fever as well as muscle and joint aches.

I hope that the information I have provided has been helpful. EWH

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