[Question #13200] HIV 1 & 2 RNA result

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1 months ago
Hello Doctors

I hope you can help me.

I have secured employment in Australia and I have my visa medical this Friday.
Part of the medical includes a blood test for HIV; and I am stressed about the result!

I have abstained from sex for the past 5 months. In January I had FIVE instances of unprotected vaginal sex and oral sex with a female friend I knew from college.

At the time of these events I had applied for the position in Australia, and after reading about the medical testing requirement, I immediately enquired about an HIV Qualitative PCR. I understand it is the most accurate HIV test available (?).

The nurse took my blood 21 days after the last incident. The result returned ‘not detected’ for both HIV RNA 1 & 2. 

Does this mean no further HIV testing is needed and I am 1000000% not at risk? (aka the result absolutely won’t change?).

Your expertise is appreciated.

Thank you
Jake
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H. Hunter Handsfield, MD
1 months ago
Welcome. Thank you for your confidence in our services. Congratulations on your new employment and upcoming move to Australia.

Do you have reason to suspect your college friend is at high risk for HIV? Is she a sex worker? Injection drug user? Immigrant from an HIV-endemic area (like Africa)? If not, and if you're in North America or Western Europe, there is little chance she has HIV. But more important, even if she had it, your negative test result 3 weeks after your last sexual contact with her is conclusive proof you were not infected. That result does indeed "mean no further HIV testing is needed and [you are] 1000000% not at risk".

I'm surprised to hear that Australia requires HIV testing for your visa -- it's certainly not required for a tourist visa, but maybe it's different for permanent residents or others who will be employed in the country. In any case, I would think they would require only a standard antibody or antigen-antibody (AgAb) test, which is every bit as accurate:  nobody can possibly have HIV and test negative with these tests. I suggest not spending extra money on another PCR test.

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

HHH, MD
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1 months ago
Thank you for your kind words, Doctor.

My college friend is English and lives in England still. I too am English and currently live in the UAE (this is where the RNA PCR test was done). I understand that the labs here are outstanding?

I was tested for peace of mind as AFTER the events she told me that she had slept with two guys more than once in the UK prior to our encounters. She works for an engineering firm and is not a sex worker; nor injects drugs (that I know of).

Unfortunately, I have sought medical guidance from you as she refused to be tested and regrettably we no longer speak.

My follow ups are:

(1) Regardless of the test type the clinic use for my medical, I will 1000% have a negative HIV result?

(2) Is it safe to start unprotected intercourse with my current GF?

Thank you for your help.
Jake 
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H. Hunter Handsfield, MD
1 months ago
You seem to have an inflated perspective on HIV risks given your sexual lifestyle. For every thousand British men who had sexual exposures like this, I'd bet that not one would become infected with HIV over the next ten years. That your partner "slept with two guys more than once in the UK" is a trivial HIV risk as well. HIV remains rare in Western Europe and North America except in men who have sex with men and injection drug users. 

Almost all labs worldwide use the same HIV tests and technologies, which are more or less foolproof. I imagine those in the UAE are as reliable as anywhere else.

(1) Repeat question, same answer. Yes. 

(2) From an HIV standpoint there was no need to stop or delay unprotected sex with your current partner and you certainly can start (or resume) it now.
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