[Question #13402] Embarrassed to be back.
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1 months ago
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Hello, I have a question regarding HIV testing and PEP. If someone had already acquired HIV without knowing it and then later had a known exposure for which they took PEP, would a 4th-generation HIV test done 8 weeks after completing PEP be accurate for detecting the pre-existing infection? One of my exposures may have been pre-masticated food, for which I did NOT take PEP. I only took PEP for receiving cunnilingus, which occurred days to weeks after the possible food exposure. I was recently diagnosed with OCD and am working with my therapist. I want to make sure my last 4th-generation HIV taken 12 weeks post my known exposure was conclusive.
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1 months ago
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Sorry, edit to the end of my message- Scratch that last sentence. I just want to make sure my final 4th gen test 12 weeks post cunnilingus was for sure conclusive. My worry now is that I was focused on worrying about the wrong exposure, and dread to think, what if I got it from the food exposure and then took pep days later, which could have affected my negative tests after.
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H. Hunter Handsfield, MD
1 months ago
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Welcome to the forum. Thank you for your confidence in our services.
The answer to your opening question is yes: your negative HIV test 8 weeks after completing PEP is proof you were not infected with HIV before the PEP; and if you were reexposed after that, either you were not infected or the PEP successfully prevented it.
Pre-masticated food has been documented as a rare source of HIV in young children, but has never been reported in adults. I also question your (or your doctor's) recommendation of PEP following cunnilingus. Oral-vaginal sexual contact has never been reported or known to result in HIV transmission. If that partner was known to have HIV, I could understand PEP as a precaution -- but otherwise I would have advised against it.
As for wanting to "make sure my final 4th get test 12 weeks post cunnilingus was for sure conclusive", it was. In other words, both exposures were zero risk or close to it and you didn't need PEP. In any case, it is completely certain you do not have HIV.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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1 months ago
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Hi,
Thank you for your reassurance, and yes it was helpful.
Another question I have, which may sound ridiculous but, I was just recently tested again with the determine HIV 1/2 Ag/Ab rapid blood test. I went to a clinic near me that was offering free rapid tests. I did not see the device used to draw blood from my finger. Is it safe to say most, if not all clinics use Single-use lancets? And if for some reason it was not new, is there a chance of HIV or hep C transmission or am I just being irrational at this point.
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1 months ago
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If I may please ask one question? I’m genuinely concerned and don’t know if I need pep. It tested at a hiv clinic with a rapid test. This was supposed to be my final test (for me) not medically. Well the tech asked my exposure which I told him, he said those aren’t a risk for hiv but proceeded to do the test anyways. He poked my finger with a lancet and then I asked how long the results will take, he said 10 minutes. Well not even two minutes had passed before he said you’re negative and showed me the result with the control line only . I asked what about 10 minutes he said nope you’re negative. I left the clinic but 20 minutes in I decided to turn back around to let the tech know I felt uneasy about not letting the 10 mins pass so I could see the results for myself. He pulled the results still in the test tube and said see it’s been what an hour not and it’s not positive. I know this was not protocol, this test shouldn’t have been read after 20 mins.
I left and went home but started wondering what else he didn’t follow protocol on. It immediately made me wonder if somehow he used a pre used lancet on me, or didn’t follow safety protocol in regards to the lancet. My question is should I get on Pep for this? To think about starting pep again makes me sick, but wondering what all he didn’t follow protocol on is making me sicker! Please please please let me know if this sounds like something I need to seek medical help for.
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H. Hunter Handsfield, MD
1 months ago
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You are correct that the technician should have waited until 10 minutes to be sure the test was negative. However, the early result plus no change at an hour is 100% proof of a negative result. lthough 10 minutes is officially recommended, most positive results are obvious within 30 seconds, and your negative result at about 2 minutes should be considered conclusive. It is not possible for a test line to appear (at 10 minutes or any other time) and then to disappear within an hour, so this test definitely was negative.
Do not start PEP because of this. There is nothing you need medical help for.
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1 months ago
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Thank you for your response, it was very much needed. So you see no reasonable need for me to be concerned about needing another test after this test (not bc of the time lapsed to when I read results) but bc of my concerns with any possible safety measures skipped, reuse of lancet, etc. this was an hiv clinic so I imagine the risk would be greater if that were to happen, which makes me more nervous. The lancet looked like a small little box with a clear top on the bottom when it was standing up straight. I’ve googled and those all seem to be single use safety lancets and I would hope with this being an hiv clinic they wouldn’t have both non single use safety lancets and the single use ones to possibly be confused. Lastly should I be concerned about having unprotected sex with my boyfriend (if your answer is I don’t need another test then I know the answer to this question but feel the need to ask) thank you for your time Dr.
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H. Hunter Handsfield, MD
26 days ago
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Sorry for the long delayed reply to these follow-up questions.
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You're way overthinking the situation. Nobody ever re-uses lancets, or is likely to confuse the type of lancet. No, you should not be concerned about having sex with your boyfriend..