I was training staff on an oraquick test by self demonstration.  To my surprise, it was positive.  I did have something to eat, drink in the last 30 min. and there was a lot of saliva.  I was shocked.  I then took 3 more.  All negative.  My risk was what I consider low giving oral sex to a guy that says he is tested annually and only engages in oral sex, i am too a guy.  This occured 38 days ago.  12 days after that event I saw my PCP for a regular check up, told him about it and because my insurance is good did a standard HIV antibody (along with annual battery of routine tests) and an HIV PCR.  All negative. I called the oraquick number and they told me that too much saliva can produce false positve tests.  Yet, everything I see about Oraquick indicates false positives are rare.  I took a 4th generation HIV antibody blood test from Quest Diagnostics today and should get results in the next day or so.  So my questions:

1. what is the frequency of false positives?

2. Can I dismiss the first Oraquick test as too much saliva and the other three I took immeidately there after that were negative as that I am really negative?

3. Given the low risk oral sex i preformed, a PCR tests 12 days post that event, 3 negative oraquick....does this cancel out my one postive?  

4. Do you feel confident my antibody test will be negative?  If so, can I put this behind me?  It will have bee 38 days post any event that could have remotely been a risk.  

thank you,

Sorry to hear of your false positive result on the oral fluids test. I understand how alarming that must have been. However, that three subsequent Oraquicks were negative strongly suggested the initial result indeed was false. More importantly, the negative PCR test 12 days after your last potential exposure proves it. And I agree that exposure was extremely low risk anyway, even if your oral sex partner had untreated HIV. (The risk for performing unprotected oral sex is estimated to be around one in 10,000, which is equivalent to giving BJs to infected partners once daily for 27 years before infection might be expected). 

2,3. I am unaware of data that "too much saliva" explains false positive results. But as I said above, that three more tests were negative plus the negative PCR prove the first result was false.

4. Today's AgAb (4th generation) blood test undoubtedly will be negative as well. Although it can take up to 6 weeks for the AgAb test to become positive, almost always it's positive within 4 weeks. And as I said, the PCR was conclusive by itself.

You can be sure you don't have HIV. Do your best to stay relaxed as you wait for the latest test result.

I hope these comments are helpful. Relax and enjoy the remainder of the holidays!

HHH, MD

Doctor,

I just noticed your response as I was typing additional information.  Thank you so much for the speedy response.  Maybe this is the first thing lucky that happened to me today.  I will let you know the results when they come in.  I assume my additional comments doesnt change your assessment.  Thank you again. 

Dr. Handsfield,

My 4th gen for both antibodies and p24 antigen at 38 days post a low risk event is negative!  My rational mind believed you.  But the vision of that oraquick was haunting me.  I even took another Oraquick yesterday while waiting for the blood test, it was negative too.  While this blood test is not fully 6 weeks or 3 months, whichever the recommendation is now (I think 6 weeks with the 4th gen. test?), is this enough?  To recap:  

(a) low risk giving oral act 33 days post sickness, 38 days with positive oraquick, 

(b) 12 days after low risk oral, had a negative PCR, 

(c) 33 days later get sick, still sick.  

(d) 38 post the risk positive Oraquick but also three subsequently negative Oraquick test on the same day, 

(e) 38 days later negative 4th gen. antibody/antigen test from quest, 

(f) 39 days while waiting for blood results, had an additional negative oraquick test.  So to my specific questions:

1.  If you would me, should I worry about this any longer?  

2.  Should I have a PCR and/or one more antibody test at a full six weeks to be on the safe side?  Right now I am at 5.4 weeks, just short of six weeks.  I assume the three month recommendation is for oraquick and/or other 3rd generation test and is now not applicable?

Thank you in advance for your expertise and previous speedy and comforting words.  Very appreciative.  

Dear Doctor,

Just following up on my previous questions.  I would feel comfortable with my testing time frames if I had not had the one positive test.  Please see my last question.  I assume, but not sure, that my PCR test at 12 days (11.5 actually), then one positive oraquick tests, and subsequent four negative oraquick tests and then a routine 4gen antibody/antigen test at 38 days will suffice for me to be considered HIV negative.  I guess my questions are:

1. Do I need additional testing at the 6 week or 3 month time frame?

2. If testing is needed should it be antibody or PCR again

3. Can I put this behind me and consider myself negative now?  I think this is the answer but given the one positive test, I dont want to make this decision on my own. 

thank you

It remains certain you do not have HIV.