[Question #13944] Handjob & 4th gen testing clarification

1 months ago

Dear Drs., hope you are in good health and thank you for all that you are doing for us..

I would like your insight on the type of exposure that I had and whether the tests that I received were conclusive.

I received a handjob from a masseuse one late evening (in Korea). I'm uncut and I didn't have any open wounds or deeps cuts anywhere on my penis, but what I'm concerned about is I didn't check if whether her hand was bleeding during the act. If her massaging hand was bleeding, I've been searching for "what-if" possibilities that the blood may have entered my urethra and caused a possible hiv infection.

For reference, the majority of platforms say no risk, and that no one has been known to contract the virus through hand-to-genital contact but maybe I might be the exception, with the mind oftentimes susceptible to irrational fears.

Because of this, and since I wanted to put this behind me, I got 2 4th gen tests at different urology clinics. Not sure which company was used, but the testing days post exposure are as follows:

-4th gen (vein draw) at 33 days post exposure

-4th gen (vein draw) at a full 43 and 12+ hours post exposure (44th day?)

I would like to know if the day 43 test is considered conclusive because I'm reading from CDC that it is at 45 days and from other health platforms that getting the test done on or after 42 days (6 weeks?) is considered conclusive.

Silly question, but is 6 weeks from your side considered 42 days or 45 days?

Based on the encounter that I had and the testing times done, should I move on or should I test again on the 45th< day?

I'm not overly concerned at this point but I believe your expert advice would provide some closure on this lingering concern. Thank you.

Edward W. Hook M.D.

1 months ago

Welcome to our Forum and thanks for your questions. I'll be glad to comment. You can be confident in your results. It is statistically unlikely that your partner had HIV. Even if she did, I can confirm to you that the encounter you describe was entirely no risk- even in the unlikely circumstance that your partner had a cut on her hand and got blood on you. Your test results prove this. Your 33 day results and more than 98% conclusive and your 43 day results are entirely conclusive. Results of 4th generation tests any time 42 or more days after a potential exposure are conclusive. You can be confident that you did not acquire HIV. It's time to move forward without concern. There is no scientific need for further testing. EWH---

1 months ago

Dear Dr., thank you for getting back to me with a quick reply and assurance.

I have some follow-up questions:

1. So a 45+ day test is not necessary? I am actually approaching Day 60 post exposure so I am a bit on the fence about getting another test done. In no way am I discounting your initial suggestion but my concern at this point is more psychological over the biological possibility that I might be infected related in connection to question 2.

2. How was the 45-day conclusive test with the 4th gen determined by the CDC and other notable health agencies/platforms? Was it rounded off from the 6-week (42 days) mark or were there scientific reports to determine that 45 days and onward is the cutoff?

3. Again, related to question 2, has there ever been a positive test on day 45+ after a non-reactive test done between days 42 and 45 detected by testing centers?

4. Lastly, if let's say the masseuse did have smears of blood on her hand, and if she was stroking over the glans, then can blood enter the urethra or would it mostly stay on the glans since I read that the urethra from the meatus slit is collapsed and shut with a mucus barrier when the penis is erect AND that blood is a viscous fluid?

I understand you are busy with other patients so much appreciated for your response. Thank you again for your advice.

Edward W. Hook M.D.

1 months ago

1. There is no scientific need for testing- you did not acquire HIV. Testing however is always a personal choice and if your unwarranted anxiety would be relieved by another test, of course you can do that. The results will not change.

2. The 42-45 day cut point for conclusive results is based on analysis of hundreds of studies involving hundreds of thousands of patients.

3. I am not aware of a case in which a person who has not taken anti-HIV medication has gone on to have a positive test. There may be someone somewhere, just as there may be someone who was struck by a meteorite falling from space while reading on of our replies. You are worrying needlessly

4. This sort of "what if" question is very familiar however the scientific data are that this is cot a concern. Our replies are based on scientific data.

One follow-up remaining

EWH

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