[Question #143] oraquick Accuracy

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102 months ago
Hello DRs

I cannot say how happy I am to find you doctors again, I have looked for all your answers in Medhelp sites on daily basis. So this is my story

I am a middle eastern guy  who studies in the USA. I am 26 and virgin.

on may 19 /2015 I did something very STUPID that cause me to be very anxious since. I went to a motel to meet a girl through backpage site.
I went only to get an oral sex since I thought it is risk free. 
I had unprotected oral sex for about 40 seconds and I ejaculated in her mouth then she went to the bathroom to spit it. Since that moment I felt very bad and crazy. I even texted her after the exposure and told her. are you free of diseases and she said " I am not like that, I would have told you to wear protection". I even asked her before she performed the oral on me  and she said that " she never had sex without condom whatever they pay her. I know these details are worthless but I just want to write.

after a week I had bumps or spot in my penis and felt really scared that I got herpes. I went to a dermotologist and he said it is normal.
I had very bad days and was very scared that i got herpes. But I still did not think of HIV at that moment. BUT

my HIV symptoms 

vomting , nausea and diarrhea and night sweats... 3 weeks post exposure  
VERY bad and painful tingling in my right hand which lasted for 4 days , actually since the tingling i started to worry about HIV. this about 2 months post exposure. 
I had VERY bad pain in my neck and shoulder lasted for 3 weeks and gone after medication . this about 2 and months after exposure
muscle pain and aches like needle pain.
rash on my back and also my head.
my arm got swollen 
spot and rash on my face

Also my head of penis got swollen and it is very red like a ring. ALSO went to a dermatologist and also said normal.

I am very scared about the neck pain , I have read someone who got HIV has the same pain as mine.

Finally I tested BUT unfournetlly with oraquick which I did it my self in my home.

I did TEST with the ORAQUICK testing on SEP 10-2015 which is 110 days after exposure. which thanks god came NEGATIVE.
My questions

1- IS this test accurate at all? I read people online who said the opposite , I asked drs from my country they say it is best to have blood test.
2- DID your thoughts changed on this test from 2014 as your last posts in MEDHELP?

3- Do you trust this Test?
Please Drs , I want you to be honest , don't lie or calm me . I just want the truth about this test.

I am very scared and if I am poz I will lose everything .

thank you , sorry for writing to much details. AND very sorry , about my poor English 

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H. Hunter Handsfield, MD
102 months ago
Welcome to the forum and thanks for your kind thoughts about our past forums on MedHelp. We hope to provide the same high quality service here.

There is a lot of information in your question, but only one thing is important:  the negative test results. With the current HIV tests, including the oral fluids self-test, the results are far more reliable than either exposure history or symptoms, as long as testing is done sufficiently long after the last possible exposure. For the oral fluids test, that time is 3 months. Even if your exposure was high risk (in fact it was virtually zero risk) or if your sypmtoms were typical for a new HIV infection (they were not), your negative test result at 110 days proves you weren't infected. To your specific questions:

1,3) See above. The blood tests are more reliable up to 90 days after exposure. After that, a negative oral fluids test is equally reliable. I trust your result, especially since you weren't at risk anyway. (HIV is rarely if ever transmitted mouth to penis.)

2) Neither the available data nor my opinions about the tests have changed in the past year.

So no worries at all. As for "I want you to be honest, don't lie or calm me", of course we would never do that. The hard truth, or our best understanding of the scientific data, is all you'll ever hear on this forum.

I hope this has helped calm your fears. Best wishes and stay safe--


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102 months ago
Hello Dr Hunter

Thank you for your valuable info. I have some more questions.

4- I forgot to tell you that I was taking this medicine for my muscle ( methylprednisolone ) will this medicine affect the result?

5- I read online that HIV usually attack body while sleep or relaxing , because I feel the pain in my neck after I wake up or before I sleep, IS that correct? and can HIV symptoms occur 3 months after exposure? 

6- If you were in my place . would test again or rely on the ORaQuick test?

7- Finally, I have  bumps on my penis and redness with swollen ring around my penis head, is that relate to any other STD. It lasts almost 3 months now with no pain or anything? 

thank you doctor, your word has helped me a lot to move back to my life
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H. Hunter Handsfield, MD
102 months ago
Thanks for the thanks. In addition to the reply above, I will add that HIV has never been proved to be transmitted by oral sex, mouth to penis. Not once in the 40 years and millions of infections in the worldwide HIV epidemic. Also, HIV remains rare in women in the US. You didn't need testing at all.

4) No medications affect the reliability your test. In theory, immunosuppressive drugs like methylprednisolone could have an effect, but only if in large doses (more than 40 mg daily by mouth) for a few weeks, and even then probably woudn't have any effect. (In any case, I don't understand why you would be takiing hat drug for a muscle problem.)
5) I have never heard that HIV usually "attacks" or causes symptoms while asleep or relaxing. It is nonsense. HIV doesn't cause neck pain.
6) If somehow I were in your circumstance, I would not have been tested at all. If for some reason I were tested anyway with Oraquick at 110 days, I would believe the test result and would not have any further tests.
7) First, since a doctor has examined you and found nothing wrong, probably your penis is normal. In any case, no STD is a likely cause of such symptoms. Most rashes of the penis are not from STDs. See a doctor if it continues and you are pretty sure it is abnormal. But it doesn't suggest STD or HIV.

I hope this settles things for you once and for all. Truly, you needn't worry at all about HIV from this event. It sounds like you are anxious and feeling guilty about a sexual choice you regret. Deal with that as you need to, but don't worry about HIV risk. They aren't the same thing.

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102 months ago
Thank you Dr, I am really scared after your respond that my medicine could have affected the test , 
I went to the Hospital on Wednesday 
took about 5 pills 4 mg each so 20 mg on day 1
Thursday I took 4mg so 16 mg ( the day I did the test)
total =26 mg on two days

 I also took Cyclobenzaprine ,3 and each is 5mg on day 1 and the same in day two
I did the test on Thursday , 

will that affect the test,??
I know I am freaking out and this is possibly the worst time of my life and I am really hoping that it is all anxiety.

I also forgot to tell you that she was a sex worker which i think is high risk , ( especially at her bad motel)

I do not know why many people say they got infected through oral sex, they are really scared me.
One last Question, If my exposure was insertive or receptive anal sex with infected man , will your answers be the same especially about the accuracy of the OraQuick.

Thank you Doctor for your help, I am just really scared to get a blood test, 

Fear of HIV is the worst thing I have encountered in my life

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H. Hunter Handsfield, MD
102 months ago
Thanks for clarifying the timing. If I correctly understand, you took those drugs recently, i.e. about the time you were tested. if so, they had NO EFFECT on the tests. To interfere with testing, you would have had to take the durgs for a fw weeks between exposure and before the test. Any drug taken more than 6-8 weeks after your exposure, but before testing, has no effect whatsoever. (And in fact, I stress that even this probably wouldn't have had any effect.)

Freaking out is frankly irrational. You need to settle down and read ALL my comments above VERY CAREFULLY. I have given you several reasons why you were not at risk and your test results can be trusted.

What is the point in asking about exposures that didn't actually occur? But the answer is yes:  If you also had insertive or receptive anal sex withi an infected male partner, my answers about the accuracy of the test would be no different. The only different thing in that case is that I would have recommended a 4th generation ("duo") laboratory test 4 weeks after the exposure.

As for being "just really scared to get a blood test", you have implied your not going to have another test. My advice is that you don't need it. However, if you want additional reassurance, a laborabory based blood test is what you need. It is not rational to be fearful of a test that you know will be negative. If you continue to be so fearful despite the reasoned, science based reassurance I have given and all that you now know, it will indicate a need for professional counseling. I suggest it from compassion, not criticism.

We have reached the limit of service on this thread (original plus two follow-up comments/questions), so this thread will be closed. Do not start a new one with the same questions. There will be no responses different than what you have already had. If any additional questions come to mind, just re-read everything in this thread. The answers are there.

Good luck and stay safe.
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102 months ago
Dear DR Handsfield

Before you close the thread, one final reassurance question

My test is conclusive and I do not need any further testing and the medicine I took has no Effect regardless of my low risk exposure. RIGHT?

Thank you , I am sorry for my crazy mind

Best Regards
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H. Hunter Handsfield, MD
102 months ago
You correctly understand. You can go forward with 100% confidence you did not catch HIV. If you have had no other porential exposures since then, you do not have HIV, cannot infect current or future sex partners, and need no further testing. Do your best to move on without worry about it. Good luck and stay safe.