[Question #1971] HIV Risk - Negative RNA Test at 15 Days

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87 months ago
Hi Doctors, I am a 24 year old heterosexual male who has had one female partner in the past 12 months prior to the random interaction below. 

While out of town in Missouri, on March 23 I met a stranger online, something I have never done before. I have no knowledge of this person's sexual history and believe she was a male to female post-op trans woman. She was 30 years old and Pilipino. Being trans, I understand this would be a high risk individual. Afterward she told me she is constantly tested and that I had nothing to worry about, but I don't know this person enough to trust them. 

During the interaction there was roughly 10 minutes of deep open mouth french kissing. I did not notice any blood. Although, I occasionally bite my cheeks out of nervous habit, which I worried could possibly be a route for transmission. 

I fingered her vaginal area briefly, but I did not have any cuts or hangnails. She then gave me oral sex briefly, perhaps 30 seconds before stopping.  

From the research I've done, this is considered to be a negligible risk encounter for HIV. Aside from one case in the 90's there has never been a transmission of HIV through deep kissing, correct? Also, there has never been a documented case of transmission from receiving oral sex or fingering?

On April 5 I developed a sore throat (I did have laryngitis in mid March) . Being on schedule for ARS symptoms my anxiety got the better of me. On April 7 (15 days post exposure) I went in for an HIV RNA test. 

The HIV-1 RNA PCR NAAT Qualitative test was conducted by LabCorp. I received a 'negative' result back this morning. 

At 15 days post exposure, how much confidence would you have in this negative test result? I still have a dry sore throat, along with green mucus and slight cough. If the sore throat started April 5 and was a symptom of ARS, surely the HIV RNA test on April 7 would have been positive? Is it safe to stop worrying and move on from this? 

Thanks a bunch,
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Edward W. Hook M.D.
87 months ago
 Welcome to our phone. I'll be glad to comment on your experience. I would disagree with you on your assessment that this encounter was  of negligible risk and instead I would say that it was a no risk in counter.  I am not aware of the report of anyone acquiring HIV from deep kissing that you mentioned.  The CDC and WHO  each categorically state that there is no risk for HIV acquisition related to kissing of any sort.   Similarly we are unaware of any instance in which a person has been proven to acquire HIV from receipt of oral sex.    Hence I would categorize your exposure as being of no risk whatsoever and had you ask what I've told you that there was no need for testing of any sort. 

 As for your sore throat my guess is that this is totally unrelated to the encounter you describe and is just one of the sorts of sore throat that most people acquire from time to time. I agree with your assessment that if you're sore throat was related to recently acquired HIV your HIV are in a test would certainly have been positive.

 I see no reason whatsoever for continuing concern related to this encounter. I would encourage you to move on without concern. No further testing is needed. I hope my comments will be helpful to you and moving on. Take care. EWH