[Question #2925] HIV testing

42 months ago
Hi doctors I'm entering a new relationship and want to make sure I'm in the clear my risks were a dozen or so cases of unprotected oral sex and 3 cases of condom protected sex in the past year and a half one of the times I had sex with a condom I realized about a minute in there was a small tear in the condom next to the head that really freaked me out so I took two oraquick home test after three months  can I trust those results and be confident that I do not have hiv? The reason I ask is because  I know you have previously said that after three month all test are conclusive but I saw on their website it's only 92% accurate. When I asked my doctor he said that's because of user error and testing inside the window period.but if I followed all the instructions I can trust the results and that he himself uses the oral rapid test in his office. Based on my risks and my testing can I finally move on with my life?
42 months ago
Just want to add on the first one I took I swabbed half of my bottom gum twice because I wasn't sure I swabbed it would that cause a false negative from what I read online that might up the chances of a false positive not a false negative is that correct?
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to the Forum.  I'll be glad to comment.  The exposures you describe are low risk for HIV- no one has ever been proven to acquired HIV from receipt of oral sex and condom protected sex is safe unless that condom broke, as it did on you, or it was not worn throughout the encounter.  Thus, as I count your history, your risk over the past year and a half is a single unprotected sexual encounter which resulted from a condom failure.  If this is correct, your risk if very, very low.  Most people do not have HIV and the risk of acquiring HIV from a single unprotected encounter with an infected partner is a fraction of 1%.  Further, you have now tested using the OraQuick test not once but twice and got negative tests, which prove that you were not infected  (the package insert/web site information is overly conservative and reflects estimates of accuracy that are the result of the way the FDA requires manufacturers to state their results)

My advice is to not worry further about HIV from the encounters you describe. If you have not already done so, you may wish to also be tested for more common STIs such as gonorrhea or chlamydia which can be asymptomatic and acquired (uncommonly) following either receipt of oral sex or condom failure. 

I hope these comments are helpful.  If any part of this is unclear, feel free to use your up to 2 follow-up questions for clarification.  EWH
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42 months ago
Thank you so What your saying is that the two oraquick results definitely show that I'm negative and I shouldn't worry about the numbers in their website. My question about other std testing is I want to get tested but am currently on antibiotics which I understand can mask the results so how long after I stop using it can I get accurate results? And does it matter for how long I have been taking antibiotics?
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Correct, no need for concern about HIV related to the exposures you have describe. 

With regard to other STIs, how antibiotics might affect your risk for infection and test results depend in which antibiotic you are taking and for how long.  Out of interest, why are you taking the antibiotics as well?  EWH
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42 months ago
I'm taking doxycycline for acne and folliculitis i wanted to get tested through one of the online services that send you to a lab and I saw on their site that you should wait six days after taking antibiotics to get accurate results I'm just wondering does it matter for how long I have been taking it I've been taking it for 4 month if I stopped 6 days ago will I get accurate results? One thing I might add I wasn't taking the antibiotics when I had my exposures so I don't think it would prevent any infection thanks for all your help
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Thanks for the additional information, it is very helpful and perhaps a good thing for you.  Doxycycline is highly active against chlamydia and syphilis and somewhat active against syphilis.  For all of these infections, effective treatment is anywhere from 1 week to 4 weeks so if you have been taking the medication for 4 months, it is probable that if you had any of these infections (which I doubt, both form your history and on a statistical basis) they would have been cured by the doxycycline.  In addition 50-60% of gonorrhea would also be cured by a week of doxycycline.  This, based on what you say, I anticipate that testing at this time (which would be accurate) will show that you are not infected and allow you to move forward without concern. 

I hope this helps.  Our Forum Guidelines permit up to three responses to questions but I will allow one more follow-up before the thread is closed.  EWH
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42 months ago
Thank you for the additional follow up question I just want to be sure that if I stopped taking antibiotics for 6 days the results will be accurate no matter how long I have been taking the antibiotics? Thanks a lot you're been a great help!
42 months ago
Sorry one more thing I forgot to ask.  do I also need to test for trich based on my exposures and would the antibiotics also take care of that? Thanks again 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Yes, six days would be fine in terms of testing.

Your likelihood of having trich is very, very low but if you want to be entirely sure, the same urine or swab specimen (either sort of specimen can be used with equal confidence) could be tested for trich as well.

This will now end this thread.  Take care nd please do not worry.  I am confident your tests will be negative.  EWH
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