[Question #3371] Oraquick in home test accuracy

37 months ago
Hi doctors 
I have always had hiv anxiety and have been abstinent for over a year.   I want to understand the accuracy of the oraquick at home test. I read online that oral fluid requires a large volume to detect HIV iGG antibodies. How is this  test accurate if it’s just a simple swab on the top and bottom gums ? How does it work as that seems to be a little volume of fluid? I know I was told as long as you have the Control line it’s working . 

 Also if this test only detect antibodies against GP41, when does one make that antibody ? Is it a guarantee that you will make it or you will make other antibodies first? I did read that oraquick misses a lot of hiv  infections but people were actually positive but didn’t have gp41 antibodies only other antibodies. Is this true ? . 
Is this test pretty accurate at 7 or 8 weeks post a possible risk ? Will the specific antibody be present ? 

Thanks for your great work !




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Correct about the control line. That's why it's there. As for how to collect the specimen, the instructions with the test kit are quite detailed and tell all you need to know -- undoubtedly more accurately than what I might recall off the top of my head.

Frankly, I don't recall exactly which antibodies are detected with the oral fluids tests. I would have thought more than GP41 only. In any case, all HIV infected people produce antibody to GP41. The Oraquick home self test indeed misses a smalll proportion of HIV infections (perhaps around 1%), and it takes the longest of all standard tests to become positive (3 months). It probably misses up to 5% of infections at 7-8 weeks. I don't know whether the ones it misses have anything to do with detection of GP41 antibody. But for these reasons, this test is best avoided by especially anxious persons. A lab based blood test, preferably an antigen-antibody test, is always the test of choice for maximum accuracy.

Thanks for the thanks about our services. However, this is your seventh question on the forum, most of them reflecting your anxieties about HIV. As you were previously informed in at least two replies over the last couple of years, repeated anxiety driven questions on the same topic are strongly discouraged. Repeated fact based replies usually don't help much, or only temporarily; such questions have little educational value for other users, one of the main purposes of the forum; and ASHA doesn't like being in the position of repeatedly charging and accepting payment in these circumstances. Thanks for your understanding.

HHH, MD
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37 months ago
Doctor. Thanks how accurate is rapid blood test. I think it’s the chembio sure check hiv 1/2 or clearview complete after that same period ? 7-8 weeks or 53 days 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
The rapid blood tests, including this one, are 100% accurate af 7-8 weeks. But this seems irrelevant, since you have been abstinent for a year.  You shouldn't be getting tested at all.---
37 months ago
Hi doctor thank you. I haven’t had sexual intercourse I meant that  no anal or vaginal sex for over a year actually. My last blood test was via regular bloodwork  a fourth generation test last August 2017 was negative .  I have engaged in minimally risky if none at all behavior since then  but I guess the important point is i need to see a therapist regarding my obsessive hiv anxiety and germ phobia.  I remember you perhaps mentioned that movie about a guy named Hughes I think I’m headed to be like him regarding germs and health phobia and avoiding certain situations. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Correct:  The Aviator, the film biography of Howard Hughes, is an excellent portrayal of OCD manifested primarily by germophobia and how serious a disability it can become. Or just google him for a wealth of information. Or "Howard Hughes OCD".

That concludes this discussion and should end your reliance on this forum, since you appear to be relying on it instead of getting the counseling help you need. I hope you understand. Best wishes.
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