[Question #3983] Dr HHH would like your opinion (updated information)

31 months ago
April 25th saw a ukrainian sex worker.  she did unprotected oral sex on me, and protected vaginal sex.  can't remember, but was concerned I lost erection as she got off of my penis, and can;t remember if condom was loosly on soft penis.  I am married.
started to worry and panic, and based on job being in remote area only had access to oraquick sold at convenience store.  Bought 2 of them and tested negative at 6 weeks and 8 weeks.  I know it was too soon, but seemed a decent indicator.  panic led me to buy a 3rd on the day I came home, which was at 79 days (10.5 weeks post exposure)

Came back from job to home area and had sex with wife.  she developed benign vertigo(diagnosed) with upset stomach and diarrhea for a day.  her symptoms have gotten better now, but was reading peoples stories about their symptoms and saw a youtube video with a woman claiming vertigo was a symptom she had.  This lead me to today...bought 2 more oraquick tests, and both were negative.  (83 days post exposure, 1 day shy of exactly 12 weeks)

questions.

1.I asked this question previously to Dr Hook (who was very informative) but wanted to know your opinions on my current situation as well.  Are my 5 oraquicks at 6, 8, 10, and 12(x2) weeks tests conclusive?  I read alot on this forum on both of your takes on the oraquick tests and how conclusive they are, but as my wife controls our bills/finances, going to my primary Dr for bloodwork was/is impossible.  I needed to buy the tests using target gift cards to not leave a papertrail.

2.  Do I need to test again? 3 months as you say would be 13 weeks, a week from tomorrow.  would it make a difference?

3.  are her symptoms/diagnosis indicative of an HIV infection?

I so desperately want to put this horrible, horrible mistake behind me.  I'm hoping 5 tests would rule out any false negative results  thanks for your time.
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome back to the Forum although I'm sorry to see that you felt the need to ask these repetitive questions.  As an FYI, Dr. Handsfield and I do not allow clients to ask the same question of each of us to "check up" and see if we agree.  The fact is that in our more than 30 years of working together, we never disagree in the substance of our advice and recommendations although our verbal styles differ.  Further, you have been warned already about repetitive, anxiety driven questions of the sort that you are making.  As a result, my responses to your questions will be brief.

1.  I will not repeat the assessment and information I have already provided.  Given your anxiety and concerns about being discovered by your wife, my advice is to seek evaluation at your local, public health STD Clinic. They are present in most areas and offer low cost, state of the art testing using high quality tests. 

2.  In my opinion, no.

3.  The symptoms of recently acquired HIV occasionally include diarrhea but typically the symptoms are accompanied by high fever, sore throat and muscle aches.  Isolated diarrhea and stomach upset are not a characteristic of recently acquired HIV.

I think you are overthinking this and your guilt over your infidelity are driving unwarranted anxiety.  EWH
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31 months ago
Dr Hook,

I cannot go to an STD clinic for bloodwork.  My schedule with work, plus my general work location make it impossible.  Ive checked, theres nowhere to go within a 25 miles radius from me, hence all the oraquick tests.  I understand like you said no test is perfect, but I was looking for the comfort of being told that 5 negative tests out to this time are conclusive.  

I did not mean to come off as offensive to you.

1.  in your opinion I don't need any more testing.  Then why tell me to go to an STD clinic?  If your answer was simply that the amount of tests and timing is conclusive, I don't understand your recommendation.  

2.  the vertigo was what I concerned with, as far as my wife's symptoms are concerned.  I understand diarrhea and upset stomach are not symptoms.

Like I said, I think I may be in the clear.  Having a professional confirm this based on the 5 FDA approved tests I took, and the time I took them, would help alot.  
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
1. It was an alternative suggestion related to your apparent high level of anxiety.  Apparently you did not believe my initial responses so I provided an alternate approach.

2.  Vertigo is not a sign of recently acquired HIV.   It could be due to dehydration related to diarrhea.

I think you should believe your test results.  I told you that before.  I'm telling you again.  EWH
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31 months ago
Thank you,  this being my last response this is my final question.

In your history using this test (oraquick mouth swab), has it generally been reliable?  Have you had patients who have had negative tests with it after 6 or so weeks after an exposure that ended up being positive later?  

I would assume the FDA would never release something for general over the counter sales unless it was very accurate.  There are many articles online, especially one about a recent study in Thailand where the oraquick missed many infections.  That's what started the anxiety for me actually.  Amazon reviews for the product are incredibly positive with almost every reviewer saying it gave accurate results that were confirmed with a blood draw.  As far as the test working, I called their hotline and they told me as long as the C line is present, that means the test worked as intended and that the specimen collected was sufficient for the test to proceed.

Again, I'm just trying to get accurate information not from the internet which misinforms, or from online keyboard warriors who read forums...but from actual professionals who specialize in understanding this test and it's results.  I hope you understand it's strictly so I am informed by the informed.
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Sigh.  Yes, the Oraquick has generally been reliable.  I have never had a patient in whom an OraQuick tests which was negative at 8 weeks became positive but of course, most such patients do not have HIV as well.  You can review my earlier comments regarding OraQick tests on your earlier posts.  If there were major questions about the OraQuick, the FDA would not have approved it. 

This is my 3rd reply to your posts.  I trust you will not return with further questions on this topic.  EWH
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