[Question #3997] Real need for panic or just being paranoid??

33 months ago
I've been reading here that many users like myself are worried that their "Oraquick at home oral swab" test results aren't as reliable as other blood test. Also, it is duly noted that doctors on this board doesn't really prefer Oraquick at home oral swab test because it takes the longest to turn positive (sometimes three months) and it can also give out false negative results. This is actual quote from FDA "one false negative result would be expected out of every 12 test results in HIV infected individuals."

Well, I received 5 seconds of unprotected blowjob from massage parlor. To cut it short, I tested myself three times 1) at 3 weeks 2) at 11 weeks and 3) at exactly 92 days (13.14 weeks) post encounter using of course Oralquick at home oral swab test. All three times results were negative. Nonetheless, I've moved on entirely. This happened earlier in the year and I put that episode behind me.

Fast-forward to today, my wife is pregnant and she'll be tested for HIV eventually. So, I resurfaced on this site to learn about recent discussions on Oraquick. To my unpleasant surprise, I'm worried now that my at home Oraquick test results weren't accurate. Needless to say that the 3rd test was exactly at 92 days post encounter. That in mind, my questions are as follow:

1) Am I really HIV negative?
2) How reliable are my three at Home Oraquick test results?
3) Any real need for follow up testing?
4) FDA also stated that Oraquick oral swab test results has 99.98% test specificity. What is the meaning of that in simple English?

Apologies if I'm coming out too strong...it took my wife forever to conceive and I want to enjoy the news not the other way around!!

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
Welcome to the forum. Thanks for your question.

You had a zero risk exposure:  HIV has never been proved to have been transmitted by oral sex, from the oral to penile partner. If it happens at all, one calculation is a risk of 1 in 20,000, which is equivalent to receiving BJs from infected partners once daily for 55 years before transmission might be likely. And undoubtedly your risk would be even lower, with only 5 seconds exposure. And statistically, it is very unlikely your massage partner has HIV anyway.

So Oraquick test performance is not the important issue here, even though it's the one you are concerned about. However, your previous research has been good:  your correctly understand the test's limitations. However, if the risk was zero to start, none of this matters. Here's a statistical calculation that should further reassure you. Let's say your exposure wasn't zero, but had a risk of 1 in a million. Your 92 day Oraquick would detect 95% of infections. That means the chance you have HIV can be calculated to be 1 in a million times 5%, i.e. 0.000001 x 0.05 = 0.00000005. That's 1 in 20 million. I hope you will agree that's zero for all practical purposes.

Those comments answer your first 3 questions, but to be explicit:

1,3) There is no realistic possibility you have HIV, and no need for further testing.

2) By itself, your 92 day test is 95% reliable. However, for the reasons explained above, it helps prove you do not have HIV.

4) Specificity of a test relates to the reliability of a positive result. It means that among UNINFECTED people, 0.02% would have positive test results. That's 2 in 10,000, i.e. very rare. But since your tests weren't positive, it doesn't matter for you.

Congratulations to you and your wife on your successful conception. Don't let your outside sexual exposure or concerns about HIV get in the way of your joy about it. There's truly no worry about HIV in this situation.

I hope these comments are helpful. Let me know if anything isn't clear. 

HHH, MD
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33 months ago
Thanks for the congrats and reassurance. As you've stated, I'll erase this no risk incident from my mind. 

However, I've had multiple encounters in year 2014, 2015, 2016 and 2017. Most before marriage and some after. Almost 99% of them were receiving unprotected BJs from massage ladies or causal date. And having condom protected vaginal sex. One condom protected vaginal sex had blood covered condom incident which worried me. Also, I enjoyed deep intense kissing and rimming during those adventurous years.

Anyhow, I never tested for HIV in Jan 2018 for above mentioned incidents from 2014 to 2017. I tested for them all during my 1st at home HIV oraquick mouth swab test. Which occurred probably 1 year after my last incident of 2017. 

In nutshell, I tested myself with HIV oraquick oral swab test for encounters of 2014 to 2017. I gave myself exactly 1 year before I tested for HIV oraquick. My last incident was in Jan of 2017. And, I tested with Oraquick mouth swab in Jan of 2018.

Would you  consider that test result conclusive? Because your original response says "your 92 day test is 95% reliable". But, how would you rate 365 day Oralquick mouth swab test? I mean if we do the math, I actually did 365 day Oraquick mouth swab test three times with negative results.

After that testing , I had the incident of 5 seconds with massage lady (the one that I listed in original question). 

But the moral of the story is that I've only tested myself through Oraquick oral swab test (at home). No other test outside of that. As you can see, I've had other incidents from 2014 to 2017. But, I gave myself 1 year or more of "window time" time to test for them.

Would you consider my HIV oraquick oral swab result conclusive? 

Sorry for the confusion. I wasn't going to ask about my previous (2014-2017) encounters and oraquick testing in 2018. Because I thought the results of Oraquick was negative after 1 year so why worry. But, when I saw 95% accurate at 92day...I couldn't resist.
33 months ago
I meant to say "Anyhow, I never tested for HIV in Jan 2018 for above mentioned incidents from 2014 to 2017. I tested for them all during my 1st at home HIV oraquick mouth swab test. Which occurred probably 1 year after my last incident of 2017. "
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
Your negative test results are equally valid for any and all exposures more than 90 days prior to testing, and therefore include your exposures going back to 2014 (or any time in your life). There is almost zero chance you have HIV, but not quite zero. If you feel the need for unequivocal100% certainty, you'll need to have a 3rd or 4th generation blood test.


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33 months ago
okay. It doesn't settle my nerves with almost zero vs. actual zero but I guess I will get the blood test.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
It's up to you. I certainly would not feel the need if somehow I were in your circumstances, and if I were advising my son or daughter, I would also recommend against testing. But you're of course free to do it if you feel the need.

That concludes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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