[Question #4314] Oralquick Finger stick at clinic, further testing needed?

30 months ago
Hi, 

Three years ago I had three sexual encounters with CSWs in China. All three involve unprotected handjobs and breast sex, no vaginal,  oral or anal intercourse involved. Last three weeks notice symptoms of swollen glands, fatigue, and mouth pain. One year ago tested non reactive through 4th gen screening (labcorp). Yesterday tested negative at PPhood using rapid  fingerstick (oraquick), forget to mention mouth pain symptoms. 

1.) what is the probability of two false negative tests? 
2.) would my symptoms impact the outcomes of results? 
3.) should I be further tested for hiv?  
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to our Forum and thanks for your confidence in us..  I'll be glad to comment.  Let me start by telling you that combination HIV antigen/antibody (4th generation) tests for HIV are amongst the most accurate and reliable tests available in all of medics.  Your results are reliable and can be believed.  They prove that you were not infected through your exposures in China three weeks ago.  I should add that experts agree that receipt of masturbation and breast sex as you describe are generally considered no risk exposures for acquisition of HIV.  You can be confident that your more recent tests will be negative as well.  In response to your specific questions:

1.  There is virtually no risk of two false positive tests for you.
2.  No, your recent symptoms will not effect your test results.
3.  There is no need for further testing.  Be.ieve your test results.  Your current symptoms are due to something other than HIV acquired fro your exposures in China.

I hope these comments are helpful to you.  EWH
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30 months ago
Thank you, 

1.)what is your overall opinion on the accuracy of the Oraquick tests administered by a healthcare clinician (PPhood). Does this decrease the chance of false negatives? 
2.) If a 4th gen test is performed today, do you expect this to be negative? I'm having symptoms and I think i've ignored them for too long.

Thank you, 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
1.   OraQuick tests for HIV antibodies have VERY, VERY rare false negative results.  We favor blood tests, particularly the combination HIV antigen/antibody tests.
2.  Yes.  Given your test results a year ago, I am confident that a repeat test performed today will also show that you did not acquire HIV from the exposure you have described in China three years ago.   EWH
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30 months ago
Dr H, 

Would you consider oralquick done with finger prick at a clinic effective test to rule out infection, or a blood test sent to a lab is more preferred? 
Would you recommend PCR testing or RNA testing in this scenario? 

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
A laboratory based, combination HIV antigen/antibody (Duo or 4th generation test) is our preferred test- a finger stick combination test is about as good.  The Oraquick test, which tests only for antibodies is our least favorite test although for the vast majority of people for all times after more than 12 weeks (three months) it is 99.99% reliable and should be believed. 

PCR testing is more expensive than the more widely used tests, gives no more information than combination tests and has more falsely positive results than any of the other tests.

Given the NO RISK nature of the exposures you mention as well as your earlier negative test results, my strong advice is for you to not continue to worry about HIV from your exposure in China three years ago. It is clear that you were not infected.

This is my 3rd response to your questions.  Thus, as per Forum guidelines, this thread will be closed in a few hours.  Take care. Please do not worry.  EWH
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