[Question #4376] Oraquick accuract

28 months ago
hello doctors:

my question i think is really simple:

at or after 12 weeks past possible exposure, is the Oraquick test, if done 2-3x, conclusive, i should say, AS CONCLUSIVE, as a lab done test?

if it should me negative need i ANY other tests?

i cannot stand needles and find the Oraquick easier and really the only way for me.

thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
The oral fluids test (Oraquick) can miss up to 1-2% of HIV infections. With 2 or 3 negative tests >12 weeks after the last possible exposure, it is highly reliable, especially if the exposure was not especially high risk. If you didn't have unprotected vaginal or anal sex with a known infected partner, I would consider the results conclusive. So probably no need for further testing. But for 100% certainty, you need a lab based blood test. (You'll just have to decide which is worse:  continuing to worry about the extremely slim chance you have HIV or your needle phobia. It's your call.)

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

HHH, MD
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28 months ago
thank you. 

so, two follow ups here. 

the risk was very low and was years ago.  perhaps so low you’d not even consider a risk. 

i think i have done >5-8 Oraquick  all negative and all well over 3 months past exposure 

in terms of clarification i thought i had read previous comments by you and Dr Hook that after 12 weeks there really is no difference between Oraquick and lab based tests. 

can i be sure at this point?

thanks
28 months ago
the exposures were protected intercourse (never think any condom slipped or broke) and unprotected insertive oral mostly with csws.    all in the usa. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
When a particular risk is extremely low, or in describing test performance, we usually try to remember to qualify with terms like "virtually no risk", "conclusive for practical purposes", etc. For the average US resident without special risks for HIV, or a risk as low as yours apparently was -- and for the large majority of HIV risk questions asked on this forum -- a negative oral fluids test >3 months after the last exposure indeed can and should be considered conclusive.

"can I be sure at this point?" Yes, it would seem so. With the kinds of exposures described, there might be perhaps one chance in a 10,000 you caught HIV. With infection acquired "years ago", most persons would have had obvious health problems due to HIV, so if you are outwardly healthy, we probably can lower this chance ten fold, making the chance you have HIV one in 100,000. If we now add a test that misses 1% of infections (1 in a hundred), the likelihood you have HIV becomes 1 chance in 10 million. I certainly hope you would consider that low enough to be confident you aren't infected!

But if even this low chance leaves you worried and you continue to obsess about the possibility you have HIV, your only option is to bite the bullet in regard to needles and have a blood test. If I were in your shoes, I certainly would not feel the need. But as I said above, it's your call.
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28 months ago
ok, thank you for the math. 

the last possible exposure would have been at least 2-3 yrs ago i would think. 

and yes i am outwardly healthy for sure.   

i would guess that having done the tests 5-8 times and each being negative makes those odds ever greater than 1 in 10 million?

lastly: can we say case closed and no medical need at all for further testing with regard to hiv and i am not infected?

28 months ago
based on the information i provided of course!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Yes, I think we can safely say case closed and you're not infected.

That concludes the two follow-up comments and replies included with each question, and so concludes this thread. Best wishes and stay safe!
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