[Question #476] Oraquick in-home test

38 months ago

Dear Doctors -

On mid-July 15 I had my first exposure with a sex worker. This exposure consisted in having oral sex (giving and receiving) without protection and also I felt some liquid coming from her on my genitals and I had shaved it. On the next month after this encounter I had no symptom related to ARS. On late September-15 I had another exposure with sex worker, but this time fully protected and without any penetration (however I took a fast shower in her bathroom). After one month I got a very itchy skin (legs) and some rash appeared. This symptom lasted one month and during this period, I had no other symptom. In December 2015 my anxiety started disturbing me a lot and then I couldn’t sleep well and I had some hot flashes, missing air, diarrhea (three times a week, only one visit at the bathroom a day at a time), and strong heart beats, itchy skin, sore throat, burning mouth, pain in my back.

On Dec 19th 2015 (22 weeks from 1st encounter and 12.3 weeks from 2nd encounter) I got very anxious about these encounters and I bought an Oraquick in-home test. The test came back negative. Just to make sure I did everything correctly, on Dec 21st 2015 (22.4 weeks from 1st encounter and 12.6 weeks from 2nd encounter) I tested Oraquick again. The test came back negative again. My anxiety was killing me and then I waited some days and on Jan 7th 2016 (25 weeks from 1st encounter and 15 weeks from 2nd encounter) I tested Oraquick again. The test came back negative again. The final Oraquick test was on Jan 17th (26 weeks from 1st encounter and 16.4 weeks from 2nd encounter) and the result was negative.

My questions:

1) Is Oraquick in-home test reliable?

2) At this time, if I was infected, would this test detect it?


Thank you.

Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome to our Forum.  I will be glad to comment.  The exposures you describe are very low risk. There is no known risk of HIV acquisition from receipt of oral sex if your partner was infected and it is unlikely that she was.  Similarly there is no proven risk of HIV acquisition from performing cunnilingus on an HIV infected partner.  Finally even after recent shaving, there is no risk from contact with an infected partner's genital secretions on your skin.  Thus your exposure was a sensually no risk.

As for your other exposure, condom protected sex is safe sex.

In addition to the no risk nature of your exposure, your test results prove that you were not infected.  The OraQuick HIV tests provide reliable test results eight weeks following an exposure. Thus you have multiple test results which prove that you were not infected.

At this time there is absolutely no reason for concern and no reason for further testing. You did not acquire HIV from the exposures you have described. I hope my comments are helpful to you.  EWH 
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38 months ago
Dear Dr Hook,
I'm glad you answered my question. I have further questions and I hope you help me. I'm sorry if I'm asking the same question in a different way, but I just want to double check my understanding and move on.
1) As I described on my first message, I took a fast shower in the sex worker bathroom, and I used her liquid soap to wash myself and a clean (apparently) towel to dry. Is this a risk of infection?
2) When I took the latest Oraquick in-home test (Jan 17th 2016) I was taking bacterial lysate 3.5mg and Ibuprofen 100mg/ml. Can these medicines interfere/modify on the Oraquick test result?
3) At this time from all exposures. Can I be 100% confident on the Oraquick in-home test result? Do you think the accuracy of this test is close to 100%? 
4) Do my symptoms resemble ARS? I forgot to say that I lost 10 lb in 4 months (what I know is that I did eat less than usual).
5) Do you think I have to take another type of test or this is enough for determining my status?
Thank you again.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

Sorry I missed your earlier follow-up questions.  Replies are below:

1.  No, STIs, including HIV are not transmitted by using another person's soap or on inanimate objects such as dry towels.

2.  No, neither bacterial lysate nor ibuprofen would effect the results of HIV tests in any way.

3.  Yes, be completely confident in your test results. 

4.  The ARS is  a severe, flu-like illness with high temperatures, strong muscle and joint aches.  It typically lasts less than a week.  The symptoms you suggest are not suggestive of the ARS.

5.  I see no reason for further HIV testing related to the exposure you have reported. 

I hope these replies are helpful.  Again, I apologize for the delay in getting back to you. EWG

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38 months ago
Dear Dr Hook,
Thank you for replying. No problem for the delay in getting back to me, I'm afraid you are a very busy man.
My last follow-up question.
1) Regardless the exposures I described, in your opinion, how reliable are OraQuick in-home HIV tests after 12 weeks? 
2) General knowledge question. Do ARS symptoms walk together with HIV antibody production? I mean, if a person has ARS symptoms it means that this person is producing antibodies and then some tests can detect the virus?
3) General knowledge question. How risky for HIV is the unprotected oral sex with a transex escort? I've read some comments that says there's almost no risk. I would like to know your opinion. 
Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

As per Forum guidelines, this will need to be my final (i.e. third) response.  Further, these questions are somewhat repetitive:

1.  As noted above, your 12 week results are conclusive and should be believed.  The OraQuick tests are held to the same performance standards as other tests for HIV antibodies such as those performed in the lab.

2.  Yes, ARS symptoms correspond with HIV antibody production.  Within days and certainly within a week of the onset of the ARS, HIV antibody tests will be positive.

3.  Oral sex is very low risk.  As I said before their are no known cases in which HIV has results from either cunnilingus or receipt of oral sex.  There are a handful of cases of HIV which may have been acquired by persons performing oral sex (fellatio) on an infected partner.

To close, once again, I urge you to accept your test results and to believe that you did not get HIV from the low risk exposures you have described.  There is no reason for further concern or testing related to the exposures you have described.  EWH

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