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 19^th 2015 (22 weeks from 1^st encounter and 12.3 weeks from 2^nd 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 21^st 2015 (22.4 weeks from 1^st encounter and 12.6 weeks from 2^nd 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 7^th 2016 (25 weeks from 1^st encounter and 15 weeks from 2^nd encounter) I tested Oraquick again. The test came back negative again. The final Oraquick test was on Jan 17^th (26 weeks from 1^st encounter and 16.4 weeks from 2^nd 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.

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.---

Dear Dr Hook,

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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Dear Dr Hook,

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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