[Question #4921] MORE HIV WORRIES, TESTING, ETC. (FOLLOW UP TO #4864)

27 months ago
Dear Doctors, 
I am trying to put my worries behind me over a non-penetrative hot tub incident that occurred in July of last year, but am having difficulty. Again, with a female partner, there was lost of mutual masturbation, possibly with each others fluids on our hands, but nothing insertive (oral, vaginal or anal, maybe brief contact). Most all contact was in or just above water. I tested negative with the Alere Determine 1/2 Ag/AB test 10 weeks after the incident. 
I called the clinic where I was tested and they said that while the results of the test are encouraging, they stopped short of saying they are conclusive due to the 3 month window period. I have also read on some other health organizations' websites (I know, the internet is not the place to go for this) that they will not consider rapid tests conclusive until 3 months. 
Also, about a week ago, I had oral sex with my partner. At the time, I was not too worried about this after getting some reassuring  responses here, but since then, my anxiety has increased again. I did not ejaculate in her mouth, but I am sure there was some pre-ejaculate fluid in her mouth. I did see in a recent  question in the forum here that generally oral sex in either direction is safe and that a good amount of the HIV virus needs to get into mucous membrane deep within the body to cause infection. However, I have also been dealing with a cold/sinus thing for over two months, voice issues (nodule on cords), and diarrhea/loose stools (about 2 weeks). This  really has me worried, like I am exhibiting symptoms .
So, I suppose my questions are
1) Did I put my partner at risk?
2)  Since my rapid test was about 2 weeks short of 12 weeks, should I be retested?  
3) Its the reliability of rapid tests at 10 weeks in question? (I may have even seen that come into question in this forum)
Thanks you again doctors..., I'm truly sorry for the anxiety. Just looking for more reassurance I guess.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
This is your fifth question on the same exposure. The answers are the same in the previous four and so my comments now are very brief. First, you were not at risk for HIV. Second, your symptoms are meanginless:  HIV doesn't cause cold/sinus symptoms, vocal cord nodules, or loose stools. So the answers are:

1) You don't have HIV and therefore could not put your partner at risk.

2,3) The same question twice, using different words. It is extremely rare, if ever, that a negative test at 10 weeks would be positive at 12 weeks. And since you weren't at risk, you didn't need testing anyway.

Please note the forum does not permit repeated questions on the same topic. This will have to be your last one; future new questions about obviously low risk exposures may not be answered, in which case the posting fee will not be refunded. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than relieving them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.
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Really, mellow out. There is simply no chance you have HIV. If you continue to obsess and worry about it, I suggest professional counseling. It is not normal to remain so concerned after the repeated, reasoned, science-based reassurance you have had.
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HHH, MD---
27 months ago
Thank you doctor. I will move forward from this without worry and wiser in a lot of ways. My apologies for being so anxious. Quite honestly, your brief "admonishment" of sorts has done wonders. Of course, I should and do believe you and your  science based reassurance. Again, my apologies for being a doubter. :-)
I guess just as a general follow up, honestly not because I am anxious, but maybe more curious and a bit confused I suppose...I would be willing to bet that I am not the only one who is confused about the different types of tests that are available for HIV and how they are used. When  people talk about testing here, its often unclear what types of test they have had. RNA and NAAT are lab test correct? Anything else would be rapid?
It also seems that the the fourth generation duo rapid fingerstick tests are the standard for screening. If they are negative after four to six weeks, no further testing is required,correct? If one happens to be positive, further lab based testing is required, yes? And there still  seems to be that standard of the "12-week" window period that I suppose freaks some of us out. But as you've said, that's a conservative guideline from the CDC that sounds like its more CYA than anything.  
So I suppose this can be my follow up question, more for educational purposes. Thank you again for your help doctor. This is truly a wonderful service, and let me apologize one last time for the anxiety. Best to you and yours!!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
You're asking for more than prctical on a forum like this. I'll just say that the 12 week window period is old news, dating back to the early antibody tests first used 20-30 years ago and no longer in use. The oral fluids test can take up to 12 weeks, but all other tests on the market are valid within 6-8 weeks of exposure (and mostly are positive by 3-4 weeks). Most blood tests are done in the lab -- not only NAAT.  Beyond that, you can easily do your online research if you want more details about available hHIV tests.

Thanks for the thanks. But let's make this your last question along these lines.
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27 months ago
Thanks for the reply Doctor.  I definitely feel much more reassured. Hopefully, I can find some explanation for the vocal issues and the sinus related stuff.  As you said previously, it could be allergies further exacerbated by the cold I had.  Again, thanks for such a great service and my apologies for the excessive worry! Best to you and yours!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Allergies and/or colds certainly casue the vast majority of such symptoms. HIV would never enter an experts mind as a possibility. Don't worry about that aspect.

Thanks for the thanks, i'm glad to have helped. But this has to be your last question on these issues. Take care and stay safe.
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