[Question #5180] HIV Risk and Conclusion

25 months ago
Hello Doctors:
I had a HIV risk that included unprotected  vaginal sex.  The person was of unknown HIV status.  She may have been of Chinese /African American descent, but I couldn't tell since I was quite drunk. 

I've had the following tests carried out so far:

10 panel STD test with HIV RNA test on the 8th day since exposure-  All were negative except HSV-1.  Not concerned about HSV-1 since I understand that 75% of the world has this. 

On the 13th day since exposure I did an Oraquick which was negative.   I know that does not tell much, but any negative test is a good test in my book. 

On the 14th day since exposure I did a 4th Generation Duo and another HIV RNA test.  Both were negative. 

On the 24th day since exposure I did another Oraquick swab test.  This was negative. 

On the  33rd day since exposure I did one more Oraquick swab test.  This was also negative.  

Can I consider this conclusive since I have a 14 day negative HIV RNA and Duo test that is negative followed up by an almost 5 week antibody Oraquick test?

Thanks for your help. 

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome to the Forum.  I'll be glad to comment.  I presume this exposure took place in North America.  If so, even before you began testing the likelihood that you were even exposed is low. Fewer than 1 in 500 women in the US have HIV and the risk for infection from a single act of unprotected intercourse if your partner was infected is less than one in 1200.  Thus even before you tested, your risk for infection was less than 1 in 200,000.  Your testing makes infection far more unlikely.  The Oraquick test does not give reliable results until 8 weeks BUT with your 14 day RNA test well over 99% of infections would be detectable (the manufacturers claim 100% but most experts are a little bit conservative).    This makes the likelihood that you acquired HIV from the exposure less than 1 in more than 20 million.  If you want completely conclusive results, the fastest way to get it would be to get a combination HIV antigen/antibody test at some point more than 42 days after the exposure.  Personally, at this time, I certainly would not worry and would not both with additional testing.  Either way, there is little to be gained from further testing with the OraQuick.

I hope that this comment is helpful.  EWH
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25 months ago
It was in North America. What if the woman was a CSW?  Again, I was quite drunk.  Does that change your conclusion?  Also, the RNA test was more in the range of 13.5 days, not a full 14 days. Also, I’ve seen Dr. Handsfield mention that a combination of a 4 week antibody test (Oraquick) with the RNA is essentially conclusive. Is this your feeling also?
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
If she was a CSW it changes your risk a little but not much.  It does not meaningfully change my assessment.  I really would not be worried in the least.  EWH---
25 months ago
So in other words, it’s safe to move on with my life and quit worrying about this?  I can quit buying all theses tests?  
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Precisely.  I encourage you to move on..

As you know, as this is my 3rd response.  Thus, as per forum guidelines, this thread will be closed shortly without further responses.  Take care.  EWH
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