[Question #5279] Happy ending and anal fingering

24 months ago
Thanks for taking the time to review my questions

Have had a couple “happy ending” massages, few times the lady inserted her finger into my rectum- no other sexual contact 

I took a rna early detection test and 4th gen blood test 13.5 days after the last time I had a “massage”

Both tests came back negative for HIV
Are these test considered Conclusive

I was debating getting another 4th gen test today at day 21 just for peace of mind

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Welcome back to the forum. Thanks for your continued confidence in our services.

My answers are similar to Dr. Hook's in your previous thread. Both your questions asked about sexual exposures not involving intercourse or direct genital-genital contact. With only very rare exceptions, there is no STD risk if a bare penis (no condom) does not enter a partner's vagina, rectum, or mouth. As for the events described to Dr. Hook, there are no known cases of HIV or other STDs resulting from hand-genital contact or fingering any orifice -- vagina, rectum, mouth or any other orifice you can think of. While I understand when people have HIV tests "just to be safe", or because the test result may be reassuring, it's overdoing it after an event like this. There is little chance your massage partners had HIV (the large majority of female sex workers do not), but even if she did, these were entirely zero risk events and you did not need testing.

Are your current tests conclusive? By themsevles, not quite. The RNA tests detect 90-95% of infections at 2 weeks and the antigen-antibody (AgAb, 4th generation) tests about 6-70% at that time. But statistically, the results are conclusive. If your risk was 1 chance in a million, with these test results, the chance you have HIV is now no higher than 1 in 20 million. I hope you would agree that's zero for practical purposes. But if you feel you need an absolutely conclusive test, have another AgAb test at 4 weels (but not 3 weeks):  the combination of this with the negative RNA test will be conclusive. You can be sure of a negative result, and if I were in your shoes, I wouldn't waste the money and would never have stopped having unprotected sex with my wife.

Please take Dr. Hook's advice and my main paragraph as conclusive. In the event of future sexual adventures, you should not need to ask about any exposures that don't involve unprotected vaginal or anal intercourse or oral sex.

I hope these comments are helpful. Let me know if anything isnt' clear.

HHH, MD
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24 months ago
Dr
Thank you for reviewing my question and providing me with your expert advice last Monday- today is the 28th day

Technically tonight around 10pm PST would be 28 days.  If I take a 4th gen test this afternoon a few hours - 7 hours shy would that still provide enough time for a conclusive result?

I also owe you an apology, anxiety got the better of me and I tested at day 24-negative- against Dr’s orders!  Please feel free to give me the proverbial smack on the wrist for not listening 

Thank you !
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
There's not nearly that much precision in the data. Probably no difference in test reliability between, say, 26, 28, and 30 days -- and certainly no difference within a few hours.

You should view your 24 day negative result as conclusive. See my comments above about how test reliability interacts with risk. At 24 days, the AgAb test is around 90% conclusive. If the chance you caught HIV was 1 in a million, now it's 1 in 10 miillion. Even if you had had unprotected vaginal sex with a known infected partner, your risk would have been 1 in 2,500 -- and with this test result now 1 chance in 25,000. Close enough to zero to be highly reassuring.

If you go forward with any additional tests, I'll be happy to comment one last time. But that will be your last opportunity -- we'll reject any further new questions about this exposure, your HIV fears, test interpretation, etc. OK?
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24 months ago
Dr
Thank you for helping me through this process- I appreciate your expert advice and guidance 

Just received my negative test results taken on the 28th day.  

Hopefully this test along with a negative RNA test at 13.5 days should suffice as conclusive results 

I understand this thread will be closed- time to move on

Please keep doing what you do!  Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Glad to hear of your negative test results, but of course not at all surprised! Indeed these results are conclusive.

Thanks as well for your kind words. Take care and stay safe.
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