[Question #5472] HIV Risk? Elisa positive and WB negative test at 5 weeks

23 months ago

i am scared as hell over a possible HIV infection.

I went to a massage parlour on 6th April 19 and got a handjob. In the process, i touched her vagina on the outside and got my fingers moist. I didnt insert my finger. I then proceeded to touch her breasts as well as my own dick with the same hand. I forgot about her vaginal fluids that i might have left on her breasts and proceeded to lick her breasts for a minute or so. There was a 1-1.5 cm cut on my lower lip due to dry weather, i am not sure if it have been bleeding but i am sure the wound is not closed. Is there a risk here? She also proceeded to masturbate me off maybe with some vaginal fluids on my dick. I have read different things about HIV virus surviving in vaginal fluids, do they die almost instantly or otherwise? Also, are there any documented cases or cases that you have come across that have hiv transmission this way? 

We also kissed for maybe 5 minutes. my gums are not in the best shape and i didn't see hers. I just brushed my teeth about 2-3 hours before the whole incident too which caused some bleeding. If we are both bleeding, what is the risk for transmission?

I have since done a ELISA test which came back reactive and then a WB that came back negative on the 13 of May 19 . I am frightened to death that this might mean the WB is wrongly negative due to being in the window period. I am now waiting on the PCR test.

How much risk is there here? Are my actions a low risk event or a no risk event? :(
Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Welcome to the Forum.  I'll be glad to comment.  Here's the short answer.  The activities you describe were no risk events and no testing was required in relationship to those events.  You tested an were unlucky and had a false positive ELISA test, as proven by your Western blot assay.  If your ELISA had been positive the Western Blot would have been positive as well.  No to elaborate a bit and ask a few questions of my own.

1.  RISK. You do not know the HIV status of your partner.  Statistically it is unlikely that she was infected.  

2.  More on RISK.  Even if she was infected, no one has EVER been infected by HIV through transfer of genital secretions between partners during mutual masturbation- not ever.  the presence of a cut, the possibility of ingestion, or the fact that you were masturbated while her genital secretions were on her or your hands makes no difference.

3. More risk.  HIV is never been proven to have been transferred by kissing, even deep kissing with exchange of saliva.  

4.  Testing.  It would be most unusual in this age to be tested with a 3rd generation ELISA test or have follow-up testing for a positive ELISA be a Western Blot - both tests are largely out of date.   Are you sure this was how you were tested?  Where are you located.

What to do.  I would repeat the test using a 4th generation assay in a few weeks.  If positive the result should be confirmed with a test other than the WESTERN Blot such as an HIV RNA test.  EWH

23 months ago
Hi Dr Hook!

1) Glad to hear that my actions were off no risk. I am still disturbed by the fact that my ELISA came back reactive. since the ELISA is sensitive and accurate at more than 99% accuracy, i am binded by fear that it is correct. What are the chances that a 3rd gen ELISA antibody catches something that a Western blot couldn't at 35 days? If there were something, the WB should show as indeterminant at more than 30 days if i am understanding the studies right?

2) I have read in different forums that a transmission via a active bleeding cut is possible if you got body fluids in the wound, which might be the case on my lip. I am extremely worried about it due to licking her breasts which might have vaginal fluids i transferred from my hands. Does HIV die instantly when exposed to air? If not, how long? Having her vaginal fluids on my dick and then having it masturbated till i ejaculated poses a risk of having the virus being rubbed into the urethra? 

3) If kissing had involved long sustained kissing with both partners with bleeding gums, wouldn't the risk of transmission be very real? 

I have spoken to my clinical doctor who told me i had a 0.01% chance of infection which puts my extremely anxious mind to work. I took the option of going for the RNA PCR test and am now waiting anxiously on the results. 

4) Regarding testing, i am from Singapore and the test just writes HIV antibody test so i think it is a 3rd gen. Its a lab test with blood work so chances of a wrong result is even lower. My doctor who thinks my exposure is very low but possible advises me taking the test again in 6 weeks as per lab recommendations but i cant face this anxiety for 6 weeks so i went ahead and did the RNA PCR anyway. 

I am a nervous wreck these 2 weeks and i can literally do nothing but think about this. It has affected my sleep, appetite and general mood to do anything. I cant spend 10 mins thinking about anything else other than this. Please advice on how to deal with this if you can. 

Your help is much appreciated Dr Hook. I am hanging onto all your advices while waiting it out in the toughest time of my life. 

Edward W. Hook M.D.
Edward W. Hook M.D.
23 months ago
Much of what you have just said was already addressed in my earlier response.  Repeating the question is not going to change the response.  Directly to the follow-up questions:
1.  It is standard operating procedure to confirm a positive ELISA with another unrelated test such as a Western blot.  If you had acquired HIV your Western blot would have been positive or at least equivocal.  You stated yours was negative.  You had a false positive ELISA. (repeat message).  Confirmatory testing is an essential part of testing for HIV just because of situations such as yours.

2.  Another repeat question.  HIV becomes non-infectious immediately upon exposure to the air and environment.  While HIV might theoretically be acquired through exposure of an infected cut there are no such instances related to the situation you describe.  Same for licking her body that might have vaginal secretions on it.  

3.  Another repeat question.  Same response.  HIV is NOT transmitted by kissing, including deep kissing with saliva exchange, even when both parties have gum disease, oral bleeding, dental problems or mouth sores.

Your doctor's estimate is too high if anything.  I am confident your HIV RNA test will be negative.

4.  I agree with this recommendation.  If for no other reason, you need to repeat your test for your own peace of mind.

I hope repeating my earlier answers will be helpful.  EWH