[Question #568] is 16 day 4th gen & 3 month oraquickn swab home test enough?

39 months ago
Hi doctors.
I am 25 years old male and never had any sexual exp till last sept when i was in dubai...i had 2 back to back exposures with CSWs 1. Involved her performing protected oral on me and me performing UNPROTECTED oral on her. 2 was just mutual masturbation and protected blowjob on me. I paniked almost the next day about hiv. Which led me to get a 4th gen ab ag test on 16th day after exposure at a well known centre in india. The test was non reactive and the head pathologist told me that i dont  need to worry any more or do any more tests...but you know how anxity works...because i am getting married very soon I dint want to take any risks so i waited it out....4 months after exposure in jan i took an oraquick home base swap test in USA which was negitive as well. I was ready to put this all behid me till last week when a numb toe flaired my anxity again and i begain searching the net..i found out that the oraquick tests do show false neg and that hiv causes neurophaty...which is why i am here to get some expert advice. My questions are
1) with my exposures how much of a risk have i put my self in to
2)is my 16 day ab ag test any good? Was the head pathologiest advice to not test further valid?
3)do oraquick test really gives alot of false neg or can i considr it as conclusive
4)can eating and drinking or chewing gum give false neg? Because i think had gum before testing. Can it dilute the antibodies
5)between the two neg tests i had...what r my odds of having hiv
6)ur advice for my next steps..should I get over it or get tested again.

Thank you .
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago

Welcome to our Forum.  I'll be happy to answer your questions. 

1) with my exposures how much of a risk have i put my self in to
The exposures you list are no risk exposures. Most commercial sex workers do not have HIV, including those in Dubai.  In addition,  there are no reported cases of men getting HIV from receipt of oral sex from an infected person or from performing oral sex on an infected woman.

2)is my 16 day ab ag test any good? Was the head pathologiest advice to not test further valid?
I suspect that the advice give to you by the pathologist was based on the exposures you had (no risk) as well as the test results.  While the 4th generation antigen/antibody tests provide definitive results 28 days after exposure, there are some infected persons who will have negative tests at 16 days.  Your test, while providing some evidence that you were not infected was too early to be definitive.

3)do oraquick test really gives alot of false neg or can i considr it as conclusive
No, the Oraquick tests give reliable results after 8 weeks.  You should believe the results form your 13 week test.  You were not infected with HIV by the exposures you described.

4)can eating and drinking or chewing gum give false neg? Because i think had gum before testing. Can it dilute the antibodies
No, eating or chewing gum before the oraquick test would not change the test reliability.

5)between the two neg tests i had...what r my odds of having hiv
You should be confident you were not infected.

6)ur advice for my next steps..should I get over it or get tested again.
There is no need for further concern related to the exposure you have described.  I recommend that you move forward without concern.  No further testing is needed.

I hope this information is helpful to you.  EWH
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39 months ago
Hi Doc...
Many thanks for your reply..its released alot of stress...now just a quick follow up question for my closure (and i know this might sound repetative hence bare with me)
1.is one oraquick test enough at 16 weeks...then why do i see in forums alot of people having multiple tests.
2.there is a talk about 1 in 12 people having a false neg on oraquick home test.whats all that about? (I hope you did notice that i had taken the home based oral swab oraquick test)
3.i never had any symptoms...but can my numb toe be a nerophaty cased by hiv?
4.is oral sex considered no risk even if i have an open cavity in my mouth where the filling fell off? 
I think with this i am looking forward to move on. Your help is appriciated.

Thank you.

39 months ago
Hi Doc....I am waiting in anticipation for your reply..and i request you not to consider this as my second follow up question. Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago

Answers below. sorry for the delay

1.is one oraquick test enough at 16 weeks...then why do i see in forums alot of people having multiple tests.
People who test repeatedly beyond the time recommended are anxious and often have unjustified fears fueled by their own guilt, shame and mis-information obtained from the internet.  As I have already said to you: "No, the Oraquick tests give reliable results after 8 weeks.  You should believe the results from your 13 week test.  You were not infected with HIV by the exposures you described."  Obviously this means a single test at 16 weeks should be sufficient.

2.there is a talk about 1 in 12 people having a false neg on oraquick home test.whats all that about? (I hope you did notice that i had taken the home based oral swab oraquick test)
I answered this question too.  OraQuick tests are approved by the FDA.  If you followed the instructions, your test is reliable.  The idea that OraQuick tests miss 1 in 12 infections (8%) is not consistent with the scientific data on the test.  If you got this information from the internet, please see my comment about this above.

3.i never had any symptoms...but can my numb toe be a nerophaty cased by hiv?
How can a person have HIV neuropathy of they do not have HIV?  Your tests are negative, reliable and should be believed.  You should look for another reason for your numb toe.

4.is oral sex considered no risk even if i have an open cavity in my mouth where the filling fell off? 
See my earlier comments on oral sex.  Just as chewing gum does not effect your test results, nor does having a filling that fell out, poor dentition of a sore in your mouth effect your risk meaningfully. Further, as I have said before , your results are reliable and should be believed.

I am not sure why you are having such trouble believing that you did not get HIV from the exposure you have described.  I hope that my comments will be helpful to you in moving forward.  EWH


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