[Question #5952] Hiv test results after unprotected oral and protected vaginal

17 months ago
Hi. I had unprotected oral and protected vaginal sex with a CSW here in the Philippines last June 20. Due to my anxiety, I have gotten an HIV Test last Aug 27 (68 days) and turned out to be non-reactive. The test (based on the comments in the test results) was a HIV 1/2 AG/AB combo kit. For my questions:

1) Is the 68 days enough (9.5 weeks)to be conclusive for this kind of test? I researched it and it is a 4th generation test. Other websites and here in the Philippines do recommend testing at the 3 month mark again..

2) I have taken 5 urinalysis and 2 out of 5 test show blood present (rbc 1-3) and wbc (1-3). My latest urinalysis (Aug 15) shows no wbc and rbc (urin taken first thing in the morning). Given no symptoms (discharge, pain), should I still go for. gono and chlamydia urine test just to be sure? 

3) I have also tested for syphilis and hepa at the 68th day and all are negative. Should i go for herpes testing as well? I have no blisters or sores in my genital area at the moment.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Welcome to our Forum and thanks for your questions.  I'll be pleased to provide some information.  In addition, your use of a condom during vaginal sex will do much to protect you from STIs.  Receipt of oral sex is a far lower risk activity for acquisition of most STIs than vaginal sex so, although it would be best to use a condom for all sex acts with new partners, if you are only going to use condoms for one type of sex, you made the right choice.  Condoms, when worn throughout sex are very, very effective for reducing STI risk.  In answer to your specific questions:

1) Is the 68 days enough (9.5 weeks)to be conclusive for this kind of test? I researched it and it is a 4th generation test. Other websites and here in the Philippines do recommend testing at the 3 month mark again.
Your results are conclusive and there is no need for further testing. HIV tests done with a 4th generation test are conclusive at 6 weeks.  The suggestion that you need further testing is out of date and overly conservative. 

2) I have taken 5 urinalysis and 2 out of 5 test show blood present (rbc 1-3) and wbc (1-3). My latest urinalysis (Aug 15) shows no wbc and rbc (urin taken first thing in the morning). Given no symptoms (discharge, pain), should I still go for. gono and chlamydia urine test just to be sure? 
Both gonorrhea and chlamydia can occasionally be asymptomatic to the best way to be entirely sure is to test.  At the same time, most infections following the exposures you describe would be symptomatic so that if choose not to test you probably will be fine.  Testing is easy however and can be done on a urine specimen.

3) I have also tested for syphilis and hepa at the 68th day and all are negative. Should i go for herpes testing as well? I have no blisters or sores in my genital area at the moment.
Your syphilis results are entirely conclusive and do not need to be repeated.  We recommend against testing for herpes if you have not developed signs and symptoms which, if you had been infected, would have most likely appeared by now.  The blood tests for herpes are often falsely positive and misleading.

I hope that this information is helpful to you.  EWH
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17 months ago
Thanks Doc. I will check with my urologist and have a gono and chlamydia urine test. He did say before that my earlier urinalysis indicated that i dont have any of it. Not too sure if a normal routine urinalysis I have taken were conclusive (have taken 5 test already and results have been consistent)

Aside from that, are there any test I need to get done? I’m looking forward to having unprotected sex with my girlfriend. Although we do use condoms for vaginal sex to avoid pregnancy, I have avoided oral sex as I’m not too sure if i have other STIs

Finally, thanks for saying my test results were conclusive. My initial plan was to test again at the 12 week mark to make it “official”. I though the diagnostic center was not using 4th gen. I was pleasantly surprised that the comment section of the results did say ag/ab combo. My question is, how come some guidelines (like the one here in the Philippines) still say 3 months? Maybe because not everyone carries the 4th gen testing or just plain conservative? 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Thanks.  Certainly a very abnormal urinalysis would have been worrisome but urinalyses such as the one you report can mis as many of 25% of infections, particularly chlamydia.  Testing is the safest approach.

I see no need for other testing of any sort at this time.  You are in the clear.

I think the fact that some still recommend testing out as 3 months has several contributors including:
1. Being conservative
2. When newer tests are evaluated for FDA clearance, they use the same benchmarks for evaluation as was used in older tests and, as a result, report their results at the same time intervals as used with older tests despite clear evidence that they are conclusive much more quickly.
3.  Finally, I think that there is not enough consideration to the anxiety generated by having to wait longer for test results to be called definitive.  when this is unnecessary, it is very hard on patients.

Thanks again for your thanks. EWH
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17 months ago
Thanks for the assurance. I will go get a urine test specifically for gono and chlamydia just to make sure I’m in the clear. 

I’m still thinking of getting the same hiv test at the 12th week mark(that would be next week and my anxiety is already impacting my work in the office)  but I’m now leaning towards not to test again given my exposure, (as plenty of replies here in the forum, has very low risk) and i did my initial test way past 6 weeks. 

I will probably just raise another question once my urine test turns positive (even then, antibiotics would have been prescribed and on the path to being clear). Thanks again
17 months ago
Hi. I just got my PCR results for chlamydia and gonorhea and both came negative. I’m going back to my urologist for the results and reconfirm with him that i dont have to retest for hiv. He did mention that 9.5 weeks is enough to be conclusive on newer types of hiv test (4th gen). Thanks again for the advice. This has been a traumatic experience for me and looks like I’m not still comfortable with the protection i used (unprotected oral). Also, this experience made me learn about HIV as well. 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Thanks for your thanks.  We do our best and appreciate the feedback and I'm pleases to her of your results for gonorrhea and chlamydia- they are conclusive.  All of your results are now conclusive and you can move forward without continuing concern about the exposure we have discussed.  Take care.  EWH---