[Question #6293] HIV Concern

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69 months ago
Good afternoon - I have a question that I hope can be answered and give me some peace/clarity. I have read through a lot of posts on this forum, and I am quite impressed with both Dr. Hook and Dr. Hansfield’s vast knowledge on the subject. 

I am a 29 year old straight female. Here’s some background... 

I had an unprotected sexual encounter on January 1 with a friend. Known him forever, and wasn’t worried. However, he did use to be a drug user. He had been clean for years. After the encounter, a family member mentioned they thought he was using again. I freaked out, and at the end of February (8 weeks later) went to the health clinic and had a full STD panel done - including HIV. Everything came back negative. I believe this was an antibody test only. My anxiety subsided and I was assured I was fine. 

Then in June of this year - I had another encounter with a former boyfriend. A condom was used. However, during intercourse, he took it off without telling me. I noticed pretty quickly, and told him that if he wanted to continue, he would need to use protection. He put it back on and we finished. Not sure how long we were without one, but I am confident it was for a minute at most. I noticed pretty quickly. Then the HIV anxiety came back. 

9 weeks later (middle of August) I took an Oraquick at home test. Negative. 
At 11 weeks (79 days) I ordered an HIV test from MyLabBox which uses dried blood spot, and testing from a finger prick. Again the results were non-reactive. 

Should I be assured by these results from my latest testing or should I seek testing by laboratory - blood from a vein? I’m pretty anxious by nature and tend to be a bit obsessive as well. So, of course, every small malady lately is HIV. I was quite distressed by the former boyfriend taking off the condom when I was adamant about it. And since then - I have only had protected sex. Any insight would be helpful! Thank you! 
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Edward W. Hook M.D.
69 months ago

Welcome to our Forum and thanks for your questions, as well as your confidence in our services.  I'll do my best to help.  I'll focus my comments on HIV which is the problem that you appear most concerned about although much of what I am saying will pertain to other STIs as well (I presume your MyLabBox tests was one of the panels which included tests for other STIs such as gonorrhea, chlamydia, trichomonas, etc.).  First a comment on your partners.  Most people, even most persons who have used drugs in the past do not have STIs and most single unprotected encounters with infected, untreated persons do not lead to transmission (chances of getting HIV from any single encounter with an untreated, infected person is less than 1 in 1000.  Further your testing provides almost certain assurance that you were not infected by either of the encounters you describe.  As I read it, you have now tested several times since the interaction with your friend and had you been infected one of those tests would have certainly been positive.  Regarding your June encounter, you had another unprotected exposure.  While shorter exposures most likely have a lower probability of leading to infection, the precise relationship of the duration of exposure to likelihood of infection is unknown so testing was a good idea. 

More and more people are choosing to do their testing with home tests such as you did.  My own personal experience with MyLabBox is limited but I have reviewed material from them on-line and everything I can find indicates you should have confidence in the results you had.  Certainly a test taken 11 weeks after an exposure your be completely reliable.  Further, I note that on their ads then note that they have been certified for their performance by CLIA, one of the nations most widely used lab certification services.

I do not see a need for further testing or for testing using venous blood.  You should certainly be in the clear and there should be no need for further testing related to the encounters yo u have described.

I hope these comments are helpful.  EWH

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69 months ago
Thank you, Dr. Hook! They are extremely helpful. I have my annual OBGYN checkup in December, where I annually check for everything just in case. I’ll probably still have the doctor test for everything then just for additional peace of mind. 

Just to reiterate- my 11 week negative, even with dried blood spot, finger prick - should be conclusive? 

My anxiety just gets the best of me sometimes. Especially when I have tried to be proactive and someone takes that choice away from me! 

Thanks again! 

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Edward W. Hook M.D.
69 months ago
Yes, your 11 week, dried blood spot HIV test result should be believed.  This method of testing (using dried blood spots) as been carefully evaluated and is highly reliable.  Please don't worry.  EWH
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69 months ago
Dr. Hook, 

Thank you again for your reassurance! 

It is greatly appreciated!