[Question #6958] Conclusive Results?

11 months ago
Hi doc, just writing in to see if my results would be conclusive at the point I'm currently at. On February 29th of this year, I had unprotected heterosexual intercourse (for the first time) with a friend of mine from college, which consisted of a blowjob (me receiving for about 30 seconds) and me rubbing the head of my penis against the outside of her vagina for 10 seconds, with maybe half an inch of my tip going just inside. From what I've gathered, this seems to have been an incredibly low risk situation, but I have some questions nonetheless. In addition, she says she got tested last summer, and had no STDs. If it wasn't clear, I was also a virgin up until this point.

1. In my current situation, I can't get to a hospital or other health center to get a blood test done, so I've been relying exclusively on Oraquick. Thanks to my OCD, I ended up using 7 of them in between 9.5 and 12 weeks - all of which came out negative. At this point, is it safe to say that those results are legitimate?

2. I also read that certain immunodeficiencies can possibly impact the production of antibodies, and thus the results of Oraquick and other 3rd generation tests. I've had what I believe to be post-nasal drip for a good chunk of my life - indicated by excess phlegm production, with no other obvious symptoms. Other than that, I am a completely healthy, in-shape 20 year old male who works out on a regular basis. Is post-nasal drip (or other sinus issues) a sign that I might not be producing enough antibodies to trust my results? Or is it more severe immunodeficiencies that affect antibodies?

I know I'm probably overreacting, as this wouldn't be the first time my anxiety issues have gotten the best of me. Thank you so much for your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Thanks for your question, as well as for your confidence in our service.  I'll be glad to comment.  As you point out, the event you describe we very, very low risk.  It is unlikely that your partner had HIV and no one has ever been proven to have acquired HIV from receipt of oral sex.  similarly, rubbing your penis on her vaginal is a likewise no risk event.  Thus the only even potential risk was your brief shallow penetration.  since then you have over tested but the results of your tests likewise prove that you did not acquire HIV.  To answer your specific questions:

1.  Your 12 week results are certainly accurate and should be believed.  Time to stop testing.

2.  Post nasal drip and increased mucus production are not signs of immunodeficiency and would not change the accuracy of your test results in any way.  You would certainly be producing antibodies if you had acquired HIV.

Bottom line, your exposure was very, very low risk and your subsequent testing has proven that you were not infected.  Further testing would be a waste of time and resources.  I encourage you to stop testing and mover forward without lingering concern.  EWH

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11 months ago
Hi doc, stopping by again with an update. Earlier today, I stopped by a nonprofit STD clinic in my area and got a free Alere fingerprick test, which - of course - came out negative. Just to wrap things up once and for all, I have two more questions.

1. Does it matter which of the Alere tests (Determine or Combo) I used? I know both are 4th generation, but is there a significant difference between either?
2. It's been exactly 14 weeks since my incident. With the negative Oraquick results and the negative Alere results, can I finally move on with 100% certainty?

Thank you for your help!
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Straight to your follow-ups:

1.  There is no difference between the two 4th generation tests other than test formats.  The results are equally valid.
2.  Yes, as I indicated before, it is past time for you to move forward.  There is no reason related to the events you described for further testing.

I hope this helps.  EWH
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10 months ago
Doc, sorry to bother you one last time.  Thank you so much for your help so far.

2 weeks and 4 days ago, I was helping clear some old junk out of a grassy lot on a private property, with thin leather gloves on. Near the end of the day, while I was looking through the bed of an abandoned truck, I felt a sharp pain on the base of my index finger, and realized that I had been poked by something.  Whatever it was lasted for a fraction of a second, and I'm pretty sure it was either a thorny branch or (worst case scenario) an abandoned needle.

I've read on here and from other reputable sources that there have been 0 confirmed cases of HIV ever from somebody getting pricked by an outdoor needle, as it dies relatively quickly outside of the body. Given the turbulent weather in my area, I feel inclined to believe that if there was indeed a needle, the elements would have easily dealt with any remnants of the virus. 

Should I bother with testing? Or given the astronomically low risk of this event, should I just move on? I haven't had anything resembling ARS symptoms since then.
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
As you point out, if you were to acquire HIV from the puncture you describe, you would be the first.  I would make sure your tetanus vaccinations are up to date but would not worry otherwise and specifically would not worry about HIV.

I hope the information I have provided has been helpful to you. As you know, with this third reply my responses to this thread are now complete. As perform guidelines, the thread will be closed shortly. Take care. EWH
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