[Question #7027] HIV Rapid Test

8 months ago
Drs, I’m a male and in February 2019 I was in Florida for a business trip and I met a girl (age 29) at a bar. Long story short, we went back to her place and we had condom protected vaginal sex. After awhile, she removed the condom and gave me oral. We then resumed vaginal sex without a condom. About 2 days after exposure I experienced intense burning in penis with a never ending urge to urinate. This lasted approximately 7 days until I went to a clinic and got an STD test. Test included penis swab for chlamydia and gonorrhea, blood vein draw for syphillis and HIV. Dr gave me multiple day dose of antibiotics for possible chlamydia and a shot for gonorrhea. Tests results came back couple days later and was negative for everything. Since then I’ve been constantly worried about HIV since I have learned my 7 day test was too early.  I’ve had the following: 
1. Negative at home Oraquick tests at 8,10,12 and 17 weeks
2. At 20 weeks went back to STD clinic and they gave me a rapid fingerpick HIV test (not sure what generation). Results were negative
3.  Negative at home Oraquick test at 35 weeks

Can I believe my results that I am HIV negative or should I get more tests done? 
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

Welcome back to the Forum and thanks for your question.  I'll be glad to comment and am pleased to reassure you that your test results prove that you were not infected at the encounter you described. 

It was a relatively low risk encounter (most women do not have HIV and even when they do, HIV is transmitted on average only once for every 1200 acts of vaginal intercourse (i.e. 99.9% of the time HIV is NOT transmitted when exposed to an infected partner).  More importantly however, your tests prove that you were not infected.  The Oraquick tests sometimes take slightly longer to become positive but your test would certainly have been positive by the time you tested at 12, 17 and35 weeks.  Furthermore, the finger prick test, which uses a different technology from the OraQuick would have also been positive at 20 weeks.  You can be absolutely confident that you did not acquire HIV from the encounter you describe.  There is no need for further testing.

I hope that this information is helpful.  EWH

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7 months ago
Thanks for the reply, that has definitely calmed my nerves. I have read through a large amount of other posts and some other searches that the Oraquick is only 92% accurate and they are never, at any point in time, conclusive. Is that accurate? Also, are the rapid finger prick tests as good as blood that is taken from a vein and sent to a lab (I.e 4th generation) test? 
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago

It sounds like you may be looking for answers on the internet- bad idea.  Much of what is to be found there is out of date, taken out of context or just plain wrong.  Particularly early in the course of infection (the first few weeks) a single OraQuick is not quite as accurate as tests performed on blood. Your three tests, plus the finger stick blood which is as accurate as laboratory based tests however absolutely prove that you were not infected in the low risk encounter that you described, as I said and explained in my original reply.  No change in my assessment or recommendations.  EWH

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7 months ago
Thank you, I have accepted my results and will move forward. I believe I have 1 more exchange so I thought I would ask about the initial ‘burning sensation’ in the tip of my penis and constant urge to pee that developed 2 days after the exposure. I tested negative for both chlamydia and gonorrhea but was treated for both, before tests results were back. The sensation went away and has not returned since (17 months since exposure). In your opinion could this have been caused by trichomoniasis or mycoplasma genitalium and should I be tested? Can the immune system rid of these without treatment? I’m just concerned about possibly passing it on to my new partner. Thanks again for all you do! 
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
At this time I see no reason for testing for either mycoplasma genitalium or trichomonas. Your vaginal exposure was condom protected and neither of these infections is transmitted through receipt of oral sex.  Thus your risk of these infections from the exposure you described is very, very low risk. Further with respect to part two of your question, when these infections do occur, the body can eliminate them without medicinal therapy with the passage of time. If you had those infections, which is very unlikely, they would almost certainly have been resolved by now.  Please see no medical or scientific reason for testing for these organisms at this time.

I hope the information I have provided has been helpful to you. As you point out with this third question, this thread is now complete and will be closed shortly without further answers. Take care. Please don’t worry. EWH
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