[Question #7640] Accuracy of Ultrasensitive RNA PCR Test

2 months ago
I’m in a quite deep anxiety and would want to know more about the RNA test. 

I asked a question few days ago and Dr. Hook gave me an answer that my risk is close to zero, and it did reassured me a bit, but then I just can’t move on still. I asked the clinic today and they said there’re 2 test that can test for HIV within a week, which is the Ultrasensitive RNA and a normal RNA test. 

I would want to know, beside talking about the risks, how accurate is the Ultrasensitive RNA test on around 10-11 days? I really wanna move on and get out of my anxiety, which is killing me now. Will a Ultrasensitive RNA test be conclusive on 10days? Thanks  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Welcome back, but I'm sorry you found it necessary. We cannot help any further -- I read your discussion with Dr. Hook and agree with all he said.

The exposure you described was extremely low risk and, like Dr. Hook, I see no need for testing for HIV. But assuming you're going to do it anyway, the RNA tests probably detect around 90% of new HIV infections at 10-11 days; they are 95% reliable af 2-3 weeks. I am unaware of an "ultrasensitive" RNA test; my understanding is that all RNA tests are the same. (If a lab is calling its test "ultrasensitive", that probably is just marketing hype.) For truly 100% testing certainty, you should also have an antigen-antibody (AgAb, 4th generation) blood test 4-6 weeks after the event.

HHH, MD

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2 months ago
Thank you so much for your reply Dr. Handsfield. It’s just my anxiety causing me to keep drilling on it. I’m still quite confuse on some questions. 

1) I know it’s just wordings, but after reading my previous post, is it ok to said that it’s Zero risk rather then extremely low risk for only HIV? (That’s the most concern for me)

2) do you agree with Dr. Hook on my risk for other STDs? (Meaning syphilis and gonorrhea) am I in extremely low risk for it too since I used a condom during oral sex?

3) I’ve also asked different people on those questions. Some say I will still have risks on getting gonorrhea or syphilis, some say don’t, it’s making me actually more anxious about it. 

4) It’s quite a repeating question, assuming the lady is HIV+, will that increase the risk in my case?

5) She wiped my penis off with tissues at the end, assume theres semen from previous customers, if she wiped in on my penis will there be any risks? (I’ve read different articles, all have different answers on how long will HIV virus gets inactive, which makes me very confused)

6) Similar to question 4, she showered me before everything starts, assuming there’s virus in the shower gel will I have any risks too?

7) Will a RNA + a Fourth generation test be better or even conclusive let say on around 14days (2weeks)?

Sorry for bringing up so much questions, I’m just too paranoid, please forgive my repeating questions. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
1) Nobody can say oral sex is zero risk. There has never been a known proved case of HIV being transmitted oral to penis, or by massage, hand-genital contact, etc. That doesn't necessarily mean it cannot happen, but certainly this rare enough for such exposures to be considered zero risk.

2) As I said above, I agree with all Dr. Hook's advice.

3) You will find more agreement if you stick with professionally run or moderated online resources and disregard other websites.

4) Of course the risk is zero if a partner is not HIV positive, and therefore of course is higher if she is infected. THis is just common sense.

5-7) Repeat questions. Re-read Dr. Hook's reply and my comments above.
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2 months ago
Thank you for your detailed reply again Dr. Handsfield, I understood that no one can say it’s zero risk for oral sex, but in my case I’m wearing a condom during the whole oral sex will that decrease the risk to very close to zero?

 And I know that a person with HIV+ will increase the risk, but by reading Dr. Hook and your comment, it’s more like it’s a theoretical risk (still extremely low, and no known cases in history). And even receiving an oral sex (without condom) from a HIV+ person, it’s still an extremely low risk and chance that you’ll catch HIV (realistic)?

The last question, (just to get more reassurance and conclusion from everything) since I use a condom during the whole ora sex session, I don’t need to worry anything from any STIs, and absolutely not HIV? Is that correct?

Thank you again for your response

 
2 months ago
Sorry Dr. Handsfield, but one more question, can you briefly explain why it’s impossible to catch HIV from outside (in my case, but it’ll be showering gel and the tissue), and how fast will HIV virus gets inactive (unable to transmit) once it is out from body. I know I’m getting annoyed, but please help me for these questions so I can be reassured and move on. Thanks much 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
" And I know that..." and "The last question...":  Correct statements, you understand.

HIV is hard to transmit. Even with vaginal sex, if the male is infected, unprotected vaginal see x -- with HIV infected semen remaining in the vagina for several hours -- the average HIV transmission chance is 1 in 1,000. For infection to take hold, lots of virus needs to be exposed to certain kinds of cells, which for the most part are deep inside the body. That is why the kinds of contact you describe have never been known to transmit HIV.

That completes the two follow-up comments and replies included with each question and so ends this thread. The forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding. 




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