[Question #9043] HIV and STI Risk
36 months ago
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Hello, 23 days ago I had protected sex with a male of unknown status. I was the top. Also received oral sex from other guys.
As I read in this site, it is low risk event but I was worried and took a PCR Qualitative RNA test at day 12 and a Chlamydia/gonorrhea at home test (everlywell) at day 12 as well, all negative
So far I don’t have symptoms, but I am anxious. We’re those tests accurate at that timeframe? I’m planning on taking an AgAb test next Monday (day 30). Would that be enough? Or do I need to wait the 42 days?
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Edward W. Hook M.D.
36 months ago
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Welcome to the Forum. Thanks for your question. I'll be glad to comment.
As you point out, this was a very, very low risk exposure. You do not know the infection status of your partner and statistically it is likely that you he did not have HIV. Further, you used a condom for your insertive anal intercourse and condoms are highly effective for prevention infection as long as they are worn throughout the entire sex act and do not break. Finally, you had an HIV RNA PCR test which was negative at day 12. We have never seen or heard of a person with a negative PCR at 12 days who went on to develop a positive test later. Taken together, you can be confident you did not get HIV from the encounter you describe. As you seem to be aware, most experts still recommend a follow-up test at 42 days but this recommendation is rather conservative. Further testing is a personal choice.
With regard to your STI tests, was your only site of exposure your penis? If not, all sites of exposure should be tested. Tests for STIs performed at 12 days after an exposure will provide accurate and conclusive results. Do you know what laboratory your tests were performed at? Some of the on-line test services use substandard tests. As long as your tests were performed at a reliable lab and your only site of exposure was your penis, they are conclusive and no further STI testing is needed.
Finally, as an FYI, we have never seen or heard of a proven HIV infection acquired from receipt of unprotected oral sex (there are rare infections which occur after performing oral sex on an infected partner)
I hope this information is helpful. It sounds to me as though you are in the clear. EWH
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36 months ago
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Thank you doctor.
I took a whole std panel at day 31 1/2 at Labcorp
HIV 4th gen Negative
Syphilis Negative
Chlamydia/Gonorrhea Negative
HSV 1/2 Ab IgG Negative
Hep A,B,C Negative.
Having the HIV RNA negative and the 4th gen negative as well can I rule out it now? Chlamydia/Gonorrhea are conclusive already, and for the rest I have no symptoms or signs for Herpes or Syphilis.
Can I move on now? Or should I get retested at a later time?
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Edward W. Hook M.D.
36 months ago
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Thank you for the additional information. LabCorp is a respected, highly reliable laboratory. You can have confidence in their test results. Regarding your tests:
1. The official recommendation is that HIV fourth generation test results are not conclusive until six weeks following an encounter. Can your case however with a negative PCR as well I would consider your results conclusive and would not feel the need for repeat testing. In addition, I should mention to you that I have never seen or heard of a person who had a negative HIV test at 28 days and went on to become positive after that time.
2. In the absence of signs or symptoms of syphilis and herpes and with your negative tests, I would also consider those results conclusive. Conservatively, some experts might suggest repeat testing at six weeks for syphilis and six months for herpes but personally given the nature of your exposure and your negative test results to date I would consider these results conclusive. If I were you I would not bother to test further for these diseases either
3. Your tests for gonorrhea, chlamydia, and hepatitis are all conclusive and need not be repeated either.
In my opinion, no further testing as needed. I would encourage you to put this episode behind you and move forward without concern. EWH
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