[Question #9212] Do I need more HIV tests?

35 months ago

Dear Doctors,

Three years ago after a traumatic experience I was helped tremendously on this forum (Question #5439). I am so glad that this service is still available!

I abstained from sexual activity since then and had negative test results for everything in July 2022 at the gyno. My most recent risk was performing oral sex on a man I was dating on 8/18/22. He showed me negative full panel std/hiv test results from LabCorp dated 8/8/22.

A few days after the 8/18/22 incident, I started having weird sinus issues like stuffy nose, runny nose, facial pressure and ear pressure/pain. Symptoms came in waves/not all at once and I still have post nasal drip and a mild sore throat to this day. I have been tested by 4th Gen Duo and PCR RNA on 9/6/22 (both were negative). I then tested on 9/14/22 with another 4th Gen Duo test and it was negative.

Also on 8/23/22, I received part one of the chickenpox vaccine. I also went to urgent care for the sinus issues on 9/7/22 and got a dexamethasone (10mg) injection in the buttocks. I hope this did not affect the validity of my results!

Do I need anymore tests or am I conclusively negative? I know I sound paranoid given the fact that he showed me dated test results but the symptom timing was odd and I also have fear he could have been in the window period.

Thank you!

H. Hunter Handsfield, MD

35 months ago

Welcome back to the forum. I reviewed our discussion 3 years ago, and remembered it as I was reading. I'm glad to have the feeling that you have largely recovered, if not entirely, from the unpleasantness of those events. I'm also glad to learn you are returning to romance and rewarding (I hope!) sexuality.

Oral sex is zero to low risk for HIV. For penile to oral transmission -- that is, if the penile partner has HIV -- CDC has estimated the chance of HIV transmission at roughly once for every 10,000 exposures. That's equivalent to giving BJs to infected men once daily for 27 year before infection might be likely. In other words, zero for all practical purposes. In addition, HIV doesn't cause nasal conditions, sinus symptoms, etc. You caught a cold and might have sinusitis, but your symptoms are not from HIV. Equally important, your HIV test results prove HIV isn't the cause: symptoms of HIV are not caused by the virus itself, but by the immune response to it. Nobody can have HIV symptoms more than a few days and still test negative for HIV. Neither the varicella (chickenpox, varicella zoster) vaccine, any other vaccine, or any medications have any effect at all on the reliability or timing of the HIV blood test results or their reliability.

That said, it can take up to 6 weeks for the AgAb (4th generation, duo) HIV blood tests to become positive. In the extraordinarily unlikely chance you caught HIV from your oral se event in August, it could take until the end of this month to test positive, so you might decide to be tested again at that time. In the meantime, please don't worry about it; as already discussed, the likelihood is zero for all practical purposes. But most worried persons are more reassured by negative testing than by professional opinion, no matter how expert. (I don't take it personally!) I suggest it strictly for reassurance, not because I suspect a positive result.

I hope this information is helpful. Best wishes and stay safe.

HHH, MD

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35 months ago

Hi Dr. Handsfield,

Thank you so much for taking the time to answer my questions. Both 3 years ago and now.

I am greatly reassured. I will follow up with a 6 week test for final reassurance. My last question is does the fact that I had a PCR RNA test at 19 days and a 4th Gen Duo at 27 days help my odds of testing negative at 6 weeks?

Thank you!

H. Hunter Handsfield, MD

35 months ago

Actually, I read your question too quickly and it didn't register you had an RNA test in addition to the AgAb test at 19 days. That result combined with your later AgAb test is a conclusive combination. For sure you do not have HIV and do not need any further testing. Sorry for any confusion!---