[Question #9882] HIV Question

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28 months ago
Good morning..this might be a stupid question but wanted to get an expert opinion regardless. I started dating a 39 year old female for a little over a month now. Shes not a stranger as we known each other froma previous job.  We had unprotected vaginal and anal sex..however she took an Oraquick test prior ( and claims she has not been sexually active for approximately 4 months before the test. Meaning the Oraquick test was taken at least 4 months after her last sexual encounter. I myself have been recently tested and was negative for STDS including HIV and have not had sex for a while. My test was an combo 4th generation. I know I put myself at risk for other STDS but regarding HIV..is it safe to assume those tests are reliable?   I appreciate all your input!

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H. Hunter Handsfield, MD
28 months ago
Welcome back to the forum. I'm happy to address your concerns.

Even before she was tested, the chance your partner had HIV was well under one in a thousand -- based on average HIV frequency in sexually active women in the US and most other industrialized countries. The oral fluid HIV test (Oraquick) misses very few infections; with her negative result 4 months after her last possible exposure, you can be completely certain she didn't have HIV. And your HIV antigen-antibody (AgAb, i.e. "4th generation") test is 100% assurance you do not have HIV.

Finally, in response to "I know I put myself at risk for other STDs":  maybe not. The frequency of transmissible STDs in women over 30 is low, even among women who continue to date fairly frequently. In absence of any symptoms, I would not recommend STD testing after such a sexual exposure. If you do pursue testing, please do not be tempted by many labs' "comprehensive" STD testing panels. Most of the tests are either unnecessary because of essentially zero risk, and others are simply not reliable enough to trust the results (especially testing for herpes -- don't do it!). If you decide to seek testing, in absence of symptoms or proved exposure to a particular STD, the only tests recommended by most STD experts are urine tests for gonorrhea and chlamydia (valid 3-4 days after exposure) and blood tests for HIV and syphilis (done at 6-8 weeks).

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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28 months ago
Thank you. That makes complete sense. In other words assuming we remain monogamous...HIV is not a concern. (Cant acquire something neither of us have) And testing for other STDS in the absence of symptoms is entirely unnecessary...
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H. Hunter Handsfield, MD
28 months ago
Exactly right. But to be clear, this doesn't mean that nobody needs testing in absence of symptoms. People who date regularly, with occasional sex with new partners, are wise to be tested from time to time, like maybe once a year. But generally not after any one exposure unless the risk is particularly high (like a probable or known infected partner).---