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Possible risk with a CSW
Dear Dr, On 31Oct13 I was in Antwerp Belgium and visited the legal red light district there. I ended up with a CSW. She put on a condom on my penis the very first thing and gave me an oral erection with condom. Then with the same condom we had 5-10 min of protected sex. Before vaginal penetration she put on a lubricant on her vagina. After the even the condom was intact and she rolled it off my penis. I did not wash off my genital area immediately and just dressed up and left back for my hotel where I had a thorough bath. However, I noticed burning sensation in my inner thighs a couple of hours after taking the bath. My dermatologist said it was a fungal infection. Do you think I might have picked an STD?
I am quite depressed at my actions and took a HIV 1 RNA RT-PCR quantitative test at 14 days after exposure which came stating target not detected (negative). On the 28th and 40th day I took the HIV 1/2 & P24 combo test done by CMIA method and the index value was 0.19 and 0.21 non reactive respectively for these tests. My doctor says that these tests are 4th gen and are conclusive and I need no further testing for HIV. I wanted to as your opinion whether these can be considered conclusive (CMIA) method at 28 and 40 days after exposure and do I need further testing? In between I had all urine analysis and culture tests done at 40 days and my sample was sterile. I also did the VDRL(RPR) test for syphillis at 40 days which was negative.
Dr HHH is also of the opinion that my tests are conclusive and that even antibody testing done at 8 weeks is conclusive. To be on the safer side, I repeated the HIV 1/2 and P24 combo test done by CMIA method after 55 days (almost 8 weeks). The index value was 0.19, hence negative. The RPR VDRL was also non reactive.
I would like to ask your opinion on my situation and whether you think I need further HIV testing at 90 days. A lot of experts still maintain a 3 months conclusive result as standard for HIV testing.
I am quite depressed at my actions and took a HIV 1 RNA RT-PCR quantitative test at 14 days after exposure which came stating target not detected (negative). On the 28th and 40th day I took the HIV 1/2 & P24 combo test done by CMIA method and the index value was 0.19 and 0.21 non reactive respectively for these tests. My doctor says that these tests are 4th gen and are conclusive and I need no further testing for HIV. I wanted to as your opinion whether these can be considered conclusive (CMIA) method at 28 and 40 days after exposure and do I need further testing? In between I had all urine analysis and culture tests done at 40 days and my sample was sterile. I also did the VDRL(RPR) test for syphillis at 40 days which was negative.
Dr HHH is also of the opinion that my tests are conclusive and that even antibody testing done at 8 weeks is conclusive. To be on the safer side, I repeated the HIV 1/2 and P24 combo test done by CMIA method after 55 days (almost 8 weeks). The index value was 0.19, hence negative. The RPR VDRL was also non reactive.
I would like to ask your opinion on my situation and whether you think I need further HIV testing at 90 days. A lot of experts still maintain a 3 months conclusive result as standard for HIV testing.
MEDICAL PROFESSIONAL
Hello - thank you for the post.
Dr HH is correct of course and you certainly do not need any further testing for HIV. I would go further and say that because the condom was used promptly and early and stayed on then you were entirely protected and did not to have any testing to begin with.
The fungal infection is irrelevant and is simply far too early to be related in any way to the sexual activity.
The very large number of tests you have had done prove absolutely that you are HIV negative.
I would say that after 6 weeks an antibody HIV test alone is more than sufficient to prove that you are HIV negative. In my clinic we unfortunately frequently see people who are very newly HIV infected and the straightforward 3rd generation antibody test performs as well as the HIV 4th generation DUO or combo tests and correctly identifies HIV positive results.
The very good news is that you were sensible and used a condom and kept it on and also have had conclusive HIV testing proving beyond any doubt at all that you are HIV negative.
kind regards, Sean
Dr HH is correct of course and you certainly do not need any further testing for HIV. I would go further and say that because the condom was used promptly and early and stayed on then you were entirely protected and did not to have any testing to begin with.
The fungal infection is irrelevant and is simply far too early to be related in any way to the sexual activity.
The very large number of tests you have had done prove absolutely that you are HIV negative.
I would say that after 6 weeks an antibody HIV test alone is more than sufficient to prove that you are HIV negative. In my clinic we unfortunately frequently see people who are very newly HIV infected and the straightforward 3rd generation antibody test performs as well as the HIV 4th generation DUO or combo tests and correctly identifies HIV positive results.
The very good news is that you were sensible and used a condom and kept it on and also have had conclusive HIV testing proving beyond any doubt at all that you are HIV negative.
kind regards, Sean
Hello doctor, wanted to inform you that yesterday I took my 12 week combo cmia test which came back negative. Do I still need to test out to six months?
Hi, I have been reading your posts regarding a duo test never turning positive at 12 weeks when someone has had a negative past the 6 week mark.
I had two possible exposures and tested with a DUO and POCT on 29/11/13 which was 42days-6.3weeks/64 days – 9.1 weeks from the two possible exposure incidents. Both tests were NEGATIVE.
I know you have said in your posts...but if you could make comment on my particular case it would be much appreciated.
I had two incidents which I could have possibly put myself at risk.
1 – 26/9/13 Random Northern European girl on a night out she performed unprotected oral then brief unprotected vaginal penetration ( less than a minute) then she performed unprotected oral again I did not ejaculate.
2 – 16/10/13 Random Bulgarian girl on a night out all protected oral and vaginal penetration. Although protected I’m concerned as she seemed a bit unstable after the event as if she should have had intercourse.
Tests
30/10/13 Duo - Reactive Negative – (1) 39 days exposure (2) 19days exposure
4/11/13 POCT Negative
8/11/13 Duo - POCT Negative / DUO – Negative (Weak Reactive Negative is what the health advisor said when I asked but the result came back from the lab saying just Negative) – (1) 43 days exposure (2) 23 days exposure
29/11/13 POCT Negative/Duo Negative (1) 64 days exposure (2) 42 days exposure
I understand from this site that a 6 week Duo test is very accurate 98.8% at 6 weeks my last exposure being at 6.3 weeks. The concern is that I had two reactive negative tests early after my exposure, possible antigens? I’m not feeling very well with night sweats aching joints and muscles, swollen lymph node in left side of neck and right inside of elbow, tightness in my chest and difficulty taking deep breaths and a constant headache for over 5 weeks.
I so worried could the final test have missed something but the original tests have picked up on something?
Thank you for your advice.
I had two possible exposures and tested with a DUO and POCT on 29/11/13 which was 42days-6.3weeks/64 days – 9.1 weeks from the two possible exposure incidents. Both tests were NEGATIVE.
I know you have said in your posts...but if you could make comment on my particular case it would be much appreciated.
I had two incidents which I could have possibly put myself at risk.
1 – 26/9/13 Random Northern European girl on a night out she performed unprotected oral then brief unprotected vaginal penetration ( less than a minute) then she performed unprotected oral again I did not ejaculate.
2 – 16/10/13 Random Bulgarian girl on a night out all protected oral and vaginal penetration. Although protected I’m concerned as she seemed a bit unstable after the event as if she should have had intercourse.
Tests
30/10/13 Duo - Reactive Negative – (1) 39 days exposure (2) 19days exposure
4/11/13 POCT Negative
8/11/13 Duo - POCT Negative / DUO – Negative (Weak Reactive Negative is what the health advisor said when I asked but the result came back from the lab saying just Negative) – (1) 43 days exposure (2) 23 days exposure
29/11/13 POCT Negative/Duo Negative (1) 64 days exposure (2) 42 days exposure
I understand from this site that a 6 week Duo test is very accurate 98.8% at 6 weeks my last exposure being at 6.3 weeks. The concern is that I had two reactive negative tests early after my exposure, possible antigens? I’m not feeling very well with night sweats aching joints and muscles, swollen lymph node in left side of neck and right inside of elbow, tightness in my chest and difficulty taking deep breaths and a constant headache for over 5 weeks.
I so worried could the final test have missed something but the original tests have picked up on something?
Thank you for your advice.
Thank you so very much for calming my nerves. Happy new year to you dear Dr.
Dear Dr, did my question get lost in the system? Sorry if I appear intrusive.
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