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Additional HIV tests
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Additional HIV tests


First of all congrats on the great job you guys do..... It is really helpful to interact with experts on the field.

Right, so here is my incident on the 15th of August, 2012. I had protected vaginal sex with a girl who had sex for money. The first condom wasnt torn and the girl changed it after a while. She also gave me a handjob and I believe that was when the second condom tore (Because she stopped suddenly).

It was first time and I regularly get tested every 2 years as a part of my visa procedures (I work in Oman, where the incident also took place)

1. However, I am having doubts whether it would have torn during the sex and she might not have noticed.

2. After 27 days.... i.e. on the 11th of October, 2012, I got myself tested at an anonymous testing center in Dubai, UAE using a HIV 4th Generation ELISA (There seemed to be only one anonymous center in Dubai anyway, I dont know how reliable their tests are). The result being a negative with 0.399 index. Is this enough testing??

3. I cant make it to Dubai and I am thinking of getting tested in Oman (Its been 16 weeks, since the incidents and I havent had any sort of illness or anything) (A huge risk as a positive result, would mean deportation) Do you think I should??

4. My last question, do you think I should have a test for the STDs, I havent had any known symptoms or signs (16 weeks since the incident).

Thanks a lot for your time and my sincere apologies for the extremely long mail.


Welcome to the Forum, I''ll address your questions but just to make sure, I'd also like to ask for a little clarification.  As I understand it, your condom tore during receipt of masturbation, not during vaginal sex- is this correct?  Assuming this is the case, here are my comments:

1. Condom protected sex is safe sex and as long as condoms are used throughout sex, from beginning to end, there is no meaningful risk for HIV of for most other STDs.  Condoms do break, about 1% of the time and when they fail, there is no question that this is the case-they break wide open.  Some people are aware of when breakage occurs, other do not notice it but either way, had your condom failed, it would have been obvious to you.

2.  The exposure you describe was rather low risk as well because most commercial sex workers, particularly in the Middle East and Arab nations, do not have HIV.

3.  There is no risk whatsoever of HIV of any other STD from receipt of masturbation- with or without a condom.

Reply continued below- ran out of space.  EWH

4.  Your 27 day test proves that you did not get HIV from the relatively low risk exposure that you describe.  The combination HIV p24 antigen/HIV antibody tests provide totally reliable results at 4 weeks (for you 27 days is close enough)  following an exposure.  Thus, there is no reason for concern related to the exposure you describe, no matter what the exposure was.

5.  If the condom broke while you were receiving masturbation, there is no reason for concern. If it broke during sex however, testing might be a good idea. The major testing I would recommend is for the two most common STDs, chlamydial infection and gonorrhea and can often be accomplished using a urine test.  Syphilis is most unlikely but easy to do as a blood test and so many people do this as well. We recommend against blood tests for Herpes in person such as yourself as the tests are not good enough to be confident of the results- you are more likely to get a false positive result than a true positive.

I hope these comments are helpful. EWH
Thanks a lot Doc,

I am confident that it tore during the masturbation, but I just have a niggling thought otherwise.

Just a few more clarifications,

1. Does Chlamydia & Gonorrhea, remain asymptomatic  for upto 16 weeks.... I'll take a test nevertheless, but just wondering.

2. Can a single HIV Duo test taken as a reliable data. I mean what is the "false negative" rate of the test.

3. I had blood drawn from my arm, do they use only a drop from the sample or do they use the entire syringe sample for a HIV Duo Elisa. I asked the lab, but they wouldnt divulge information ( in their website, they do advise the clinics to submit a small plastic container of blood )

Thanks Doctor, i think that shall be all......
Dear Doc,

In connection with my above query, is it safe to say that I didnt catch any STDs, considering the fact that I havent had any kind of symptoms or abnormalities in the past 18 weeks from the incident.
Again, what you described was safe sex and should not worry you. In answer to your questions:

1.  Yes, gonorrhea and chlamydia can be asymtomatic for 16 weeks.  this is uncommon however and as I already told you, this was ano risk exposure.

2.   The false negative rate is very, very low-far  less than 1 in 1000 among persons with HIV.  Believe your test results

3.  They use only a small amount of the blood drawn for testing.

Thanks a lot Doc for all your help......

warm regards.....
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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