HIV - Prevention Expert Forum
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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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Clarification

Gday Doc,
Apologies for a longer post.

Dr i have posted on the International forum but have not had any response for over a week on my final question and i would like an answer so i am posting to your good self.

Exposure - Brief Oral (receiving) of about 10 secs from fem csw in the middle east. (unprotected)

Question 1 - Tests - is negative duo tests at day 26 and day 39 a good indicator that i have not obtained HIV?

Reason for concern - After my 12 day neg test and after reading much literature about HIV transmission and Oral exposures i believed that i was worrying about nothing and moved on with life, including with my wife. After doing so i felt terrible and could not believe how irresponsible i had been. 19 days after i was with my wife she awoke during the night extremely hot, vommitted and returned to sleep (one night only). The next morning she had a saw throat and an ulcer on the back of her tongue. Sore throat and ulcer was very sore and continued for about 4 days. Disappeared with antibiotics. No fever other than waking hot on the first night and vomitting 15 mins later. I will add this occurred the night after a day of about 8-9 glasses of wine at a birthday party. She stated her body was sore (lasted about a day or so) No rash. She had suffered strep throat about 1 month earlier.

Timeline
Exposure
12 dyas negative DUO ag/ab test
18 days after exposure resumed with wife
26 days after exposure negative Gen 4 Duo ag/ab test
37 days from my exposure (19 days from intimacy with wife) Wifes symptoms started
37 days negative AB test
39 days negative DUO ag/ab test

Would appreciate your thoughts DR. Thankyou

I would like to know if my test results are reliable and that i am not infected with HIV and further more was unable to infect my wife. I feel completely terrible at the  moment and hope that my initial thoughts of this feeling being guilt and anxiety are correct.
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I read your interactions the you ha on the International Forum and concur that there is no difference in the opinions you will get at either site.  Your risk was virtually zero before you were tested and your negative DUO test proves this.  For you to continue to worry about this or to attribute potential symptoms that either you or your wife have to possible HIV is a symptoms of the guilt and anxiety you have over your behavior, not a manifestation of HIV.  The symptoms you noted occurred coincidentally and not because of HIV.

To recap:
1.  Your partner told you she was not infected, this is probably true.
2.  If she was infected, there is virtually no risk of HIV from receipt of oral sex.
3.  You have proved to me and should have proved to yourself that you did not get HIV from your encounter 39 days before testing.

Thus there is no reason to worry, no reason for further testing, and no way that you have HIV form this encounter. I hope my comments will help you to move forward. EWH
5 Comments
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Avatar_m_tn
Thankyou Dr for your reply, it is greatly appreciated and has eased my anxiety/stress ridden mind somewhat. The Duo Tests (Gen 4) that i had can you explain why at 39 days they can be considered conclusive when you still hear a lot about 3 months.

I have read on the International forum that at 4 weeks the Duo or Combo tests are considered 99.5% accurate. Do you agree with this information AND would the ag/ab test become more accurate past 4 weeks?

Thankyou in advance for this extension to your above answer.
best regards
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300980_tn?1194933000
You appear not to be paying attention to the details surrounding your questions.  The DUO test IS an AG/AB test, detecting the HIV p24 antigen and antibody to the the virus.  That is the reason is provides definitive answers sooner than the antibody alone tests for which some overly conservative persons still recommend 3 months to be sure that a person is not infected.

Your anxiety is clearly impacting you.  You ask for the facts and my opinion.  You have them.  YOU DO NOT HAVE HIV FROM THE EXPOSURE YOU DESCRIBE!!.  EWH
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Avatar_m_tn
Last post from me.

I have taken further tests despite your recommendation i am fine. I tested at 7.5 weeks and at 9 weeks HIV 1/2 Antibody tests. Both Negative. These tests coupled with previous results are conclusive - Correct?
Thanks Doc...won't bother you again.
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300980_tn?1194933000
You still do not have HIV. There is no need for additonal testing and no need for additonal answers from me.  Further questions will be deleted without comment.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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