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Earliest reliable test
Hello Dr,
Last Friday I went to a strip club and engaged in vaginal sex with a stripper. I spoke with her about her status and she told me she uses condoms all the time as she knows the type of job she has and what she's prone to and she protects herself. She also said she test regularly and all her previous test were negative. This was all before the act. As soon as my penis was exposed she put a condom on. Shamefully, I asked her of she can give me unprotected oral sex and then protected vaginal and she told me no that oral sex also needs to be protected and told me I should be smarter because I don't know what she has and she does not know what I have. So she have me condom protected oral sex and then we moved on to have vaginal sex. I was having sex with her and I will pull out regularly to check the condom. At one point after checking the condom i was trying to reinsert and missed and my penis bent and the condom broke ( this is what I kind of remember happening but not 100% sure, thus the reason I'm worried). I clearly remember telling her don't worry it broke outside. She took out another condom and we went to completion. The reason I am worried is because I was a little drunk and although I remember 100% saying "don't worry the condom broke outside", I don't remember exactly what was that happened. Besides remembering that I can just recall bits and pieces. So if I assume the worst and the condom broke and I penetrate her without a condom I want to know which test I can take to get the earliest reliable results.
1) I cannot find an HIV duo test. However, I can take an ultra sensitive HIV RNA PCR and a third generation antibody at 28 days. Percentage wise, how accurate will this combination be at 28 days? I know the antibody alone is about 90% so I'm assuming the RNA can only add to the sensitivity? 2)had slight soar throat 3 days after with ear pain, ARS or to early? 3) if combo is neg. what test will completely rule out HIV after that?
Last Friday I went to a strip club and engaged in vaginal sex with a stripper. I spoke with her about her status and she told me she uses condoms all the time as she knows the type of job she has and what she's prone to and she protects herself. She also said she test regularly and all her previous test were negative. This was all before the act. As soon as my penis was exposed she put a condom on. Shamefully, I asked her of she can give me unprotected oral sex and then protected vaginal and she told me no that oral sex also needs to be protected and told me I should be smarter because I don't know what she has and she does not know what I have. So she have me condom protected oral sex and then we moved on to have vaginal sex. I was having sex with her and I will pull out regularly to check the condom. At one point after checking the condom i was trying to reinsert and missed and my penis bent and the condom broke ( this is what I kind of remember happening but not 100% sure, thus the reason I'm worried). I clearly remember telling her don't worry it broke outside. She took out another condom and we went to completion. The reason I am worried is because I was a little drunk and although I remember 100% saying "don't worry the condom broke outside", I don't remember exactly what was that happened. Besides remembering that I can just recall bits and pieces. So if I assume the worst and the condom broke and I penetrate her without a condom I want to know which test I can take to get the earliest reliable results.
1) I cannot find an HIV duo test. However, I can take an ultra sensitive HIV RNA PCR and a third generation antibody at 28 days. Percentage wise, how accurate will this combination be at 28 days? I know the antibody alone is about 90% so I'm assuming the RNA can only add to the sensitivity? 2)had slight soar throat 3 days after with ear pain, ARS or to early? 3) if combo is neg. what test will completely rule out HIV after that?
MEDICAL PROFESSIONAL
Welcome to the forum. thank you for your question.
My first response is to reassure you about the exposure itself. You describe a partner who is statistically very unlikely to have HIV, both because (contrary to popular opinion) the vast majority of commercial sex workers don't have HIV; and from your description, it seems your partner knows the score and is careful to protect herself. And her reaction to the condom failure tends to confirm that: she was worried that you might have HIV. That is as it should be; sex workers are at far higher risk for HIV from their clients than the other way around.
Second, even if your partner had HIV, your exposure was virtually entirely condom protected. Condoms work! Finally, what if the condom really broke, and what if your partner had HIV? Even then, the chance of transmission to you would average one chance in 2,000. That's equivalent to having unprotected vaginal sex with infected women once daily for 5 years before transmission would be likely. Had I been in your situation, I would not even feel a need to be HIV tested, and I would continue unprotected sex with my wife without worry of infecting her.
Having said all that, I understand that some people in your situation are not going to be satisfied only with reassurance like this, and that a negative test result would help you relax about the situation. So go ahead and get tested.
If you can't find a duo test, feel free to go ahead with the PCR test plus antibody test. That combination at 28 days will be even more reliable than the duo test. The negative results will indeed rule out HIV with 100% certainty. Your symptoms don't change anything. They aren't typical for HIV, and anyway the test results rule; the negative results will prove HIV isn't the cause.
Feel free to report your test result(s). You can be absolutely confident they will be negative. You really should not be worried about this event; it was safe sex with essentially no risk of transmisison anyway.
I hope this helps. Best wishes-- HHH, MD
My first response is to reassure you about the exposure itself. You describe a partner who is statistically very unlikely to have HIV, both because (contrary to popular opinion) the vast majority of commercial sex workers don't have HIV; and from your description, it seems your partner knows the score and is careful to protect herself. And her reaction to the condom failure tends to confirm that: she was worried that you might have HIV. That is as it should be; sex workers are at far higher risk for HIV from their clients than the other way around.
Second, even if your partner had HIV, your exposure was virtually entirely condom protected. Condoms work! Finally, what if the condom really broke, and what if your partner had HIV? Even then, the chance of transmission to you would average one chance in 2,000. That's equivalent to having unprotected vaginal sex with infected women once daily for 5 years before transmission would be likely. Had I been in your situation, I would not even feel a need to be HIV tested, and I would continue unprotected sex with my wife without worry of infecting her.
Having said all that, I understand that some people in your situation are not going to be satisfied only with reassurance like this, and that a negative test result would help you relax about the situation. So go ahead and get tested.
If you can't find a duo test, feel free to go ahead with the PCR test plus antibody test. That combination at 28 days will be even more reliable than the duo test. The negative results will indeed rule out HIV with 100% certainty. Your symptoms don't change anything. They aren't typical for HIV, and anyway the test results rule; the negative results will prove HIV isn't the cause.
Feel free to report your test result(s). You can be absolutely confident they will be negative. You really should not be worried about this event; it was safe sex with essentially no risk of transmisison anyway.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
I was aware of the timing. Negative PCR at 17 days and antibody at 4 weeks is 100% reliable; ieven better (in theory) than doing both PCR and antibody at 4 weeks.
Please let it go. You don't have HIV -- you should be jumping up and down at the good news, not still worrying about it!
So that winds up this thread; I won't have any further comments or advice.
Please let it go. You don't have HIV -- you should be jumping up and down at the good news, not still worrying about it!
So that winds up this thread; I won't have any further comments or advice.
I understand doc, but I don't know if you noticed. I took the PCR at 17 days not 28..only the antibody was at 28 days. Does your advice change?
MEDICAL PROFESSIONAL
The reliability of your test results is100%. See paragraph 4 of my original reply.
Test results always overrule symptoms in judging whether or not someone might have HIV. Your negative HIV test proves your current symptoms, or any others you may develop (no matter what they are) are not due to HIV.
Of course see a doctor or clinic if your symptoms continue. But you can rest assured they aren't caused by HIV.
Test results always overrule symptoms in judging whether or not someone might have HIV. Your negative HIV test proves your current symptoms, or any others you may develop (no matter what they are) are not due to HIV.
Of course see a doctor or clinic if your symptoms continue. But you can rest assured they aren't caused by HIV.
Hey doc,
Well today has been a month since my exposure. I tested negative with HIV RNA PCR test from labcorp sensitive down to 20 copies at 17 days post exposure and a negative HIV antibody test from labcorp at 4 weeks post exposure. How accurate do u thibk this combo is at the designated times? I know it's a bit early so which other and final test do you recommend regarding this exposure? Part of the reason I remain worried is because my tricep in my left arm is swollen with erythema and hurts quite a bit and I do not remember hurting it. It just appeared that way. My doctor just sent me Voltaren gel and told me it was significantly swollen. My question is I know there is lymph nodes near the top of the arm towards the armpit and near the elbow, but is there lymph nodes within the tricep because the pain is coming from the actual tricep itself. It is sensitive to the touch. Thank you for your time doc
Well today has been a month since my exposure. I tested negative with HIV RNA PCR test from labcorp sensitive down to 20 copies at 17 days post exposure and a negative HIV antibody test from labcorp at 4 weeks post exposure. How accurate do u thibk this combo is at the designated times? I know it's a bit early so which other and final test do you recommend regarding this exposure? Part of the reason I remain worried is because my tricep in my left arm is swollen with erythema and hurts quite a bit and I do not remember hurting it. It just appeared that way. My doctor just sent me Voltaren gel and told me it was significantly swollen. My question is I know there is lymph nodes near the top of the arm towards the armpit and near the elbow, but is there lymph nodes within the tricep because the pain is coming from the actual tricep itself. It is sensitive to the touch. Thank you for your time doc
Hello Doc,
So after having the burning sensation I went and got tested for chlamydia and gonorrhea with a urine NAA test using first void 12 days after exposure. I'm a bit relieved with the results and also that I didn't have any discharge as you mentioned previously would make it unlikely to be a urethral std without discharge. So now I'm back to square 1 and just waiting for 4 weeks to take the HIV PCR/ antibody combo. Thanks.
So after having the burning sensation I went and got tested for chlamydia and gonorrhea with a urine NAA test using first void 12 days after exposure. I'm a bit relieved with the results and also that I didn't have any discharge as you mentioned previously would make it unlikely to be a urethral std without discharge. So now I'm back to square 1 and just waiting for 4 weeks to take the HIV PCR/ antibody combo. Thanks.
MEDICAL PROFESSIONAL
Urethral STDs (gonorrhea, chlamydia, nongonococcal urethritis) generally do not cause burning alone. With no discharge, my bet is that you don't have anything important. But if the burning doesn't stop or if discharge of pus or mucus appears, visit a doctor or clinic for exmaination. And if youur gonorrhea/chlamydia test was done at least a couple days after the sexual exposure, the result will be reliable.
It is also true that if you indeed acquired a urethral STD, it indicates the sex was not as well protected as intended. That would increase the chance of HIV transmission. However, you can't catch HIV if you aren't exposed, and in the US it is the very rare stripper who has HIV.
You may also be reassured to know that in the nearly 8 years of this forum, not one person has reported an exposure they were concerned about and turned out to have caught HIV. You aren't going to be the first. If and when that happens someday, it will be someone with a substantial risk, not a low risk situaiton like yours.
It is also true that if you indeed acquired a urethral STD, it indicates the sex was not as well protected as intended. That would increase the chance of HIV transmission. However, you can't catch HIV if you aren't exposed, and in the US it is the very rare stripper who has HIV.
You may also be reassured to know that in the nearly 8 years of this forum, not one person has reported an exposure they were concerned about and turned out to have caught HIV. You aren't going to be the first. If and when that happens someday, it will be someone with a substantial risk, not a low risk situaiton like yours.
Hello Dr.
I was staying mellow and waiting for 4 weeks to do the combo HIV RNA and antibody, but now 10 days after exposure I have a burning sensation in my penis. In assuming it could b chlamydia or gonorrhea. I will be testing for those. My question is if these are indeed symptoms of one of those 2 STD's, will the test be positive? And if negative will it rule out those 2 as the cause of my symptomss? I feel this test can be a great indicator because if either one is positive that means the sex was NOT 100% protected therefore I wil be at increase risk for HIV. However, regardless of the results I will stay mellow until 4 weeks where I can obtain reliable HIV results. After you answer this question I will only be posting back with test results. Thank you.
I was staying mellow and waiting for 4 weeks to do the combo HIV RNA and antibody, but now 10 days after exposure I have a burning sensation in my penis. In assuming it could b chlamydia or gonorrhea. I will be testing for those. My question is if these are indeed symptoms of one of those 2 STD's, will the test be positive? And if negative will it rule out those 2 as the cause of my symptomss? I feel this test can be a great indicator because if either one is positive that means the sex was NOT 100% protected therefore I wil be at increase risk for HIV. However, regardless of the results I will stay mellow until 4 weeks where I can obtain reliable HIV results. After you answer this question I will only be posting back with test results. Thank you.
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