HIV - Prevention Expert Forum
Rapid Antibody Test, P24 Antigen Duo test Results
About This Forum:

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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Rapid Antibody Test, P24 Antigen Duo test Results

Hello from Canada,

I would like your advice.

I am a male and I received unprotected oral sex, had protected vaginal sex, and the girl I was with inserted her finger in my anus. She was a sex worker based out of Asia (who I think may have been on her period as I thought I noticed drips of blood on the white sheets afterwards). Two days after this event I had small white pimples form on the tip of my penis. They went away after a few days through some skin shedding, but needless to say I was scared. The other symptom I am feeling is very noticeable joint pain in my wrists and ankles 4 weeks after the potential exposure and pain under my arm pits.

Anyways, I am a rational person and will not continue to bug you if you can provide me with answers to the following questions:

1. Would you consider this to be a risk for HIV in anyway?

2. I had the duo p24 antigen and antibody test 6 days post exposure and 12 days post exposure, both the antigen and antibody (I understand there's a window period with the antibody test) test came back negative with normal WBC. Did I do these tests too early? Are these results conclusive?

3. I had the rapid antibody HIV test at 5 weeks and the result was negative. This test did not test for the p24 antigen so I am worried that this test is not accurate given that it may not track low levels of antibodies. What is the accuracy of this rapid antibody test at 5 weeks?

4. If there was blood or vaginal fluid on her finger and she inserted it in my anus would this be a risk. I have read other threads that state that HIV cannot be transmitted outside it's living host. Not sure if this applies here or what that really means.

I've seen other comments that show the risk in terms of a probability, but I am not a gambler :) I would love to understand the accuracy of the test themselves (e.g. 5 week rapid antibody test is 90% accurate). Any details you can provide would be very much appreciated.

Thank you from CANADA!
Related Discussions
300980_tn?1194933000
Welcome to our Forum.  I'll go straight to your questions:

1.  No, I would not consider these activities to put you at risk for HIV.  Masturbation (such as insertion of her finger into your anus) and condom protected sex are safe sex and are not associated with HIV transmission.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

2.  These tests, while supportive of the fact that you did not get HIV are not definitive.  A DUO test such as you had is definitive at 4 weeks following exposure.  While I am confident you did not get HIV from this exposure, if you need to prove it to yourself I suggest you repeat the test.

3.  At 5 weeks and antibody test would detect between 90 and 95% of infections.  In your case, given the low risk to begin with, this should be sufficient to prove that you did not get HIV even though, technically, it is not definitive.

4.  HIV is not spread through hand to genital (or anal) contact.

I hope these answers help you.  You really have no reason for concern.  EWH
5 Comments
Blank
Avatar_m_tn
Thank you. So you are saying that if I receive a negative DUO test at four weeks that this is conclusive? What if I received a negative antibody only test at 6 weeks, would that be conclusive. I ask because getting the antibody test here is much easier than the DUO test. Thanks again.
Blank
300980_tn?1194933000
Please re-read my answer.  At 4 weeks a negative DUO test is definitive .  Antibody tests alone are not definitive until 8 weeks following exposure, not 6.  EWH
Blank
Avatar_m_tn
Good news doctor. I had a negative DUO antibody and p24 test at four weeks. So, that means...

Negative DUO at 6 days post exposure
Negative DUO at 12 days post exposure
Negative DUO at 28 days post exposure
Negative RAPID Antibody test 35 days

According to your email the 4 week result is conclusive. I'm just confused as to why other expert moderators on MedHelp say that you have to test at 13 weeks for a conclusive result. Not to mention names, but these are well respected experts on this site. Why the discrepancy?
Blank
300980_tn?1194933000
This will be my last answer.  

The recommendation for 12 weeks is an overly conservative recommendation regarding tests for HIV antibodies not comined antigen/anitbody tests such as the DUO assays.  We get many questions about the meaning of HIV test results at different time points.  This is now confused by the availability of a variety of different types of tests.  The traditional and most widely used tests for HIV are tests for antibodies to HIV which are available both as so-called "rapid" or point of care tests which can be done in the clinic and laboratory based antibody tests. For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.  

Believe your test results.  You do not have HIV and to have further testing is a waste of time and money.  EWH
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank