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unprotected vaginal intercourse
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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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unprotected vaginal intercourse

5 weeks ago, I had unprotected vaginal sex.  With in a week, I was at my DR. with a fever and a mild pain at the tip of the urethra.  Was given antibiotics for a UTI, but urine test results came back negative for UTI, chlamydia and ghonorhea.  Both pain and fever persisted, sore throat developed, lower neck was swollen bright red and warm to touch.  I took an at home oraquick oral test at 32 days, was negative.  After reading that most people would test positive by 25 days I had a little reassurance in the results, but knew the 6 week would be more accurate and 3 month was conclusive.  I just recently saw a posting, that said the oral swab test takes longer to dedect the antibodies, and that an 8 week oral swab test is only about 90%.  I have an appointment this week with my Dr, and will get a blood test done.  In the meantime, can I take anything out the negative oral test at 32 days?  If these symptoms were related to HIV infection, would the oral test dedect them by now, or would that be delayed as well?
300980_tn?1194933000
Welcome to the Forum.  I'll try to help.  The issue of interpreting the ever increasing numbers of tests for HIV can become a bit confusing.

First, while you do not go into detail about your exposure, the fact is that most people do not have HIV and, even if your partner had HIV, the risk for HIV from a single exposure is low, less than 1 infection for every 1000 exposures. Thus, even before testing, the likelihood that you acquired HIV is low.

Second, your negative test at 32 days is good news.  Although oral tests are slightly less sensitive for detection of HIV early in the course of infection than blood tests, at 32 days about half of infections would be detected, therefore your negative test makes the likelihood of infection lower still.

Third, when symptoms occur early in course of HIV infection (the so-called ARS), they are a manifestation of increasing amounts of antibodies to infection.  Thus soon (typically 4-5 days) after symptoms of early HIV begin, blood tests are positive.  Thus since your test was well after your symptoms began, you can be confident that your symptoms were not due to HIV.

I hope these comments are helpful. I am confident that your symptoms were not due to HIV and your risk for having acquired HIV from the single exposure that you mention is very, very low.  EWH
13 Comments
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Avatar_m_tn
Thank you for the quick answers.  The incident was mostly oral, her receiving and a few minutes of vaginal intercourse.  You mention that a blood test would be positive 4-5 days after symptoms, so the 20 days for the oral test would be sufficient time?

Thanks again.
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Avatar_m_tn
Dr Hook, I just had 1 more question for you.   Yesterday I had another oraquick home test, which was just past 6 weeks.  Test results came back negative.  I went to my doctor today and had a blood test taken.  I won't get the results back for a few days.  The glands in my neck are still still swollen and so are the glands in arms and groin.  Would the last oral swab at 44 days been positive, if these symptoms were from Hiv?  
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300980_tn?1194933000
As we have said here many times, the oral tests are slightly less sensitvive and take slightly longer to become positive following infection than blood tests.  Even so, your results are strong evidence that you were not infected.  On the other hand, there are no data to give precise answers to the sorts of questions you are asking, i.e what happens at 44 vs 42 days, etc.

Lymph node swelling is typically non-specific and can have many causes.  Rather than just focusing on HIV, for which there is much evidence that you are NOT infected, I suggest that you move forward. If the lymph node swelling concerns you, see your doctor but do not worry that it is due to HIV.  EWH
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Avatar_m_tn
Just wanted to follow up, I did receive my blood test results, not sure what type of test but it was a lab based blood test.  Results were negative at 45 days.  Still trying to figure out the cause of my inflamed lymph nodes, was given antibiotics but don't seem to be helping much.  Thank you for your comments and time, they have been greatly appreciated.
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Avatar_m_tn
Dr. Hook, last question. How conclusive is the 45 blood test?  I've seen anything from 90% up to 99%.  Can I take this as a reliable result?

Thank you
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300980_tn?1194933000
The reliability of antibody tests are known for 6 weeks and 8 weeks, not day by day.  At 6 weeks (42 days) over 95% of persons with recent HIV will be detected.  At 8 weeks (56 days), the figure rises to 100%. EWH
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Avatar_m_tn
Dr. Hook, I did receive my negative 8 week lab results.  I tried to confirm what type of test was used, but was only told it was an antibody test.  Your previous comments regarding the accuracey at 8 weeks is for all antibody test, regardless of type/generation?  Thank you again for your time.
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300980_tn?1194933000
Correct.  You need to figure out how to move forward.  EWH
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Avatar_m_tn
Dr Hook, I appreciate your comments and certainly trying to move on.  I have taken another oraquick oral swab yesterday which was just short of 11 weeks, which came back negative as you have said it would.  I have been to my doctor 4 times regarding the swollen glands, been tested for mono, Lyme disease, thyroid, CBC done, hepatitis, herpes, chlamidia,  ghonorhea and Hiv twice, all of which have come back negative/normal.  Also, saw a urologists regarding the inflamation (inflammation) at my urethra, possibly a yeast infection.  He prescribed a cream, but no relief.  Anyway, I am at a loss, my doctor basically said if the swollen glands cause a concern I should see a general surgeon and I have another appt with the urologist, but couldn't get in till July.  I know your are busy and this probably isnt the correct forum, but any thought or comments or suggestions you could offer would be greatly appreciated.
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300980_tn?1194933000
I'm sorry you remain concerned about this. The focus of this Forum related to HIV and you clearly do not have it.  To address your continuuing concerns about what may be swollen glands, my advice is for you to seek further evaluation by a trained clinician such as an internal medicine specialist.  EWH
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Avatar_m_tn
Dr hook, I apologize for bothering you again.  Last week I went to my doctor and had my 12 week test (antibody) and today I had at home oraquick which was just past the 90 days, both negative.  I can finally take these results as conclusive and be certain that none of the issues I've had are Hiv related? Again, thank you for your time and patience over the last several weeks,
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300980_tn?1194933000
Final answer.  Just as with your prior tests, these results are defintive and prove that you do not have HIV.  There is no need for further testing.

Further, repetitive, questions will lead to deletion of the entire thread without further comment.  This thread is now over.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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