Aa
Move on?
Dear Doctor,
I am 29 years old male who moved to London 3 months ago. I am also married. 6 weeks ago, I visited a gay sauna and received unprotected oral sex for 15-30 seconds from 55-60 years old guy. Then, I stopped him and wore a condom. Then I just rub my penis to his anus while the condom was on its place. No penetration with condom or without condom. Then I left the sauna immediately and after 6 weeks I am still miserable and depressed- even no smiling for a minute.
The tests I have taken:
22 days: INSTI HIV finger test: Negative.
30 days Hiv Duo and other STDs: Negative
42 days: INSTI HIV finger test: Negative
1-The doctor in Soho STD clinic-London told me that 4 weeks HIV DUO test is conclusive. Moreover, she said that if it is negative, they are not doing an extra test later on. Do you agree? If yes, what does it mean exactly?
BASHH Guideline
"They should be offered a 4th generation laboratory HIV test and advised that a negative result at 4 weeks post exposure is very reassuring/highly likely to exclude HIV infection. An additional HIV test should be offered to all persons at 3 months (12 weeks) to definitively exclude HIV infection."
2- Receiving oral sex is theoretical risk if the giver has blood in his/her mouth because saliva is not infectious. But how much blood is needed? Is miniscule enough or much more needed for infection?
2- I would like to be 100% sure that I am hiv negative from this encounter because I and my wife are not using condoms. Do my tests show that I have not been infected? Or should take a test at 8 weeks before making sex with my wife?
Thank you and best regards
I am 29 years old male who moved to London 3 months ago. I am also married. 6 weeks ago, I visited a gay sauna and received unprotected oral sex for 15-30 seconds from 55-60 years old guy. Then, I stopped him and wore a condom. Then I just rub my penis to his anus while the condom was on its place. No penetration with condom or without condom. Then I left the sauna immediately and after 6 weeks I am still miserable and depressed- even no smiling for a minute.
The tests I have taken:
22 days: INSTI HIV finger test: Negative.
30 days Hiv Duo and other STDs: Negative
42 days: INSTI HIV finger test: Negative
1-The doctor in Soho STD clinic-London told me that 4 weeks HIV DUO test is conclusive. Moreover, she said that if it is negative, they are not doing an extra test later on. Do you agree? If yes, what does it mean exactly?
BASHH Guideline
"They should be offered a 4th generation laboratory HIV test and advised that a negative result at 4 weeks post exposure is very reassuring/highly likely to exclude HIV infection. An additional HIV test should be offered to all persons at 3 months (12 weeks) to definitively exclude HIV infection."
2- Receiving oral sex is theoretical risk if the giver has blood in his/her mouth because saliva is not infectious. But how much blood is needed? Is miniscule enough or much more needed for infection?
2- I would like to be 100% sure that I am hiv negative from this encounter because I and my wife are not using condoms. Do my tests show that I have not been infected? Or should take a test at 8 weeks before making sex with my wife?
Thank you and best regards
So why don't centers just test p24 alone after 16 days of encounter for early diagnoses? As far as I know the specitifity (true negatives) is almost 100%.
So why don't centers just test p24 alone after 16 days of encounter for early diagnoses? As far as I know the specitifity (true negatives) is almost 100%.
MEDICAL PROFESSIONAL
Hello
Relax - the Forum is not instantaneous I'm afraid.
With refernce to your first posting:-
1-The doctor in Soho STD clinic-London told me that 4 weeks HIV DUO test is conclusive. Moreover, she said that if it is negative, they are not doing an extra test later on. Do you agree? If yes, what does it mean exactly?
Yes, I agree with her entirely. You were not at risk of HIV in the first place through being sucked. The HIV DUO test at 28 days or more, together with a no risk scenario gives a conclusive result.
You have qoted from the BASHH Guidelines - repeat testing is appropriate where 1) there has been a significant risk and 2) where there may be diagnostic uncertainty or 3) where the patient desires a further test.
However, as I have said, you were never at risk, and you had an excellent test for a no-risk scenario -= you do not need further testing.
2- Receiving oral sex is theoretical risk if the giver has blood in his/her mouth because saliva is not infectious. But how much blood is needed? Is miniscule enough or much more needed for infection?
There are NO known cases where a person being sucked has become HIV positive - I'm not going to get drawn into speculative "what if's" - you did not have a risk and you have been tested negative - you are HIV negative.
2- I would like to be 100% sure that I am hiv negative from this encounter because I and my wife are not using condoms. Do my tests show that I have not been infected? Or should take a test at 8 weeks before making sex with my wife?
You have established already that you are HIV negative.
You asked a further question:-
"Does p24 antigen occur 1 week before antibodies? Or does p24 antigen occur just after the infection? I am asking that because test manufacturers state that p24 occurs approximately 1 week before antibodies. You say 3rd generation tests give conclusive results at 12 weeks. Therefore, should 11 weeks hiv duo test be conclusive. Am I wrong? "
Yes, you are wrong. P24 forms as a result of HIV viral replication and begins to rise very dramatically at 10 or so days. At 12 to 16 days the p24 element will be huge. The majority of people will form antibodies by 4 weeks. The use of the p24 antigen will enable near certainty of result at 4 weeks. I do not say that third generation tests will give conclusive results at 12 weeks - if you read my threads in connection with third generation testing then you will see that I say that a third generation HIV antibody 1 and2 test will give greater than 99% accuracy at 6 weeks.
You are HIV negative.
best wishes, Sean
Relax - the Forum is not instantaneous I'm afraid.
With refernce to your first posting:-
1-The doctor in Soho STD clinic-London told me that 4 weeks HIV DUO test is conclusive. Moreover, she said that if it is negative, they are not doing an extra test later on. Do you agree? If yes, what does it mean exactly?
Yes, I agree with her entirely. You were not at risk of HIV in the first place through being sucked. The HIV DUO test at 28 days or more, together with a no risk scenario gives a conclusive result.
You have qoted from the BASHH Guidelines - repeat testing is appropriate where 1) there has been a significant risk and 2) where there may be diagnostic uncertainty or 3) where the patient desires a further test.
However, as I have said, you were never at risk, and you had an excellent test for a no-risk scenario -= you do not need further testing.
2- Receiving oral sex is theoretical risk if the giver has blood in his/her mouth because saliva is not infectious. But how much blood is needed? Is miniscule enough or much more needed for infection?
There are NO known cases where a person being sucked has become HIV positive - I'm not going to get drawn into speculative "what if's" - you did not have a risk and you have been tested negative - you are HIV negative.
2- I would like to be 100% sure that I am hiv negative from this encounter because I and my wife are not using condoms. Do my tests show that I have not been infected? Or should take a test at 8 weeks before making sex with my wife?
You have established already that you are HIV negative.
You asked a further question:-
"Does p24 antigen occur 1 week before antibodies? Or does p24 antigen occur just after the infection? I am asking that because test manufacturers state that p24 occurs approximately 1 week before antibodies. You say 3rd generation tests give conclusive results at 12 weeks. Therefore, should 11 weeks hiv duo test be conclusive. Am I wrong? "
Yes, you are wrong. P24 forms as a result of HIV viral replication and begins to rise very dramatically at 10 or so days. At 12 to 16 days the p24 element will be huge. The majority of people will form antibodies by 4 weeks. The use of the p24 antigen will enable near certainty of result at 4 weeks. I do not say that third generation tests will give conclusive results at 12 weeks - if you read my threads in connection with third generation testing then you will see that I say that a third generation HIV antibody 1 and2 test will give greater than 99% accuracy at 6 weeks.
You are HIV negative.
best wishes, Sean
It has been more than 24 hours and still waiting an answer doctor. I am very nervous and stressed. Please let me ask a brief extra question:
Does p24 antigen occur 1 week before antibodies? Or does p24 antigen occur just after the infection? I am asking that because test manufacturers state that p24 occurs approximately 1 week before antibodies. You say 3rd generation tests give conclusive results at 12 weeks. Therefore, should 11 weeks hiv duo test be conclusive. Am I wrong?
Does p24 antigen occur 1 week before antibodies? Or does p24 antigen occur just after the infection? I am asking that because test manufacturers state that p24 occurs approximately 1 week before antibodies. You say 3rd generation tests give conclusive results at 12 weeks. Therefore, should 11 weeks hiv duo test be conclusive. Am I wrong?
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