RNA test and Oraquick Swab Test

[Sean116]

Good evening Doctor.
I want to start by saying that past month as been probably the worst month of my life (Paranoia, Anxiety, Stress). I'm a 27 year old healthy male (play sports and train).  A little over a month ago, I was in Tijuana, Mexico. Had sex with a Registered Sex Worker. During sex my condom broke. She realized it and I pulled out. I put on another condom finished having sex. My penis was exposed for about 3-5 seconds before she realized the condom broke. Afterwards, she assured me that she is clean. She advised me that she has to get checked every 12 days for all stds and HIV test every 3 months in order to work at that specific bar (where I was at). I asked her a few times, since I was very paranoid and she assured me she was fine. She asked me if I was clean? The reason I was worried was because I had a jock itch on the head of my penis (No open sores or anything). I have a Fiance and really worried about giving it to her.

I went to the doctor 7 days later. The doctor checked out my genitals and said it was probably a jock itch, and said there is nothing wrong. I also got tested for Chlamydia, Gonorrhea, and HIV (Because I hadn't been tested in a year). All came back negative.
13 Days post incident: Did an HIV RNA test performed by LabCorp, came back "Non Reactive. No HIV RNA Detected"
28 Days post incident: Did an Oraquick Swab test, It was Negative
I haven't seen any major symptoms. My neck/throat were sore after 3 weeks (it might have been due to my wisdom tooth hurting along with my jaw).

My questions are:
Does the my jock itch increase my chances of getting HIV?
Are my tests reliable?
Do I need to do further testing?
Can I move on with my life without having to worry about HIV anymore?

Thank you for your time Doctor!

[H. Hunter Handsfield, M.D.]

See my original reply.  The test results rule, and your results prove you don't have HIV.  HIV wouldn't cause symptoms like this anyway and you've seen a doctor who reasured you it's nothing serious.  You don't need any more HIV testing.  Don't owrry about it.

[Sean116]

Good evening Dr. Handsfield! I apologize for taking your time however I have one more question:
I have been having  jaw pain (which I mentioned in my first post) on the right side of my face since 2 weeks after the initial incident and its still there today. The pain is my back jaw, and also front skull/jaw joints. Also causes sore throat, ear and neck pain. I went to doctor, he said its muscle joint issue in my jaw and prescribed me muscle relaxer.

1. Do you think this might be a symptom of new HIV infection?
2. Should I do another Antibody test?

Again, I'm sorry to be taking your time again.
Thank you very much doctor!

[H. Hunter Handsfield, M.D.]

To your 3 questions:  yes, yes, and yes.

Thanks for the thanks.  I'm glad to have helped.

[Sean116]

Good morning Doctor!
As you recommended, I went to doctors office today and got a Blood Antibody test done. It came back negative. So here are all my testes and results:

13 days past incident:  HIV RNA Test by LabCorp - Nonreactive / No HIV RNA Detected

28 days: Oraquick Advance Swab test- Negative

5 1/2 Weeks past incident (today): Blood Antibody Rapid Test - Negative / Non Reactive

Should I be confident in my results?
Are my testes conclusive now?
Can I leave this all behind and move on with my life?

Thank you for your time Doctor!

[H. Hunter Handsfield, M.D.]

HIV is rarely if ever transmitted by oral sex.

The RNA test is highly reliable no matter what lab does it.  Your two results together probably are 99.99% reliable proof you don't have HIV.  Don't overthink it, and you can safely ignore any and all "what if" questions that come to mind.

The official advice is often for a final test at 3 months.  That is likely to change soon, when CDC releases new recommendations.  Even now, it really isn't necessary to be tested at that time.  See the thread linked below.

http://www.medhelp.org/posts/show/1891685

[Sean116]

Thank you for your prompt response Doctor!

Also I forgot to mention, She gave me unprotected oral for about a minute. Does that increase my chances of getting HIV.
How reliable is the RNA test performed by Labcorp?
As advised I will go to a local Planned Parenthood and get another Blood Antibody test this weekend. If test comes back negative, Do I need to do a 3 Month test again?

Thank you Dr. Handsfield!

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You provide very strong evidence that your commercial partner doesn't have HIV.  It sounds like she is one of those sex workers who knows the score, uses condoms regularly, and gets tested.  For the most part, such women don't want to get HIV any more than you do!  And mostly they don't lie about their testing and status in this sort of situaiton.

Even with completed vaginal sex for several minutes, unprotected, the average HIV transmission risk has been estimated at about 1 in 2,000 for each exposure.  Even if your partner was infected, your rrisk was even lower, given the brevity of exposure.

Finally and most important, your test results are virtually 100% conclusive.  The combination of negative RNA test at around 12 days and negative antibody at 1 month is definitive.  The oral fluids test is a little less reliable at that time than a blood test, so you might want to have another blood antibody test as well.  However, considering all factors, you can be confident you don't have HIV and any further testing will remain negative.

1) Your jock itch made no difference in risk.
2,3) Your test results are reliable, but you may want to have one more test, as just discussed.
4) You can move on.  If I were in your situation, I would resume unprotected sex with my wife without worry of infecting her.

I hope this has helped ease your concerns.  Best wishes and stay safe--

HHH, MD