Oral Sex + HIV Testing questions

Hello Doctor,

I have posted my exposure details at http://www.medhelp.org/posts/HIV-Prevention/Freaking-out---please-help/show/1273516?personal_page_id=1548622 and have got a few reassurances. However I would like to further explain and hopefully put this thing to rest.

The only thing I need to add is that 2 days before the exposure, I had a couple of cavities filled (1 temporary and 1 permanent filling). My gums were bleeding on the day of the treatment but I'm assuming healed by the time I had the exposure since I did not see any blood on the day of the exposure.

I went to a local hospital (well known) on the 3rd day of my exposure and was directed to a counsellor. She said that any exposure is a high risk one as all the body fluids of a positive person have the virus. She was very non-committal about my degree of risk. She called an HIV specialist and he said that I should get a PCR DNA test. I got the result back today (7th day after exposure). It was negative.  

On the 5th day of exposure, I asked the other person (with whom I had the exposure) to get a HIV test (Elisa). His result came back negative for HIV as well as VRDL. But this person has had multiple partners in the last 3 months.

The questions I have are:
1) What is my risk for HIV? None as I understand from the public forum post.
2) What is the implication of my negative PCR DNA test? Is it valid at just 70 hours after exposure? When is the right time to take a DNA PCR test?
3) Which HIV tests should I take and when - to put this thing to rest?
4) Which HIV tests should this other person take and when? Is there a test that he can take right away to prove that he does not have HIV? Not sure if I can get him to do another test but can try.
5) I don't have any blisters, sores, etc... as of today. Am I safe from other STD's or do I need to wait for another couple of weeks to know for sure? Any tests I need to take for other STD's?
6) Do you agree with the counsellor?

Thanks.

[Edward W Hook, MD]

The folks on the HIV Community site have informed you correctly and that you had dental work a few days before exposure makes absolutely no difference.  Your risk from the exposures you describe was virtually zero to begin with and your partner has tested negative making the chance that he has HIV close to zero as well. for you to still be worrying about this makes no sense at all.  Rather than repeat what you have already heard I will go straight to your questions:

1.  Correct. given the facts you have provided, there is no risk of HIV from these activities.
2.  The time course for which HIV tests are useful for detection of HIV is unknown. that is the reason they are not recommended for routine use.  While it is further proof that you did not get HIV, how strong that proof is cannot be stated; that you had a negative test following a no risk exposure is not particularly surprising.  Getting further HIV PCR tests is an anxiety-driven, mis-informed waste of money.  
3.  You really do not need further testing since your exposure was no risk and your partner has tested negative.  If you had been at risk, a standard HIV antibody test a 6 weeks detects over 95%of infections and at 8 weeks detects virtually all.  
4.  Your partner really does not need further testing. the statistical chance that he was in the so-called window period is very, very low.
5.  Testing for usual STDs (gonorrhea, chlamydia, NGU) can be performed at any time more than 3 days beyond exposure with great confidence in the results.  There is no need for herpes testing. If you do not develop lesions in the next 10-14 days, you did not get HSV.  Syphilis is very, very rare and not a major concern unless you develop a lesion and since your partner's test was negative, that is very, very unlikely. If you do develop a lesion, you should have it tested.
6.  Read above.  Your counselor was being overly conservative.

Hope this helps.  You are overly concerned and really need not be.  I hope my comments will be helpful to you.  If not, please look at other posts on this site and you will see further verification form both of us as we answer questions of the sort you ask almost daily.

Please no, "what if...." or "could it be that...." questions.  the exposure you describe was virtually no risk to start with.  EWH

[VeryConcernedMortal]

Dear Doctor,

Another peice of data - One of my root canal caps also came off a couple of days before the exposure.

Thanks.

[VeryConcernedMortal]

Thanks Doctor. Hopefully I can be at peace now.