Oraquick Advance at 6 weeks..

[Lostandscaredtx]

How accurate would the Oraquick Advance (Oral Swab) at 6 weeks after possible exposure?
I've read all through the forums about how the newer generations are more sensitive, but since Oraquick doesn't go by "generations", how accurate would it be at 6 weeks?

I know 3 months is "conclusive" per CDC guidelines - but I've seen many EXPERTS saying 6 week tests are accurate and they haven't seen anyone's test change from negative to positive at that time.  Does this also apply w/ the oraquick advance?

[joggen]

Is your exposure your broken condom incident with a female in January?

[Lostandscaredtx]

Yes.  I was tested 6 weeks after the possible exposure.

[joggen]

Dr. HHH and Hook typically recommend 6-8 weeks for exposures such as yours.

If the exposure is high risk (e.g. confirmed HIV positive partner) then they usually recommend testing out to three months.

And it doesn't make any difference if the test is an oraquick test.

[Lostandscaredtx]

She actually took an HIV test a couple weeks after our encounter which came back negative - but she went to the doctor because she became ill.  She was diagnosed w/ Autoimmune Vasculitis.. apparently her red blood cells are swollen or something.

I just don't know about all this...  autoimmune vasuclitis??? hiv????

i'm afraid her hiv test wouldnt be accurate because of the autoimmune vasculitis but i don't know.

[joggen]

Autoimmune vasculitis has nothing to do with HIV and does not affect test results.

[Lostandscaredtx]

So based on my 6 week negative and her negative (don't know how long before her last possible exposure was) ... but statistically...  the likelyhood of her being infected and within 6 weeks is pretty low, amirite?

[joggen]

Unless she was having regular sex with an HIV positive partner, I would think her chances of having HIV are just about zero with her negative test.

For the average heterosexual woman without any special risk factors, it's below 0.1% anyway.

[Teak]

You need to get a conclusive test at 3 months. An oral test given earlier than three months is known to give false negative test results. Only a 3 month test is conclusive.

[Lostandscaredtx]

I will be taking another at three months per CDC guidelines.  With that said, from what I've read, a 6 week negative is highly unlikely to change.  Plus the girl tested negative and my exposure was for no more than 5 seconds...    I'm hoping dr h and everyone else is right about 6 week time frame and somewhat low risk exposure.

I'm hoping dr h and everyone eps

[Lostandscaredtx]

And thanks for scaring me some more teak. ;)

Lots of what i've read says to not expect 6 week results to change as average seroconversion time is less than 30 days

[LIZZIE LOU]

no one is "trying" to scare you.  FACTS ARE FACTS ! ! !

[Lostandscaredtx]

Dr hhh and Dr hook's posts seem to indicate 6 week test is closer to 99% than 90%.  So does most other forums where people have first hand experience eithe being a counselor or a doctor.  

[joggen]

Teak and Lizzie are just going by the official guidelines. But that doesn't mean your result is going to change.

Broken condom incidents usually don't even require testing from a risk perspective, and with your 6 week negative you're more likely to get hit by a flying sheep than have HIV.

[Teak]

Broken condoms incidents USUALLY don't requiere testing? Tell that one to the people that have been infected because of a condom failure. Had joggen send the notice given on the oral tests taken to early he would have seen the problems with taking the oral tests to early and he would also have seen what state discontinued using oral tests for that reason.

[joggen]

Yes, just read the Expert forum archives where they have repeatedly said such incidents don't require testing..

The average male who has a broken condom incident is more likely to die from a lightning strike than contract HIV.

Yes there are people who are at significant risk from condom failure (high risk partner (e.g. confirmed HIV) or activity (bottoming)), but that doesn't apply to the original poster.

If you don't comprehend those facts than that's fine but don't needless scare the OP about his HIV risk or the validity of his 6 week test result.

[Teak]

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=54297

Why were they missing so many, it was because the testing centers were not following the manufactures guidelines and were giving conclusive test results before the recommended testing guidelines. Their guidelines states 3 months post exposure to obtain a conclusive negative test with the oral tests as does the guidelines for all blood tests.

[joggen]

That could have been through user error, a bad batch from the manufacturer, or any number of reasons.

[Teak]

Let us know when you get an educational background in HIV education.

[joggen]

Yes, I know, that's your mode of last resort- when you can't attack the argument, you attack the arguer.

[Teak]

No, it's that you don't have a background in HIV education. You can't argue that.

[LIZZIE LOU]

I'M ABOUT TIRED OF THIS.  I'LL BE SENDING A LONG, DETAILED EMAIL TONIGHT ! ! ! !

[Lostandscaredtx]

I appreciate everyone's passion in relaying accurate information.  Teak, I understand that from your standpoint, you're referring to CDC guidelines and what the test manufacturers state.

Joggen, I understand what you're explaining is that a heterosexual encounter with a woman of unknown HIV status, having a condom break and withdrawing within 5 seconds is considered "low-risk" and that after having a 6 week negative, my chances of that changing are very low.

What I understand myself, is that time after time, the medical experts/Dr's/counselors on this forum and others have stated that they have never seen a 6 week negative turn positive since the 80's.  I also understand that due to my very short exposure time, my risk is even lower.

Per the topic of this forum: "If you believe you have been exposed to HIV and want help to judge your risk, would like advice about HIV testing...."  I would really like teak to help me "judge my risk", especially after 6 week negative.  Instead of simply stating "3 months is conclusive", which I, and anyone else that has taken the time to read any amount of CDC guideline/manufacturer information would already know.

I'm not here asking what my risk was from oral sex or from eating from the same silverware.  I believe my question is valid and would deserve more than a copy-and-pasted excert from the CDC webpage.

I

[jonathan03]

are you serious with what you said about the oral rapid test accuracy?? you said here that it could give FALSE NEGATIVE before 3 months period?? ok,, you scared me now...i thought i have read someone else's post here that at 11 week is somehow reliable and conclusive??? i have a NEGATIVE test result at 10 weeks???? i shouldn't be certain that i am really NEGATIVE????i'm confused,, can you please stress out more info..thanks!!

[joggen]

Unless you tested at the Department of Health in Seattle recently that doesn't remotely apply to you.

And you obviously haven't understood a word of my previous posts.

I really don't understand why you won't take one more test and be done with it, since you're so concerned about HIV.

[diver58]

Agreeing with Teak totally, once your condom fails, it puts you at a risk (degree of risk may be debatable but it would certainly be not Zero). This is simply because, whenever condom fails, almost all the cases you are "in" and a rupture condom leaves you exposed to her/ his body fluids (vaginal fluids or anal environment possibly containing blood around), unprotected.

In this situation, would anyone feel comfortable to remain without being tested, especially when partner's health status is not known accurately?

[jonathan03]

it's because i'm afraid to know the answer....what if it turns out to be positive?

[joggen]

Then you can take appropriate action to maintain your health. You must know that intellectually.

But I still don't understand what all the fear is about, when you already have an 11 week negative, which is probably more than 99% reliable.

There probably is no practical difference between a test at 11 weeks and one taken now, but I just think this will keep bothering you until you have had an 'official', conclusive result.

[Lostandscaredtx]

jonathon03, don't be a thread jacker.

Here, we are talking about MY condom breaking, pulling out seconds later, and testing negative at 6 weeks.

The girl claims she tested a 2-3 weeks after our incident and was negative too.

[jonathan03]

thank you....teak's words was confusing when he said an ORAL RAPID TEST before 3 months can give you a FALSE negative result...that's y it scares me....but anyway,,,thanks again....

[diver58]

I got never confused with Teak's words, precise yet comprhensive.

What confuses me, two different standards for detecting the same virus. Three months for an event when someone had unprotected (or condome broken) sex with an HIV positive person. In my opinion, more than a test he is an aligible case of PEP (knowledgeable, please guide me). For rest of all other exposure, 6 weeks are enough,,,?? I am trying to understand how and why. Whnever there is a transmission, it got to be and has to be from someone positive. So why 6 weeks are enough in this particular case, just because we did know the confirmed status?

Once the virus invaded, now the matter is between the invader and the immune system of the person, how sooner it produces antibodies. The virus gives a damn care to its route and mode of entry,

[Lostandscaredtx]

Diver, regardless of the type of incident, CDC says 3 months.  The doctors on this forum have said 6 weeks is statistically sufficient if the persons status is unknown.  Your confusion is exactly why the CDC states 3 months (one of the reasons, at least).

[joggen]

They're not using two different standards. It all comes down to the risk of the person being tested.

Risk of infection is based on two factors- the likelyhood the partner is infected x the frequency of transmission of the particular sex act.

Say a male college student has a condom break with a girl during vaginal sex.  So, for him his risk would be 1/1000 x 1/2000 = 1/2,000,000. If that person tests at 6 weeks, the likehood of a false negative would be no higher than 1/20, so a negative result would make his odds of infection at 1/40,000,000 (1 in  forty million). Most people would consider that pretty rock solid evidence that the person is free of HIV.

Now, say a bisexual man bottoms an anonymous partner at a gay bathhouse. His odds of infection would be 1/5 x 1/100= 1/500. If that person tests at 6 weeks, a negative result would shift his odds to 1/10000. An encouraging statistic, but still high enough that another test would be needed at 3 months to put the risk to a more acceptable range (in the 1 in millions).

The same standard is being used, it's just that different people can have vastly different risks. All conclusive testing really is a reduction of the odds of infection to an improbable range. There is nothing magic about the arbitrary designation of 3 months as conclusive.

This is how Dr. HHH has explained it- just read the archives.

[Teak]

That explaination is totally wrong. Look at the new data of the increase in hetrosexual transmission and then tell me those odds are reliable.

[joggen]

Teak, those numbers (prevalence of HIV in hetero females without risk factors, and frequency of transmission) are from Drs. HHH and Hook.

Both doctors use those figures almost every day in their assessments on the _Expert_ Forum. If you have a problem with that then take it up with them.

[Teak]

Odds and factors are used in statistical computations for funding not for assessments in an assessment forum.

[joggen]

Again, take it up with Medhelp.

I'm not aware of any Medhelp policy banning such assessments.

I am only complying with this Forum's stated purpose:

"If you believe you have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or risks associated with specific sexual practices, this is the site for you."

[Teak]

You can't judge a risk using statistical factors. Statistical factors will not tell anyone if they were infected or not by their exposure, only a test at the proper time will tell them their status.

[joggen]

Risk is always judged using statistical factors and empirical evidence and it is not the same as status.

You are making the mental mistake of equating the two.

Telling everyone here who had unprotected sex that they need to test at 3 months is not a risk assessment.

[Teak]

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

Look at who wrote it and you show us where they used statistical values in when to test and who should test.

[joggen]

Those are testing guidelines, which include testing everybody regardless of risk, not risk assessments.

I'm done with this thread.

[nursegirl6572]

This isn't a numbers game!  A person either had a risk or they didn't.  Yes, of course we can use risk assessment to help ease the mind of a worried person, or help to explain the urgency of seeking PEP in a high risk situation, but a risk is a risk, period.

It would be crazy to advise someone who had a true risk that testing isn't necessary. And irresponsible as well.

I certainly wouldn't take the "odds" if I had a risk...I would be testing.

And, yes.....a 6 week negative IS extremely reassuring, but the reason that teak, lizzie, myself and others recommend testing out to 3 months is because 1.) it is the CDC guidelines, and 2.) Testing POS after a 6 week negative isn't likely, but it is not IMPOSSIBLE.

Like lizzie said...facts are facts.  Using risk assessment, and giving approx % is great to allow a person to know how concerned they may need to be.....but again...a risk is a risk, and in the end...the "odds" don't matter when it comes to the NEED to test.

[diver58]

Very good discussion went on this post. Difference of opinion is always good, if done with an intention to share knowledge and convince other purely on the basis of logic. And I really appreciate that this intention was well preserved in this debate.

In my humble opinion, I would agree with Nurse Girl that yes, risk is a risk, regardless of its degree of magnitude and must be ruled out by appropriate screening. Naturally, we don't compromise anything less than zero when it comes to our own life, and especially in my part of the world, HIV/AIDS is still a horrible life threatening disease due to, lack of quality medical care, non-availability of proper nutrition to everyone and limited accessibility to HAART. So in our part of the world, we focus more on abstinence and monogamy, purely under the influence of local environment and conditions, which may not be that applicable in the developed world.

[joggen]

I think I've generated some confusion in a statement I made here.

I will post here one more time so I can clarify.

When I said that testing usually isn't necessary after a low risk condom break, I meant that in the context of _annual HIV and STD screening_ for sexually active people, which would cover such incidents.  

I have stated this before repeatedly in previous threads, but forgot to mention it here.

I'm sure people will still differ with me on this, but the main argument for annual testing vs. testing immediately after the low risk incident is cost in terms of health care dollars vs. benefit.

However, if someone has an incident and hasn't been tested recently, that is certainly a good time for their regular checkup. And, annual screening applies to sexually active people who haven't had condom breaks as well.

[Lostandscaredtx]

I like what everyone has to say - but this is the deal, in my opinion.

Why would I want to post on a forum and be told information I already know, ie. "3 months test is conclusive"?

When I take the time to post on the forum and explain my situation, I'd really appreciate more than a copy-and-paste from the CDC website.  I've looked at the CDC website, I've read the manufacturers inserts, I've read through the forums...

What I was expecting is pretty much what joggen has done, given me his opinion.  Not reiterated what I've read on countless websites spouting off CDC guidelines.  I agree with the guidelines, but I'm not asking for what the CDC says, not asking for what a CYA lawyer driven approach is - but in terms of real life experiences of experienced people like teak and lizzie.

I just think that with someone as experienced and well educated as teak, that an actual well-thought out post rather than quoting what the CDC says would mean alot more to me, and all the people that read these forums.  I'm not at all saying that I don't appreciate what teak does here, it's just that I'd really appreciate knowledge regarding HIS experience - not what the CDC says.  I already know what the CDC says.

[Teak]

Have no idea as to Why you would post on a forum when you alread knew you had a risk and you knew when you needed to test. Guess you have a lot of time on your hands to waste and you believe that waisting other peoples time is of some benefit to you.

[LIZZIE LOU]

i am having a difficult time understanding exactly "why" this post is continuing.

the poster had a REAL risk.
the poster educated himself and knew the testing guidelines about when to test.
the poster tested at 6 weeks.
the poster "knows" when a conclusive test is.

now.  is it a fact that today's tests are more sensitive than they were in the past?  can they pick up hiv earlier than they did in earlier years?  of course...it's called progress.  with that being said...UNTIL THE CDC, FDA, AND THE MANUFACTURERS OF THE TESTS CHANGE THE GUIDELINES...NO ONE SHOULD BE SAYING DIFFERENTLY...AND I MEAN NO ONE ! ! ! ! !

as you know, a 6 weeks test is a good indication of your status...and is highly unlikely to change.  you also know that the guidelines still state that in order to get a conclusive result...you must test out to 3 months.

you have been given the facts...it is up to you to either test again or accept your 6 weeks negative.  if i were in your shoes...i would FOLLOW THE GUIDELINES FOR OBTAINING A CONCLUSIVE RESULT.  

this post needs to end ! ! ! ! !

[joggen]

Per joggen's disclaimer, "Always consult your personal physician or referred health care professional if you are concerned about any symptoms you may be experiencing and/or your risk of possible infection with HIV or other sexually transmitted diseases, and follow his or her advice concerning their testing, treatment, evaluation, diagnosis, or prevention (including Post Exposure Prophylaxis (PEP))"

[Teak]

Make sure you use a doctor that specializes in HIV and it's transmission and follows the proper guidelines to testing and does not use off label tests that are not approved by the FDA and their manufacturer which would be a violation of the federal and state False Claims Acts .