RNA by PCR

Dear Doctor,

I've been really worried about two separate incidents in which I think I might have been exposed to HIV virus. The 1st a condom broke while protected vaginal intercourse. I immediately pulled out but the head of my penis was unproteced inside her for about 5 seconds, she assures me she's not infected with any STD's but you never know. In the 2nd incident I was fingering this other girl for about 5-10 minutes after I finished I noticed a small bleeding cut on the side of my pinky finger, I don't know how I got it. Also we both performed brief oral sex on each other. A week  after the second incident I developed a fever with a sore throat, diarrhea, and the back muscles of my neck got really stiff. I panic and when and got a rapid oraquick test exactly at two weeks of possible exposure, it was negative. And also payed for an RNA by PCR test at 20 days of exposure and this where the results: "HIV-1 RNA by PCR < 48 copies/ml, HIV-1 RNA not detected. Te reportable range for this assay is 48 to 10,000,000 copies of HIV-1 RNA/mL." I also tested again with the Oraquick at 30 days after last exposure and it was negative. I guess my question is, how reliable is the RNA test? If I would be infected would the test detect the virus? The person that I talked to from the testing or lab company said that the RNA test is very reliable. And last, where my exposure risky?
I really appreciate you taking time to answer all of our question, God bless!!!    

[Edward W Hook, MD]

Your concern is misplaced.  There was absolutely no risk whatsoever from your masturbation activities.  No one has ever gotten HIV even with cuts on their fingers.  As for your first episode, unless your partner is an IV drug user or commercial sex worker and I suspect that is unlikely, her likelihood of having HIV is less than 1 in 1000 and the risk of HIV, if your partner was infected is 1 infection for every 1000 exposures. Thus your overall risk is mathematically less than 1 in a million.  Your test results make your risk even lower.  The HIV test has a problem with false positive results but the negative test result, along with your negative Oraquick combine to make it safe to say with confidence that you did not get HIV from the exposures you describe.  Forget about HIV from these exposures, you did not get it. EWH