Risks to "extended" partners

    Today, my ex-girlfriend informed me that she just tested HIV positive via testing that was done at a hospital. I immediately went and got tested using the "fingerprick" test, and it came back negative. My last sexual contact with her was approximately one month ago - there was no intercourse, but there was oral sex.  Prior to that, we had been having unprotected sex for around two years with the last intercourse...?

    Since that last sexual contact with my ex, I have had multiple unprotected sexual encounters with one woman and protected sex (though unprotected oral) with two others. I informed the woman that I had unprotected sex with, and she also tested negative today with the rapid test via oral swab (last unprotected intercourse with her was Monday).  My questions are these:

1) What is the rate of "false negatives" for the fingerprick and rapid oral swab test?
2) What is the acceptable period of time that must pass from last sexual contact until the test can be considered definitive?
3) What is the danger to the two women that I had protected sex/unprotected oral with? Should they be notified?
4)What is the risk to the woman that I had multiple unprotected intercourse/oral with?
5)The woman that I had unprotected sex with also had unprotected sex with another man - what, if any, is the risk to him?  Should he be notified?

Thank you for your time.

[Edward W Hook, MD]

Welcome to the Forum.,  Before I say anything else, let me say that I hope your ex-GF is OK and that she is in care for her infection.  In addition, I am sure that it was difficult for her to tell you of her infection – she has done a very good thing by letting you know. Now, let's address your risk.  Most exposures to persons who have HIV infection do not lead to infection. For genital contact, HIV infection is transmitted on average about once for every 1000 exposures.  For oral sex. the quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.

In your case, you are now more than 4 weeks beyond any exposure of any sort.  Your blood tests at 4 weeks would be expected to detect over 90% of infections which had been acquired.  At 6 weeks more than 95% of infections are detectable and at 8 weeks the figure rises to over 99%.  A negative test beyond 12 weeks following exposure provides complete assurance that you did not get HIV.  Thus your test result is very good news and makes it unlikely that you acquired HIV from your ex. As for your specific questions:

1.  The answer is time dependent with the figures for positivity over time having been listed above.
2.  See above. Neither of us on this site have seen anyone become positive for HIV more than 8 weeks following exposure for over two years now.  Some more conservative sites debate this and use a time of 12 weeks for declaration that a person definitively does not have HIV.
3.  Low.  You should wait until you have a more definitive answer. There is little to be gained by raisi9ng concerns because you may have been exposure to a partner with HIV at this time other than anxiety.
4.  I have provided those figures, on a per exposure as above.
5.  Same answer as 3 above.

Hope these answers are helpful to you.  I know this is a nervous time for you.  Please feel good about the results you have at this time and continue to test.  EWH