Additional Testing

[renoraines2012]

Dear Doctors,

I performed oral sex on a female CSW for a few minutes and I am concerned about STD and HIV.  I never put my mouth near either hole, but when we washed up she notice a drop on blood on the towel.  I have a very clean mouth had not brushed my teeth since earlier in the day (at least 8 hours).  I took a NAT DNA PCR and Standard HIV Antibody test at 8 days, 15 days, and 21 days, and 28 days and all were negative.  I took a STD panel at five days and all were negative.  I plan on taking a STD panel and Antibody test at 42 days next Wednesday.  Any chance of the HIV test results turning positive and would you recommend any other testing?  Are my HIV test results at 28 days very accurate or conclusive???

Thank you. .

[Edward W Hook, MD]

Oh please.....  it is well past time for you to stop worryng about the exposure you have mentioned, stop worrying, stop testing and move forward.

I'll have nothing more to add to this thread. EWH

[renoraines2012]

I took a STD panel test at 6 weeks with a throat swab and everything was negative.  Because of the possibility of a drop of blood got in my mouth should I be worried about Hep B or C.  Both test at 6 weeks were negative -Antigen for Hep b and Antibody for Hep c?

[Edward W Hook, MD]

At this point, I urge you not to worry further and move forward.  EWH

[renoraines2012]

I was reading a couple of your posts from 2009 and you stated that you could not get Chlamydia from performing oral sex on a female.  However, there was a small risk you could get gonorrhea or NGU.  Do you think I need to get a throat swab or should I consider myself lucky and no further testing is needed for STDs or HIV?

Last question

[Edward W Hook, MD]

The PCR is not a recommended test for HIV diagnosis although many compnies sell it for this purpose (it is a great money maker for the companies that sell the test).  We do not recommend it either. The reason is not the issue of sensitivity but the fact that the rate of false positve test results are more common with the PCR than for the tests recommended for the purpose of diagnosis.  EWH

[renoraines2012]

Thank you again and I will get a test this week using a throat swab.  Why do some of the people on this site say that the DNA PCR and Antibody are not conclusive at 28 days?  Is that do to historical norms?

[Edward W Hook, MD]

Even in the unlikely situation that you broke her skin and got her blood in yoru mouththere would be no risk.

The testing you had for gonorrhea and chlamydia was the right test, performed from the wrong site.  Your mouth was what contacted her genitals, not your penis, therefore if you wish to be tested you should have your throat tested. While urine tests are fine for diagnosis of penile infection, a throat swab is needed for diagnosis of a throat infection.  EWH

[renoraines2012]

Doctor,

The following is the test I used:

This test detects the actual bacteria of Nesseria Gonorrhoeae and Chlamydia Trachomatis from a small urine sample (20ml). This test uses nucleic acid amplification for higher accuracy

There is very little risk of a false positive, however, there is a measurable risk (~5%) of a false negative. Ensuring "first void" urine (without urinating for at least one hour prior) improves this significantly. The CDC recommends this type of testing over swab tests for asymptomatic patients.

[renoraines2012]

Thank You.  What if I cut her with one of my teeth and a drop of blood got it my mouth?

[Edward W Hook, MD]

Welcome to the Forum.  If you had both a negative HIV PCR and a negative HIV antibdy test at 28 days.  You do not need further testing - the results are conclusive and show that you did not get HIV from the exposure you have described.  there is no need for further HIV testing and if you choose to do so despite the fact that it is not needed, you can expect to continue to get negative HIV tests related to this exposure.

For STD testing, I presume that you had oral testing (mouth swabs) for gonorrhea and chlamydia -if so, these tests are very accurate and you can be confident that you did not get these STDs through the exposure you describe either.

You have no reason for further concern or testing.  EWH