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Dr Hook - Test Accuracy Question
Dr Hook
I came to this site a few weeks ago and have been on it every since. I was feeling confident of the information I read as it relates to my issue that is until last night. I had a boyfriend who cheated on me and just learned he is positive after we had sex mutliple times since he thinks he was infected. The sex was anal and unprotected with me being the insertive parnter. I also performed oral sex on him although he not ejaculate in my mouth but there was pre cum present. I tested at 5 weeks using an Oraquick rapid finger stick test. It was negative. I then tested at 8 weeks and 1 day and it was negative using the same test. I felt very confident based on your comments on other posts. Then I saw the post yesterday about the reliability of the Oraquick rapid. After reading the report in Europe and then seeing other studies done which gave the same results I am scared to death. I then looked at Oraquick's site and read their studies which even showed the test missed a few people who were really HIV positive. Oraquick says they are over 99% accurate but other studies show a range of accuracy between 68% and 94%. Why in the world would the FDA allow Oraquick to use this product if it gave false negatives?? I then read some posts from Dr HHH in the archives dating back to Nov 2010 where he says not to use rapid test if you can use the EIA test due to accuracy of the rapid test. Then I see where he says in posts this year that the rapid test are just as reliable as the EIA. This seems inconsisent and confuses me. Why does he seem to give two different answers? Should I have more test done and if so, which ones and when? During the past couple of weeks of hell waiting on 8 weeks to get here, I had a sinus infection and was treated with steroids to reduce symptoms. What, if any drugs can delay seroconversion and/or effect the test? I have no one to turn to for information and am very scared. Please help. Thanks
I came to this site a few weeks ago and have been on it every since. I was feeling confident of the information I read as it relates to my issue that is until last night. I had a boyfriend who cheated on me and just learned he is positive after we had sex mutliple times since he thinks he was infected. The sex was anal and unprotected with me being the insertive parnter. I also performed oral sex on him although he not ejaculate in my mouth but there was pre cum present. I tested at 5 weeks using an Oraquick rapid finger stick test. It was negative. I then tested at 8 weeks and 1 day and it was negative using the same test. I felt very confident based on your comments on other posts. Then I saw the post yesterday about the reliability of the Oraquick rapid. After reading the report in Europe and then seeing other studies done which gave the same results I am scared to death. I then looked at Oraquick's site and read their studies which even showed the test missed a few people who were really HIV positive. Oraquick says they are over 99% accurate but other studies show a range of accuracy between 68% and 94%. Why in the world would the FDA allow Oraquick to use this product if it gave false negatives?? I then read some posts from Dr HHH in the archives dating back to Nov 2010 where he says not to use rapid test if you can use the EIA test due to accuracy of the rapid test. Then I see where he says in posts this year that the rapid test are just as reliable as the EIA. This seems inconsisent and confuses me. Why does he seem to give two different answers? Should I have more test done and if so, which ones and when? During the past couple of weeks of hell waiting on 8 weeks to get here, I had a sinus infection and was treated with steroids to reduce symptoms. What, if any drugs can delay seroconversion and/or effect the test? I have no one to turn to for information and am very scared. Please help. Thanks
MEDICAL PROFESSIONAL
As I said above, "Your negative results at 8 weeks prove you weren't infected, regardless of your partner's HIV status." If you decide to have another test for even greater reassurance, an EIA at 3 months is the right time.
Thank you for your answer. I think you are saying that I do not to test anymore and that I should consider my results conclusive. If that is not the case, at what point in time should I take the EIA test to be sure I am OK? At 3 months?
MEDICAL PROFESSIONAL
Welcome to the forum. Dr. Hook and I take questions based on our own availability and schedules, without regard to requests for one of us or the other. Our opinions and advice are always more or less identical, even if our styles are somewhat different.
The important information in your question is your test results. When HIV testing is done suffcieintly long after the last possible exposure, the test results overrule all other considerations, such as exposure history or symptoms. And 8 weeks is plenty for all the HIV antibody tests. Your negative results at 8 weeks prove you weren't infected, regardless of your partner's HIV status.
Scientific data change as new studies are done. The current understanding is that Oraquick and other rapid tests are just as reliable as lab-based EIA tests. Therefore, you really don't need any additonal tests. But of course you are free to do that if you remain nervous about it.
Finally, there are no drugs or illnesses that have been demonstrated to delay seroconversion or to otherwise intefere with HIV test reliability. There are theoretical concerns about potent immunosuppressive drugs, potent cancer chemotherapy, and certain life-threatening illnesses -- but even these are theoretical only, with no cases (to my knowledge) of actual interference. In any case, minor illnesses like sinusitis or the low doses of steroid drugs like you took have no effect.
So all things considered, there is no basis for you to be "very scared". It is clear you don't have HIV. But as I said, if you would like further reassurance, visit your local health department clinic or your primary care provider and have a lab-based (EIA) HIV antibody test. For the reasons discussed, you can expect continued negative results.
I hope this helps. Best wishes-- HHH, MD
The important information in your question is your test results. When HIV testing is done suffcieintly long after the last possible exposure, the test results overrule all other considerations, such as exposure history or symptoms. And 8 weeks is plenty for all the HIV antibody tests. Your negative results at 8 weeks prove you weren't infected, regardless of your partner's HIV status.
Scientific data change as new studies are done. The current understanding is that Oraquick and other rapid tests are just as reliable as lab-based EIA tests. Therefore, you really don't need any additonal tests. But of course you are free to do that if you remain nervous about it.
Finally, there are no drugs or illnesses that have been demonstrated to delay seroconversion or to otherwise intefere with HIV test reliability. There are theoretical concerns about potent immunosuppressive drugs, potent cancer chemotherapy, and certain life-threatening illnesses -- but even these are theoretical only, with no cases (to my knowledge) of actual interference. In any case, minor illnesses like sinusitis or the low doses of steroid drugs like you took have no effect.
So all things considered, there is no basis for you to be "very scared". It is clear you don't have HIV. But as I said, if you would like further reassurance, visit your local health department clinic or your primary care provider and have a lab-based (EIA) HIV antibody test. For the reasons discussed, you can expect continued negative results.
I hope this helps. Best wishes-- HHH, MD
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