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recent exposure

So Doctor I had an exposure 30 days ago with a female sex worker. Had protected sex condom broke and had unprotected vaginal sex for about 20 mins.

I did an oraquik test at 25 days- negative.How reliable is this test for me being negative?
I have symptoms of rash itchy looks like welts or hives with some spots of red acne pimples in groups and some spotted. I got this rash accompanied with excssive sweating that lasted 2 days. real excessive sweating wet pillow blanket able to ring my shirt. Does this sound like ars or hiv realted? besides that I feel fine except for some muscles that feel weak or strained.

I wanna have another hiv test, which would be the best one if taken today for an accurate and reliable result?
I have an oraquik test readily available when would you recommend taking that with the above question taken into consideration.

Some doctors say an pcr test would be accurate after ten days or so is that accurate? if not when?
What test could I take as of now to be considered definite in terms of knowing if I have hiv? Thank you.
5 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

You've been quite busy the past 4 months on the HIV community and international forums.  You seem to have had difficulty understanding (or believing?) the generally reassuring comments and advice you received there.

The basic fact is that in the US, the risk of catching HIV from any single exposure to a female sex worker is very, very low.  The large majority of such women do not have HIV (mostly under 1 chance in 1,000), and if a woman has HIV, the average transmission risk for a single epsiode of unprotected vaginal sex is around 1 in 2,000.  Therefore, we can calculate a rough risk of 1 in 2 million for the event you describe above.  This is why experts don't even recommend HIV testing after any single exposure, except in special circumstances, e.g. unprotected sex with a partner known to have HIV.  With your apparent sexual lifestyle, I would encourage you to ignore individual sexual exposures and just plan on routine testing for HIV (and other STDs) from time to time, like once a year or so.

But I imagine that, having started down the testing pathway, you're going to want to continue until you have a conclusive result.  The oral fluids test is the slowest of all standard HIV tests to become positive.  The standard ("3rd generation") blood antibody tests are virtually always positive within 6 weeks, but oral fluids require 3 months for a conclusive result.  Your negative result at 25 days isn't useless, though; it's probably around 70-80% reliable.

PCR testing is not recommended in such low risk situations.  My advice for a definitive test is that you wait another 3 days, i.e. to the 4 week mark, and then have a duo (also called "combi" or "4th generation") test for both HIV antibody and p24 antigen.  That test is 100% conclusive at 4 weeks.

Below are links to two threads that discuss the times to conclusive HIV test results, depending on the specific test (or combination of tests), including why testing earlier than 3 months is usually conclusive, despite official advice that says 3 months is necessary.

http://www.medhelp.org/posts/show/1891685
http://www.medhelp.org/posts/show/1704700

I hope this has helped.  Best wishes--  HHH, MD
239123 tn?1267647614
MEDICAL PROFESSIONAL
I forgot to comment on your symptoms.  As Dr. Gonzalez-Garcia told you a few months ago, symptoms are never useful in judging possible ARS, and test results always overrule symptoms.  In any case, the symptoms you describe are not at all suggestive of a new HIV infection.
Avatar universal
Thank you so much for your comments and help. I just have a phobia of contracting hiv. I know maybe I should make better choices. Point taken. I just need to embed that in  my head. So I don't even think about putting myself in this kind of situation. Thank  you.
Avatar universal
so the oraquik is not going to be reliable till 3 months?
239123 tn?1267647614
MEDICAL PROFESSIONAL
Correct, if you mean 100% reliable.

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