Welcome to our Forum. I'll be glad to comment. The exposure you describe almost certainly did not put you at risk for HIV. Protected or unprotected, receipt of oral sex has never been proven to lead to HIV infection. Further, condoms are completely effective for prevention of HIV from vaginal intercourse as long as they are worn throughout the sex act. Thus your only risk for HIV is from the "possible penetration" that you mention which, I doubt occurred. if you had actually penetrated your partner, you would know it.
As for your symptoms, indeed they do have many of the characteristics of the ARS which sometimes occurs in persons who have recently acquired HIV however I am confident that your symptoms were not due to HIV. When persons are evaluated for classical ARS, only about 1% of them turn out to have HIV while the remainder have other viral illnesses such as the flu. Further, when persons have the ARS, their HIV blood test is typically positive within a few days of their beginning, thus your negative OraQuick nearly two weeks after your flu-like symptoms began is strong evidence that they were not due to HIV.
In answer to your specific questions:
1) How risky was my behavior?
See above. Low risk.
2) I've read in numerous posts that symptoms are not a good indicator of HIV status. Do my symptoms at all resemble ARS?
You are correct, symptoms are a poor indicator of HIV but your symptoms do resemble the ARS. Your negative OraQuick proves however proves that your symptoms were not the ARS.
3) Is a 24 day OraQuick test any indication of my current status? What percentage of people would test positive with an OraQuick at this point of infection? I read that the CDC says 25 days is the average number of days for antibodies to appear. Not sure if this is the same for OraQuick.
See above.
4) What testing schedule would you recommend?
At 28 days you can seek testing with a 4th generation HIV test. At that time the results will be definitive and no further testing is needed.
5) Any other general advice?
No
I hope these comments are helpful. EWH
As I have already told you, the exposure you are concerned about did not put you at risk for HIV. I see no need for concern or testing. Despite that you are testing and want to know about trest perfromance. I have posted a recent comment, based on recent data that I made to another client below.
"If you are interesting in putting your concerns about HIV aside sooner than later however, the OraQuick is the wrong test to use. While there are no formal scientific studies which compare all test types to one another, there is an emerging consensus about how quickly test results can be expected to be definitive. The quickest way to be sure that a person has not acquired HIV is with a combination HIV antigen/antibody test (also called 4th generation or DUO tests). these tests give completely reliable results 4 weeks after an exposure. The combination of a PCR plus a standard antibody test would provide results in a similar time despite what the people who sell them tell you and the PCR tests are typically the most expensive tests one can get. If you are tested only with an antibody only test, results will be definitive at about 8 weeks whether that is a laboratory-performed test or a rapid, finger stick test. The OraQuick which tests for the [presence of antibodies in saliva provides reliable test results a bit later, perhaps taking as long as 12 weeks in a very small proportion of persons with recently acquired HIV."
As I said earlier, I see no need for testing. If your anxiety means you need to be tested however, a 6 week OraQuick, while strong evidence that you were not infected is not 100% conclusive. EWH
Dr. Hook - Thank you for your response a few weeks ago. I visited my doctor at the 4 week mark for a follow-up test. His office does not offer the 4th generation test, so instead he performed a standard antibody test (not sure the generation). The results came back negative. He also gave me a physical exam and was not concerned that I was experiencing ARS at the time of the visit. I took an at home OraSure oral swab test at 6 weeks 4 days (46 days). This result of this test was also negative. I've read numerous posts claiming that >95% of individuals will produce antibodies within 6 weeks. I've also read posts claiming that the OraQuick oral swab test has a high number of false negatives.
How accurate is a negative OraQuick oral swab test at 6 weeks 4 days?
I've read numerous times that most individuals will test positive by 6 weeks and virtually all individuals will test positive by 8 weeks. Do you recommend that I have a follow-up test at 8 weeks?
This sex act is outside of my normal behavior, which is why I'm so concerned. Do you feel that my test results are accurate enough to resume unprotected sex with my regular partner?
Thanks!
No, neither the timing or the fact that your test was an OraQuick changes my assess or advice . EWH
Thank you for your quick response. In your response, you mention a "HIV blood test is typically positive within a few days" of ARS symptoms. I have looked back and confirmed that my doctor performed his STD test on the 13th day. Also, the OraQuick test is an oral swab test, not a blood test. Would either the timing of my physicians test or the fact at OraQuick as an oral swab test modify your response? As you would expect, I am extremely concerned. Thanks again!