CSW condom breakage

[Stillwater194]

Hi there, I recently had a condom break with a CSW 18 days ago. I tested negative for all STIs on day 4. I was fine and going to put this behind me as I realize how hard Ilthe virus is to transmit.  Then I developed a cold sore on the corner of my lip.  When I looked up symptoms i saw oral ulcers which has me now a little concerned. Should I be worried about a cold sore popping up on day 18. I know sumptoms are not a good indicator but should this cause any concern to get a test? Thanks

[shaunw84]

We too use NAAT test for C/G, but the recommendation here is 7 days.  It's good to know that they can be used sooner.

[shaunw84]

Wow, I see the test window for HIV even with a 4th gen is 3 months.  

That's very unusual.  Most countries are trying to encourage early testing, since the 4th gen can catch acute infections.  

The CDC believes possibly as many as 1/2 transmissions occur during the acute phase.  So if people can be diagnosed early, hopefully a large number of new cases will be averted.

I've spoken to AIDS Vancouver person before -- the worlds oldest service organization.  He said since they've been using 4th gen tests, they've never seen a negative turn positive after 4 weeks.  I wonder why Canada policy is 3 months.

[Stillwater194]

I am a little worried still. Is it really that hard for a male to catch it from a female. I also read that you would need a triad of symptoms fever, sore throat , and rash to be worried about ARS is that true?

[Stillwater194]

No problem, here is a good overview of testing windows. Used to be 7 days but thatnhas changed.

http://www1.toronto.ca/City%20Of%20Toronto/Toronto%20Public%20Health/Health%20Professionals/Sexual%20Health/Files/STI%20Treatment%20Guidelines%20-%20Double%20Sided%20%282014%29%20Letter.pdf

[shaunw84]

Hey thanks for letting me know that.  I'll have to find out some more.

I know one of those two  C or G can be tested earlier.   But I understand that since they are done with urine, they are done at the same time at 7 days.

Do you know what they are called?  I.e. what method was used?

Be well

[Stillwater194]

Thanks for the feedback. The STi clinic here said with the Test given at 4 days it is more than enough for chlam and gonorhea. They actually said they consider it conclusive after 48hours so I am not sure what tray they use. I will follow I with HiV testing.

[shaunw84]

Don't want to be the barer of bad news, but STI testing 4 days after an encounter would not be conclusive.

Gonorrhea, Chlamydia, Trich testing can usually be done after 1 week.
Other STDs can take 12 weeks if the normal tests are used.  But molecular tests can be done much sooner.  

Discuss this with your doctor.  I'm a fan of early testing and early treatment so I would talk to my doctor about these, if I were in your shoes.

HIV test is done at 4 weeks after last exposure.  Choose  a 4th gen HIV test.  If you are in the US, you will have to specifically ask for it.  Unfortunately there are still too many doctors using 3rd gen tests, when this is readily available.   In UK, a 4 week 4th gen test is considered conclusive.  

I think you'll save yourself a lot of heartache and worry if you get a 4th gen then follow the rules for 3rd gen which is test at 4 - 6 weeks and then repeat at 3 months.  Discuss with your doctor.  But keep in mind that a lot of US doctors don't' know about 4th gen ag-ab test.   It's also called a HIV duo test.  So  you may have to educate your doctor.

As far as a cold sore, it's probably just that a cold sore.  HIV ARS symptoms are different.  And symptoms aren't always present.  And other times, you have symptoms and it's not HIV.  So don't rely on symptoms.  Rely on testing.

Be well