Rapid Test Anxiety

[billywilliams30]

Doctors:

I will try and be brief but please understand that I am very anxious.  Two years ago I had a very risky encounter and had two RNA test done at 14 and 28 days, 5 Oraquick Rapid test done out to 14 weeks all negative. Thought I was in the clear at that time.  In May of this year got stupid and met a guy on line.  He performed oral sex on me to completion and then masturbated himself but I got some of his semen on my hands.  Had a few scabs on each hand but none that were openly bleeding.  Freaked me out all over again.  Did not experience any major symptoms except for sinus problems and a cold about 4 weeks after the incident.  So I had an Oraquick Rapid HIV 1/2 fingerprick done at 6 weeks after the incident and it was negative.  Have done a lot of research on the Oraquick Rapid and felt a little comfortable that it was negative.  Now, 3 weeks later I still am having some sinus issues but just 3 days ago came down with shingles.  I have never had shingles and really did not know what they were.  My doctor was very surprised that a guy my age (38) and in very good shape (runner and workout a lot) would have shingles.  Am now on 4 different meds including antiviral, steroid, pain med, and nerve med.  Symptoms are much better but I am very concerned that people with shingles are most likely immune compromised.  Also concerned especially since I read that Dr. HHH had posted recently about the Oraquick test missing over 15% of all true positive test and is only 85% accurate.  So my question is this...were all the rapid test I took two years possibly wrong?  Was my test taken 3 weeks ago wrong?  Could these shingles be related to acute viral syndrome?  What should I do now?  Please help.  Thank you

[Edward W Hook, MD]

No shingles are not a part of the so-called ARS which is present in some people with recently acquired HIV.  Entirely different process.. Take Care.  EWH

[billywilliams30]

One final question and I will sign off....are shingles a part of the acute viral syndrome that a lot of people have a few weeks after infection?  Thanks again

[Edward W Hook, MD]

I would not worry about oral sex.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.

Most medications do not interfere with HIV antibody tests.

Studies demonstrate that the performance of rapid and laboratory based EIA tests for HIV antibodies perform equivalently.  

Getting tested is up to you.  Your risk for HIV is quite low from what you tell me.  If you wish to absolutely rule out the possiblity of HIV, get tested.  I am confident the result will be negative.  

[billywilliams30]

Thank you for your response. You did not mention anything about the oral sex part...how much at risk was I there?  In addition, should I get re-tested now or wait (its now been 10 weeks since the event), and should I do a rapid or the standard EIA test?  Will the meds I am on interfere with the results of the test?

Thanks

[Edward W Hook, MD]

Welcome to the Forum. Sorry to hear of your shingles but I have to say, it sounds as though your doctor is doing all of the right things.  I suspect part of the reason for your concern is that you are aware that persons with HIV are at increased risk for development of shingles, causing you to worry about your earlier test results.  I'll try to help.

First I will mention that while shingles is more common in persons with HIV an among older persons, the fact is that many young people also regularly get the illness.  I suspect your illness is more of a matter of bad luck than a sign of other, more serious underlying illness.  

The post that you mention by Dr. Handsfield is at least a year and perhaps several years old.  At that time he was citing relatively recent experience in Seattle which raised some questions about the sensitivity of the OraQuick tests.  Since then however there have been numerous studies which have consistently shown that the OraQuick tests are just as accurate as other, laboratory based tests for HIV antibodies and should be believed.  Your combination of multiple negative OraQuicks and negative RNA tests should be believed.  At 6 weeks an Oraquick test, like other tests for HIV antibodies will detect at least 90% of recently acquired infections and probably more.  

I will also comment that even with cures/sores on your hands and the fact that you got your partner's genital secretions on you, mutual masturbation is a no risk activity and does not put you at risk for HIV.

I hope these comments are helpful to you.  EWH