Questions on repeating OraQuick Rapid HIV Test

[quiteconcerned13]

Hi,

I had one instance of unprotected sex with a Canadien female on the night of 2/19 and did a OraQuick Rapid HIV Test on 3/22 which was thankfully negative.  According to previous posts, a negative test at this time point (about 4.5 weeks) typically picks up 90% of new infections.  My question is: if I were to get restested now (about 8 weeks after the incident), do I need to get retested again at 3 months as per the CDC recommendation? I am hearing many conflicting reports about this.

Thanks...

[Edward W Hook, MD]

Welcome to the Forum. this is one of the few instances in which Dr. Handsfield and I both disagree with the information that is provide on the STD Community site by Teak and his colleagues.  They are providing the "official" CDC answer to this question.  An 8 week test should be considered definitive.  I will paste an excerpt from an earlier response to another client which I hope will be helpful.

"The traditional and most widely used tests for HIV are tests for antibodies to HIV which are available both as so-called "rapid" or point of care tests which can be done in the clinic and laboratory based antibody tests. For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies."

Neither I nor any of my colleagues has had or is aware of any person who has had a positive test for HIV develop after the passage of 8 weeks unless they had been taking anti-HIV therapy in an unsuccessful effort to prevent infection.  For you, particularly after a single exposure to a partner who is statistically unlikely to be infected, an 8 week test should be considered definitive and does not need to be repeated.  EWH

[Edward W Hook, MD]

As I said, your risk for infection is quite low. I would not seek further testing at this time.  EWH

[quiteconcerned13]

Thanks for the input yet again Dr. Hook,

Given the previous negative test at 4.5 weeks and low risk based on history, do I even need another test?  I recall you mentioning that above 95% of new infections are positive within 5 weeks.  

[Edward W Hook, MD]

I agree that your risk is quite small.  

Regarding what the counselor said, I've pasted in something I wrtoe about the 3-month testing guideline below:

"The traditional and most widely used tests for HIV are tests for antibodies to HIV which are available both as so-called "rapid" or point of care tests which can be done in the clinic and laboratory based antibody tests. For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies. "

take care. EWH  

[quiteconcerned13]

Dear Dr. Hook,

So I went in to get my 8 week test and the counselor there would not give me the test because she claimed that I was not at the 3 month point, as per the CDC recommendation.  Perhaps, I am being excessive in my worry, but should I feel reasonably safe given that:

a. I had a negative Oraquick test at 4.5 weeks
b. It was only 1 act of unprotected intercourse with a girl (unknown sexual history)

It's just tough to wait for another 3 weeks...

[Edward W Hook, MD]

When you do, since it will be more than 8 weeks since your exposure, the result will be definitive.  EWH

[quiteconcerned13]

Thanks Dr. Hook,

i hope to have recieve a negative test tomorrow just like my test at 4.5 weeks.