Aa
Please help
Hi
1. I have had two negative PCR RNA tests using a Multiplex test thats tests for HIV1/HIV2/HBV/HCV. I believe they pool the samples. It is the same test that blood is screened with. is pooling safe? If it is used for blood transfusions, it must be. correct?
I have had negative INSTI tests as well as negative DUO tests. For the DUO tests I waited after 28 days, antibody - 3 months. I had the RNA PCR tests at roughly 9 months. I have also had DUO and antibody tests well after 6 months since the last event.
2. I have only ever had condom protected anal sex where I was on top. Once, I ejaculated, the condom remained in the mans anus and when I pulled out I was flaccid. I was inside him for a minute max. after I ejaculated and kept thrusting. I pulled out and was soft. I worry the thrusting may had been unprotected by pushing the condom up the mans anus (if this is possible), is this protected?
I have had unprotected fellatio roughly 25 times by 8-10 men and performed fellatio 8-9 times on 7-8 or so men and swallowed once.
I am very worried about HIV1 Group N and Group P.
The tests say they look for HIV1, Groups M and O.
3. However, as all the groups share similar elements and only have very minor mutations from each other, do you think that the RNA tests, DUO tests and antibody tests would pick up HIV Group N or P?
4. Logically, p24 is part of HIV1, and as the DUO tests are looking for p24, then if p24 is present in the blood caused by HIV1 Group N/P, it would be picked up. Correct?
5. Is it the case that the reason why the tests do not say they detect Groups P and N, is because of licensing and that when clinical trials were being conducted, because of the rarity of Groups P and N, there simply wasn't enough people with Groups N and P to test so they could be licensed saying they test for Groups N and P. I believe a handful of people only have Groups P and N, but I worry about those who may have it and not know and spread it to others.
1. I have had two negative PCR RNA tests using a Multiplex test thats tests for HIV1/HIV2/HBV/HCV. I believe they pool the samples. It is the same test that blood is screened with. is pooling safe? If it is used for blood transfusions, it must be. correct?
I have had negative INSTI tests as well as negative DUO tests. For the DUO tests I waited after 28 days, antibody - 3 months. I had the RNA PCR tests at roughly 9 months. I have also had DUO and antibody tests well after 6 months since the last event.
2. I have only ever had condom protected anal sex where I was on top. Once, I ejaculated, the condom remained in the mans anus and when I pulled out I was flaccid. I was inside him for a minute max. after I ejaculated and kept thrusting. I pulled out and was soft. I worry the thrusting may had been unprotected by pushing the condom up the mans anus (if this is possible), is this protected?
I have had unprotected fellatio roughly 25 times by 8-10 men and performed fellatio 8-9 times on 7-8 or so men and swallowed once.
I am very worried about HIV1 Group N and Group P.
The tests say they look for HIV1, Groups M and O.
3. However, as all the groups share similar elements and only have very minor mutations from each other, do you think that the RNA tests, DUO tests and antibody tests would pick up HIV Group N or P?
4. Logically, p24 is part of HIV1, and as the DUO tests are looking for p24, then if p24 is present in the blood caused by HIV1 Group N/P, it would be picked up. Correct?
5. Is it the case that the reason why the tests do not say they detect Groups P and N, is because of licensing and that when clinical trials were being conducted, because of the rarity of Groups P and N, there simply wasn't enough people with Groups N and P to test so they could be licensed saying they test for Groups N and P. I believe a handful of people only have Groups P and N, but I worry about those who may have it and not know and spread it to others.
Thanks a lot. Best Wishes for 2012.
Appreciated. as I said, have a lovely weekend.
Appreciated. as I said, have a lovely weekend.
MEDICAL PROFESSIONAL
"...you have also never heard of such a patient either in any medical literature or general practice. Is this correct?" Yes.
And I'm glad to hear you're being responsible with regard to your oral herpes. But you need to be aware that transmission can occur from asymptomatic viral shedding. Avoiding oral contact during outbreaks reduces the transmission risk, but not to zero.
I'm glad the forum has been of help. But that should wind up this thread. Take care and stay safe.
And I'm glad to hear you're being responsible with regard to your oral herpes. But you need to be aware that transmission can occur from asymptomatic viral shedding. Avoiding oral contact during outbreaks reduces the transmission risk, but not to zero.
I'm glad the forum has been of help. But that should wind up this thread. Take care and stay safe.
Dear Dr.
Thank you very much. I appreciate your answers to a level that I truly can't explain in words.
My mind plays on me, and when you say that you have never seen a patient who has had a negative test result with current tests but actually has later turned out to be positive by being infected with HIV either Group N or P, I assume, you have also never heard of such a patient either in any medical literature or general practice. Is this correct?
Sorry I just want to make sure. Thank you again. I shall stay safe too. You stay safe too as thousands if people rely on your expertise greatly. I appreciate your non-judgmental candid nature.
I obviously do not know if these partners had HSV2, but I have never had any symptoms on my lips or anything save the tiny little sore which appears infrequently for years, so I shall take that as good news and relax.
And I actually informed all partners of my HSV1 and would never give oral sex had I been having an active outbreak - that is just plain irresponsible in my eyes.
Have a lovely weekend.
Thank you very much. I appreciate your answers to a level that I truly can't explain in words.
My mind plays on me, and when you say that you have never seen a patient who has had a negative test result with current tests but actually has later turned out to be positive by being infected with HIV either Group N or P, I assume, you have also never heard of such a patient either in any medical literature or general practice. Is this correct?
Sorry I just want to make sure. Thank you again. I shall stay safe too. You stay safe too as thousands if people rely on your expertise greatly. I appreciate your non-judgmental candid nature.
I obviously do not know if these partners had HSV2, but I have never had any symptoms on my lips or anything save the tiny little sore which appears infrequently for years, so I shall take that as good news and relax.
And I actually informed all partners of my HSV1 and would never give oral sex had I been having an active outbreak - that is just plain irresponsible in my eyes.
Have a lovely weekend.
MEDICAL PROFESSIONAL
1) Yes, probably still protected.
2) Already answered, both by me above and by your discussion with the Freedom Health doctor. I see no need to repeat the same answers.
3) No, I haven't seen that.
4) Oral infections are rare in people with HSV-2, and that virus is rarely if ever transmitted by oral to genital contact. However, your risk of oral HSV-2 if exposed to someone's genital infection is higher.
The biggest STD risk implied by your questions is transmission of your oral herpes to a partner's genitals. You should inform any and all sex partners of your HSV-1 infection, so they can make informed decisions about whether to proceed with oral sex with you.
That will be all for this thread. Take care and stay safe.
2) Already answered, both by me above and by your discussion with the Freedom Health doctor. I see no need to repeat the same answers.
3) No, I haven't seen that.
4) Oral infections are rare in people with HSV-2, and that virus is rarely if ever transmitted by oral to genital contact. However, your risk of oral HSV-2 if exposed to someone's genital infection is higher.
The biggest STD risk implied by your questions is transmission of your oral herpes to a partner's genitals. You should inform any and all sex partners of your HSV-1 infection, so they can make informed decisions about whether to proceed with oral sex with you.
That will be all for this thread. Take care and stay safe.
Sorry Dr. H. I have a nagging for attention to detail.
Perhaps you could answer these:
1. Regarding the condom slippage that I referred to, would that be defined as still condom protected?
2. So, despite the fact that the test website states that it only tests for HIV 1 Groups O and M, you believe that Groups P and N would be picked up?
I spoke to a Dr. at a clinic called Freedomhealth in London and he said that the vast majority of virologists would agree that Groups P and N would be picked up by current tests whether DUO or antibody or RNA because of how similar all strains are. He said those that disagreed were because they weren't educated enough!
3. Have you ever heard of or seen a patient who tested negative with current tests but actually has HIV1 caused by Groups N or P?
And finally, I know this is an STD question not HIV (so if you want me to post a new question in the correct forum I will), but in relation to herpes, all penetrative sex was condom protected (hopefully incl. the slippage), and I have never had any genital symptoms.
In terms of oral HSV2, and I right to say that it is rare that the people performing fellatio on me would have oral HSV2, and if they did, it is difficult to transfer from them to me.
and, in my limited cases of performing fellatio on a man, am I right to say that my risk of oral HSV2 is rare - indeed no symptoms apart from a tiny coldsore very infrequently which I have had from child hood which I attribute to be HSV1.
Perhaps you could answer these:
1. Regarding the condom slippage that I referred to, would that be defined as still condom protected?
2. So, despite the fact that the test website states that it only tests for HIV 1 Groups O and M, you believe that Groups P and N would be picked up?
I spoke to a Dr. at a clinic called Freedomhealth in London and he said that the vast majority of virologists would agree that Groups P and N would be picked up by current tests whether DUO or antibody or RNA because of how similar all strains are. He said those that disagreed were because they weren't educated enough!
3. Have you ever heard of or seen a patient who tested negative with current tests but actually has HIV1 caused by Groups N or P?
And finally, I know this is an STD question not HIV (so if you want me to post a new question in the correct forum I will), but in relation to herpes, all penetrative sex was condom protected (hopefully incl. the slippage), and I have never had any genital symptoms.
In terms of oral HSV2, and I right to say that it is rare that the people performing fellatio on me would have oral HSV2, and if they did, it is difficult to transfer from them to me.
and, in my limited cases of performing fellatio on a man, am I right to say that my risk of oral HSV2 is rare - indeed no symptoms apart from a tiny coldsore very infrequently which I have had from child hood which I attribute to be HSV1.
MEDICAL PROFESSIONAL
Whoa! You're expecting far too much for an online forum like this. And it's obvious you are obsessed with arcane details of sexual safety and HIV and STD transmission for which precise data do not exist. Freedom Health is a highly respected clinic; you might continue your dialog with them; they are in charge of MedHelp's international STD/HIV forum. However, with such detailed questions you should expect to undertake your own online research.
Thanks you Dr. I should say these are exposures I regret from sexual experimentation and I have a long term GF, some of these exposures were whilst I was with her, so I regret these events.
Some follow ups if possible:
1. Regarding the condom slippage that I referred to, would that be defined as still condom protected?
2. So, despite the fact that the test website states that it only tests for HIV 1 Groups O and M, you believe that Groups P and N would be picked up?
I spoke to a Dr. at a clinic called Freedomhealth in London and he said that the vast majority of virologists would agree that Groups P and N would be picked up by current tests whether DUO or antibody or RNA because of how similar all strains are. He said those that disagreed were because they weren't educated enough!
3. Have you ever heard of or seen a patient who tested negative with current tests but actually has HIV1 caused by Groups N or P?
I wanted to know regarding oral sex:
4. Where a person gives a blow job to another man, and that person giving the blow job swallows, then the risk is between 0 and 0.04 percent if the man who has ejaculated is positive and 0-0.0006% if the person's status is unknown? Correct?
5.. Where a person gives a blow job but does not swallow, the risk would be even lower, despite the fact that pre-cum will be present in the person giving the blow jobs mouth? Correct?
6. Where a person gets a blow job and the person giving the blow job swallows, is there a risk for the person receiving the blowjob who ejaculates in the other persons mouth?
7. Where a person gets a blow job but doesnt ejaculate in the persons mouth giving the blow job, the risk must be even lower, despite the fact that the man who is getting the blow job will have had precum coming from his penis? Correct?
I wish to assess the risk level in the first two scenarios, for the person who is giving the blow job, and in the second two scenarios for the person receiving the blow job
And finally, I know this is an STD question not HIV (so if you want me to post a new question in the correct forum I will), but in relation to herpes, all penetrative sex was condom protected (hopefully incl. the slippage), and I have never had any genital symptoms.
8.In terms of oral HSV2, and I right to say that it is rare that the people performing fellatio on me would have oral HSV2, and if they did, it is difficult to transfer from them to me.
9. and, in my limited cases of performing fellatio on a man, am I right to say that my risk of oral HSV2 is rare - indeed no symptoms apart from a tiny coldsore very infrequently which I have had from child hood which I attribute to be HSV1.
Thanks again. Hopefully I can put this to ease.
Some follow ups if possible:
1. Regarding the condom slippage that I referred to, would that be defined as still condom protected?
2. So, despite the fact that the test website states that it only tests for HIV 1 Groups O and M, you believe that Groups P and N would be picked up?
I spoke to a Dr. at a clinic called Freedomhealth in London and he said that the vast majority of virologists would agree that Groups P and N would be picked up by current tests whether DUO or antibody or RNA because of how similar all strains are. He said those that disagreed were because they weren't educated enough!
3. Have you ever heard of or seen a patient who tested negative with current tests but actually has HIV1 caused by Groups N or P?
I wanted to know regarding oral sex:
4. Where a person gives a blow job to another man, and that person giving the blow job swallows, then the risk is between 0 and 0.04 percent if the man who has ejaculated is positive and 0-0.0006% if the person's status is unknown? Correct?
5.. Where a person gives a blow job but does not swallow, the risk would be even lower, despite the fact that pre-cum will be present in the person giving the blow jobs mouth? Correct?
6. Where a person gets a blow job and the person giving the blow job swallows, is there a risk for the person receiving the blowjob who ejaculates in the other persons mouth?
7. Where a person gets a blow job but doesnt ejaculate in the persons mouth giving the blow job, the risk must be even lower, despite the fact that the man who is getting the blow job will have had precum coming from his penis? Correct?
I wish to assess the risk level in the first two scenarios, for the person who is giving the blow job, and in the second two scenarios for the person receiving the blow job
And finally, I know this is an STD question not HIV (so if you want me to post a new question in the correct forum I will), but in relation to herpes, all penetrative sex was condom protected (hopefully incl. the slippage), and I have never had any genital symptoms.
8.In terms of oral HSV2, and I right to say that it is rare that the people performing fellatio on me would have oral HSV2, and if they did, it is difficult to transfer from them to me.
9. and, in my limited cases of performing fellatio on a man, am I right to say that my risk of oral HSV2 is rare - indeed no symptoms apart from a tiny coldsore very infrequently which I have had from child hood which I attribute to be HSV1.
Thanks again. Hopefully I can put this to ease.
MEDICAL PROFESSIONAL
Noted before my reply above.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
There is almost sufficient information in your opening line to reassure you with 100% certainty that you are not infected with HIV. The available PCR tests for HIV DNA/RNA detect any and all types of HIV known to exist, with the exception of some strains of HIV-2. But that virus is picked up by all the standard antibody tests. Therefore, the combination of negative PCR plus the negative antibody tests you have had prove without doubt that you don't have HIV. To your specific questions:
1) Pooled HIV PCR tests are 100% reliable, whether used for transfusion donor screening or testing of individual patients.
2) Based on the exposures decribed, you are at quite low risk for HIV. As a man who has sex with men, it is reasonable for you to have a standard antibody test (or combo test for antibody + p24 antigen) from time to time, like once a year. You did not need any other testing and should stop doing it.
3,4) To my knowledge, the answers are yes. The combination of tests you have had would pick up any and all known groups, types, and subtypes of HIV.
5) I don't know the answers to these questions, except that the rare types of HIV you mention are generally understood to be rare in the UK and other industrialized countries. In such locations they are essentially limited to immigrants from HIV endemic areas like tropical Africa, and are not circulating at detectable levels in gay men or the general population. However, I am not familiar with this detail of the epidemiology of HIV in the UK. You could contact the Health Protection Agency, or search HPA's online information.
My advice is that you continue to follow safe sex practices. In addition to restriction of most exposures to oral sex and condoms for anal sex, you should always ask partners about HIV before having sex, and avoiding those who are HIV positive, don't know, or seem evasive about it. If you do those things, you can expect to never catch HIV. Searching online for details about virus types at the depth you have done probably serves to heighten anxiety more than necessary.
I hope this helps. Best wishes and stay safe-- HHH, MD
There is almost sufficient information in your opening line to reassure you with 100% certainty that you are not infected with HIV. The available PCR tests for HIV DNA/RNA detect any and all types of HIV known to exist, with the exception of some strains of HIV-2. But that virus is picked up by all the standard antibody tests. Therefore, the combination of negative PCR plus the negative antibody tests you have had prove without doubt that you don't have HIV. To your specific questions:
1) Pooled HIV PCR tests are 100% reliable, whether used for transfusion donor screening or testing of individual patients.
2) Based on the exposures decribed, you are at quite low risk for HIV. As a man who has sex with men, it is reasonable for you to have a standard antibody test (or combo test for antibody + p24 antigen) from time to time, like once a year. You did not need any other testing and should stop doing it.
3,4) To my knowledge, the answers are yes. The combination of tests you have had would pick up any and all known groups, types, and subtypes of HIV.
5) I don't know the answers to these questions, except that the rare types of HIV you mention are generally understood to be rare in the UK and other industrialized countries. In such locations they are essentially limited to immigrants from HIV endemic areas like tropical Africa, and are not circulating at detectable levels in gay men or the general population. However, I am not familiar with this detail of the epidemiology of HIV in the UK. You could contact the Health Protection Agency, or search HPA's online information.
My advice is that you continue to follow safe sex practices. In addition to restriction of most exposures to oral sex and condoms for anal sex, you should always ask partners about HIV before having sex, and avoiding those who are HIV positive, don't know, or seem evasive about it. If you do those things, you can expect to never catch HIV. Searching online for details about virus types at the depth you have done probably serves to heighten anxiety more than necessary.
I hope this helps. Best wishes and stay safe-- HHH, MD
Further, the RNA by PCR test states that it only looks for Groups M and O NOT P and N
I should say I live in UK and the Multiplex tests were carried out by a lab called tdlpathology who are very reputable.
Thanks
Thanks
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
