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ANXIOUS, SCARED, TIRED. PLEASE HELP, NEED RELIABLE HIV EXPERTISE.

Question: 

Hi,

Approximately 3 days ago I had sex with a CSW. During this encounter, I performed oral sex on her but for a very short amount of time (kissing, not really licking), and I am not sure if I had any sores in my mouth, but when I took time to notice that evening and the following morning, I didn't see or feel anything unusual. She also performed oral sex on me, but I was wearing a condom and ejaculated in the condom in her mouth. This was the extent of our activity.

Six months prior to this, I had a different encounter with a CSW (also the first time I really thought about the possibility of contracting HIV) where we did oral/protected vaginal sex, and I made sure to get tested regularly afterwards. My last HIV test, taken sometime before the encounter 3 days ago, was negative. During those six months, the thought of having possibly contracted HIV really wore me down mentally, and it is an awful feeling to know I have to go through another six months of hell in order to clear the HIV-possibility for this last encounter.

I just have a few questions that I am hoping can set my mind at ease. 1) What is my risk of having received HIV? 2) Do you recommend that I get tested given my experience? 3) If I were to take a 4th Gen Antibody/Antigen test (available at a clinic nearby) when would I need to get tested to get a conclusive result, or are there any tests that provide conclusive results before the standard six months (all the tests I have taken were 3rd gens)?

Please help. I'm very anxious and worn out from the fear and just can't think that this nightmare has begun again.

Answer: 

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline for your HIV/AIDS related health information. It seems you're concerned about the possibility of HIV transmitting during a couple encounters. We're happy to answer your question for you.

All of this information comes from our risk assessment page, so we encourage you to check it out when you get a chance.

Here is a summary of your activities:

  • gave oral sex

  • received oral sex

  • protected vaginal sex

Giving oral sex is considered a low risk activity. Low risk means that while transmissions are possible, they require specific circumstances to occur. These circumstances might be that you had had major recent dental work immediately prior to performing oral sex, for example. Receiving oral sex is considered a negligible risk activity, meaning that transmissions are only theoretically possible, and have never been shown to actually occur. Protected vaginal sex is considered a low risk activity, again meaning for transmissions to occur specific things need to happen (like the condom breaking, for example).

So you'll see that at most your activities were low risk. We at AIDS Vancouver recommend routine testing for all sexually active individuals, and considering none of your activities are really high risk, we'd simply recommend that you go for routine testing. It's great that you've been proactive and have already gone for testing.

As for the test you want to get, here is a bit more information on it:

Test Name
Method
Window Period
Conditions
4th Generation EIA Blood test that looks for antibodies AND p24 protein antigens. Commonly referred to as the "combination," "combo" or "DUO" test. P24 protein is detectable immediately after infection but only for the first few weeks. The antibody (ab) test has a window period of 4-12 weeks post exposure. This test is widely available in North America. Most HIV specialists consider this test to be conclusive at 6 weeks but official HIV testing guidelines still recommend re-testing at 12 weeks for conclusive results. Conclusive at 3 months post exposure.

You'll see in the chart that this test is considered conclusive 3 months (not 6 months) post-exposure. Keep in mind your risks involved, but to know your status conclusively after your last encounter you'd need to wait 3 months. We really encourage you to keep these risk levels in mind, as we are only recommending routine testing for you. It's great that you use protection in all of your encounters as it substantially reduces the risk of both HIV and other STIs.

Thanks for contacting the AIDS Vancouver Helpline with your questions, we hope we've answered them fully.

Trevor

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org