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Question: 

Hello,

I am a straight 21 year old male. I had unprotected sex for the first time on June 25 with a girl for a few minutes. I started with a condom but could not finish so I took it off for the end. A few days after, I developed a lot of pain in my groin area and legs. I went to my doctor and he said I have an infection and prescribed me penicillin. It turned out to be a muscle strain after an MRI and pain pills. However, I finished the medicine. About 7 days into the medicine treatment, I developed a rash on my chest, oral thrush and a rapid heart rate. My doctor said I was allergic to penicillin and gave a steroid which helped for a while. It then came back and I have had severe anxiety about it being HIV. I asked my partner to get tested about 7 weeks later and she did and was negative. She said I have nothing to worry about however my anxiety is killing me. I did an Oraquick test last week and was negative which was about 11 weeks later. I still cannot get it out of my head. Should I be worried? I have never felt so alone and scared in my life. Thank you.

Answer: 

Hello and thank you for contacting the AIDS Vancouver helpline.

We gather that you are asking about the accuracy of a self administered Oraquick HIV test. At AIDS Vancouver, we generally do not recommend home testing kits because there is no opportunity for counselling and these tests can yield false results.

Consider the following from the Canadian AIDS Treatment Information Exchange:

"The Oraquick test approved in the United States has a lower sensitivity than other tests, about 98%. In other words, if 1000 HIV-positive people were tested, 980 would test positive and 20 would incorrectly test negative. This means that the chance of false-negative results for this test can be higher than for other tests. However, since the vast majority of people testing for HIV are actually HIV negative, the chance of a negative result being false is still very low" (1)

While you can take some comfort in your negative Oraquick test result, we would recommend receiving a fourth generation EIA test, administered by a healthcare professional. It sounds like you are currently at about 3 months out from your potential exposure and many HIV specialists consider this test conclusive at 6 weeks. Fourth-generation HIV tests have a sensitivity of about 99.9%. In other words, if 1000 HIV-positive people were tested for HIV, 999 would test positive and one would incorrectly test negative. Since the vast majority of people who get tested for HIV are actually HIV negative, the chance of a negative result being false is extremely low.

It is impossible to attribute your symptoms to HIV in the absence of a positive HIV test result.

You are likely already aware that when you removed the condom, you increased your risk level for an HIV transmission. The length of time that you had unprotected sex is not significant to your risk level.

We have included a link in the additional resources below regarding the effectiveness and proper use of condoms for HIV prevention.

Regards, AIDS Vancouver Helpline/Online, Dyson