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HIV transmission through jock itch and testing

Question: 

Hello!

I had a protected vaginal sex. This was my only sexual intercourse for 3-4 month period. I used condom from beginning to end. There were kissing and oral sex (I didn't give, only received for 20-25 seconds and she didn't have a place which is actively bleeding as far as i saw)

But the problem is: I've been dealing with jock itch for a long time. I itch the place between my groin (left and right side of the penis/leg) and it's usually red-rash area. It wasn't bleeding during the sex or before the sex but I read that rashed skin may help tranmission of HIV if any vaginal fluid contacts with it. Is this true? Do I have a chance to catch HIV from my jock itch even If I used condom? (condom doesn't cover that area)

My second question is: She had a suspectful sexual intercourse. We both had tested. (4th generation Alere Determination HIV 1/2 AG/AB Combo, fingerstick) We had tested in 38th day after her possible sexual intercourse. Our tests resulted negative/nonreactive. Is 38 day enough to detect If there was antigens or antibodies? I read some guidelines and research articles and as far as i understand after 28th day (both ab and ag peaks) there may be a time which both antigens or antibodies are not enough to detect. Is this true? Is 38 day enough to understand our situation?

Can you help me with these two questions?

Thank you so much!

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about risk of acquiring HIV from a jock itch coming in contact with vaginal fluid and the validity of the fourth generation EIA testing. From the information given, having protected vaginal intercourse is considered Low Risk (Evidence of transmission occurs through these activities when certain conditions are met) Eg: Due to improper use and potential breakage of the condom.

Regarding your concerns about the jock itch: For you to get infected the vaginal fluid (which carry HIV) must gain direct access to the blood stream through open cuts/sores. In the above mentioned scenario the skin is intact and there is no active/visible bleeding from the rash therefore there is essentially no significant HIV-transmission risk (Essentially no open sores or bleeding wounds.) Most of the body's surfaces are dry skin (e.g Legs, arms) and they do not allow HIV to enter the body. Wet skin (or mucous membranes) is more vulnerable to HIV. These include: Foreskin and urethra in penis,Cervix and vagina, Anus and Rectum, Mouth and Throat ,Open cuts/ sores.

In order to contract HIV the following conditions must be met: There must be HIV present in a bodily fluid. The five bodily fluids that carry the HIV virus include: blood, semen (including pre-ejaculate), vaginal fluids, breast milk, and rectal secretions. The bodily fluid containing HIV must have direct access to the bloodstream. This can be through cuts, tears, rips, mucous membranes, open sores, or needles. Transmission occurs through a risky activity in which the first two conditions are met. For example: condom less sex, sharing needles, unsafe tattoos or piercings, vertical transmission–from mother to child (in utero, during delivery, breastfeeding).

4th Generation EIA (DUO) Test: The antigen (ag) portion of the test is detectable immediately after infection for the first 2-4 weeks. The antibody (ab) portion of the test has a window period of 4-12 weeks. Most HIV specialists consider this "DUO" test conclusive at 6 weeks. Official HIV testing guidelines still recommend re-testing at 3 months (12 weeks) for completely conclusive results.Accuracy is 99.9%. If the fourth-generation combination assay is negative, the person is considered HIV-uninfected, and no further testing needs to be done. Your tests results were negative at 38 days (which falls within the 6 week period). However, you can get tested at 12 weeks in order to get completely conclusive results.

Recommendation: Refer to Physician for HIV test

Regards, AIDS Vancouver Helpline/Online, Vardah.