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Possible HIV? 07/13/2016

Question: 

Please help!

I performed oral sex on guy who, without asking, ejaculated in my mouth. A couple days later I had IBS and heat burning sensation in my hands, bottom of my feet, legs and back and some uncolored rashes that comes and goes within a day or two. Not knowing if these symptoms were related to anxiety (me checking my body in the mirror and worrying too much) or if I contracted STD ...at 11 days post "possible" exposure I took Lab Corp HIV RNA Qualitative blood test and come out NEGATIVE. Then, at 32 days post "possible" exposure I took Lab Corp HIV 4th Generation wRfx which also came out NO REACTIVE on on both - P24 & Antibodies, and if my anxiety was not enough at "40" days post "possible" exposure I took another HIV AG/AB, 4TH GEN with Quest laboratory which also came out both as NO-REACTIVE. I stilll feel burning sensation on my hands, legs and body but my doctor says it s nerves due to too my stress. With these tests done - I know everyone says after 12 weeks is conclusive BUT Can I be really sure I don't have HIV virus ?? Is it possible to get p24 gen NO-REACTIVE and Antibodies NO-REACTIVE at the same time after 32 and 40 days post exposure?? Please help

Answer: 

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline with your HIV/AIDS related health information. It seems you have some questions about the accuracy of some HIV tests after a potential exposure. We're happy to answer your questions for you.

First off, we'll say that giving oral sex is considered a low risk activity. This is true even if he ejaculated in your mouth. Low risk means that while transmissions are possible, they require specific circumstances to occur (like you having had major recent dental surgery prior to performing oral sex). To see the risks associated with this and many other common activities, we encourage you to check out our risk assessment page.

It looks like you've had the 4th generation DUO test at 11, 32 and 40 days post exposure. Here is a bit more information on the DUO test:

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 mention you're already aware of this, but in Canada the DUO test is not considered conclusive, meaning the results are not taken as accurate, until at least 12 weeks or 3 months post exposure (90 days). The tests you've have are too soon to show your status conclusively after this encounter, but we'd encourage you to consider the risks involved.

It's great you've gone for an HIV test, as we at AIDS Vancouver recommend routine HIV testing for all sexually active people. As for the symptoms you are experiencing, we at AIDS Vancouver are not healthcare providers, so cannot comment on them. However, HIV infections are never diagnosed based on symptoms alone, simply because the symptoms of an HIV infection are quite common to many other common medical conditions. Testing is the only way to diagnose an HIV infection, so if you want to know conclusively your status after this encounter you'll have to wait to get a test after 90 days. If you're concerned about any symptoms you're experiencing, we'd encourage you seek further clarification on them from your healthcare provider.

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

Trevor

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org