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worried about toddler

Question: 

Hi i had an exposure(oral recivsex with a girl) in mid december 2018, since then i got tested at 45, 72, 83,111 days past exposure all 4th gen tests in GUM clinic London, However recently i am getting more sore throats than i used to get and i had one episode of ulcers near ulva, are my tests conclusive? I am worried because as child i used to get more episodes of cold which upon googling might be probably because i might have CVID

I have a toddler who keeps putting hands in her mouth, yesterday when i was holding her she touched my mouth when lips are a bit open, probably got saliva on her hands and she kept fingers in her mouth within a minute, now i am feeling bad and worrying , if all i am late seroconverter am i putting my kid at risk?

h

Answer: 

Hello. Thank you for contacting us with your question.

We understand that you would like to know whether multiple 4th generation HIV tests you've had after receiving oral sex are considered conclusive. You are also concerned about HIV transmission to your child through saliva.

Receiving oral sex is considered a Negligible Risk for HIV transmission. This means that there is theoretically a risk of acquiring HIV in this manner, but there has never been a documented case of such a transmission.

According to the Canadian AIDS Treatment Information Exchange, Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection. Fourth-generation HIV tests have a sensitivity of about 99.9%. (1) Since all four of the tests you had were past the one and a half month window period, you can consider each of these test results to be conclusive. Late sero-conversion is extremely rare and occurs only under certain specific conditions. A sore throat is not indicative of an HIV infection in the absence of a positive HIV test result. A sore throat could be attributed to any number of causes.

In regards to passing HIV to your child through saliva, some information about how HIV is transmitted might be helpful. In order for an HIV transmission to occur, all three of the following conditions must be met:

1 - 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. (2) HIV is not transmitted through saliva.

2 - 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. (2) This condition did not exist in your scenario

3 - Transmission occurs through a risky activity in which the first two conditions are met. (2) Unprotected anal or vaginal sex and sharing hypodermic needles for injection drug use are examples or high risk activities for transmission of HIV.

Recommendation: There are no evidence or no documented cases of transmission from this activity. Consider seeing your doctor if you require more personalized answers or to address your sore throat.

Regards, AIDS Vancouver Helpline Volunteer, Dyson