Anonymous
hello.i visited a massage parlor on 9 jan and get protective sex( using condom) and unprotective oral sex. im just wondering and i want to know if its any risk if your finger has a severe small cut and not bleed, fingering a woman and been giving an oral sex on her with posibble me having a mouth ulcer and bleeding gum.am i at high risk?. about the 4th generation(cmia) if we get tested early in first couple week from that event, (actually i get cmia test 4th day and 11 day after the event ) and the result is non reactive, should i be worry because lately i havent slept well, ate well, and my shoulder aching. how accurate the cmia test? im very afraid to get next test.
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Anonymous
Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It seems like that you are worried about the test (4th generation) that you had at 2 weeks after exposure, and afraid to get your next test.

Fingering a woman is a negligible risk activity, meaning that there has never been a confirmed report of transmission in this way. Any cuts that you have which are not actively bleeding present no entry point to your blood stream and therefore do not increase your risk of acquiring HIV. Giving an oral sex is a low risk activity, which is the same as having sex using a condom.

For HIV to enter our body, 3 factors must be present. Our transmission equation shows this in more detail.

HIV TRANSMISSION EQUATION


BODY FLUID
+
ACTIVITY
+
DIRECT ACCESS TO BLOODSTREAM
---------- -------- ----------------------------
• blood (including menstrual) • unprotected anal or vaginal intercourse • vagina
• semen • sharing needles • anus
• pre-cum • mother to child (in specific cases) • urethra in the penis
• rectal secretions • open cuts and sores (in theory)
• vaginal fluids • other mucosal membranes
• breast milk • points of needle injection


The 4th Generation test that you took is looking for both antibodies and antigens. It's an excellent test to have. The 4th Generation is considered conclusive at 12 weeks, which means that you will need to return for a follow-up test for a conclusive result. Your 12 week test does not have to be a blood draw, another popular test is the Rapid (finger prick) test, which is far less intrusive and gives a result within 20 minutes.


Here's some information on the test you took, and the Rapid for you to consider in the future:

4th Generation test

= RISK OF HIV TRANSMISSION

Rapid 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.


I hope this information helps lessens your anxiety and that you are able to sleep and eat. Please congratulate yourself for looking after yourself, and continue to be proactive with your sexual health.

Thank you for contacting the AIDS Vancouver Helpline. You might want to visit this websites to give you more information [AIDS Vancouver](http://www.aidsvancouver.org/) and [CATIE](http://catie.ca/).

Best in Health!

Roel

AIDS Vancouver Helpline/Online

Monday-Friday 9am-5pm (PST)

1 844 INFO-HIV (Toll free Canada & U.S.)

helpline@aidsvancouver.org

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Test Name Method Window Period Conditions
Rapid or “Point-of-Care” Blood or oral swab test that looks for antibodies. Up to 95% of infections are detectable within 4-6 weeks post exposure. Most people develop detectable antibodies in 21-25 days. Two forms of rapid test available: finger prick blood sample or oral swab. Oral swab test is most common in the U.S. but in Canada it is not approved and blood collection is more likely. Many places in the U.S. and abroad may charge a fee for rapid testing. Conclusive at 3 months post exposure.