PEP to be taken? Condom slippage

[Tensed0389]

Hi,
I am very tensed and wanted some feedback. I had vaginal/oral sex with a woman. Oral sex was not protected (which i believe anyway does not cause any problem).
So, the next part is that I had vaginal sex with her which lasted for a long time. I used 3 condoms in all and while inserting for the first time (using the first condom) I had the condom intact. This lasted for long and I checked intermittently during this and it was intact on the head few times I checked. However, after sometime when I was about to put in my penis again in her vagina I found that condom was not on my penis and was on the bed. During the time it was in the vagina (first time) I never felt any sensation that the condom was not on my penis. So, after noticing that there was no condom on my penis I opened up another pack and in subsequent events the condom was always intact during the entire intercourse
I have the following concerns:

1. I went to the ER and practicing nurse (two separate occasions) they did not put me on PEP. I still have some hours before the 72hrs ends and I am concerned as I did not know when the condom slipped off that I may have contracted HIV.
2. Based on my explanation what are the chances of HIV (I asked her about her status and she said she was OK as negative HIV 2 months ago but anyway you cant trust it)
3. What kind of test would give me conclusive results at the earliest?

Very tensed, please get back to me so that I will know if PEP needs to be taken.

Waiting for your reply.

Thanks

[Tensed0389]

I also wanted to add that I am not a circumcised individual, if that will help in the assessment

[JamesD1991]

PEP  would not usually be recommended in your situation,

If you had brief unprotected penetration, you had a small risk.  Take a DUO test at 28 days

[Tensed0389]

Thanks for getting back. What does small mean in this scenario? If you have any numbers. To give more background about the girl, she was white, was OK to have sex w/o condom (scary), says HIV negative two months ago. I don't think she takes drugs (but did not ask).
Is DUO at 28 days conclusive? Also, if I take PCR RNA 3 weeks down the line will that be conclusive?
Please advice!

Thanks!

[JamesD1991]

DUO will be conclusive at 28 days.

RNA test will be a good indicator, but must be backed up with an antibody test to confirm no infection because they are designed for diagnostic purposes

[Tensed0389]

Hi James,
Thank you for the prompt response. In the previous post I was also looking for
1.Is DUO at 28 days conclusive?
2. What does small mean in this scenario? If you have any odds
3.RNA test will be a good indicator, but must be backed up with an antibody test to confirm. When is this back up antibody required?

Please share your thoughts.

[JamesD1991]

1. I've already answered that.
2. Small as in small. There's no need to play the numbers game because one time occurances can lead to infection.
3. I've also already answered this.

[JamesD1991]

3. Sorry I had a typo so I'll answer again. These tests are NOT designed for diagnosing infection. They are for people who already have HIV. So not have anything detected doesn't absolutely exclude infection.

[Tensed0389]

Yup, sorry had missed the DUO part. Wanted to confirm
1. duo test is the p24 antigen and antibody? I mean what should I say to the lab if they as me what kind of test o want? With so many names flying, I wanted to make sure. Sorry if its naive.
2. Someone mentioned to take hiv quantitative assay pcr. I am 4 days to possible exposure. Is this a good test to have within this timespan?

I would really appreciate your inputs

[JamesD1991]

1. Ask for a DUO or a 4th Generation test.
2. No

[Tensed0389]

Thanks for your response.  Really appreciate it!

[Tensed0389]

Around 12 days after the exposure I felt a lot of fatigue which went away after I had enough sleep. I have the following q's
1. Is that a sign of hiv?
2. DUO at 30 days would be fine as well, right? I mean the sensitivity does not reduce correct?

[JamesD1991]

1. No.
2. Yes. The test is best around 27-30 days

[Tensed0389]

Hello,
There is another q and although there has been a lot of mixed info on internet.. wanted to know if unprotected oral has any hiv transmission risk or not?

[JamesD1991]

No

[Tensed0389]

Thanks James..!!

[Tensed0389]

Hello,
Just wanted to infrom that my 30 days which said it is HIV AG/AB, 4th Gen. This is the same as DUO, right? Had some follow-up questions
1. Should I take DUO again after 90 days?
2. In between this I also had an unprotected oral with someone who was a high risk (smoked cig and pot before giving me oral), should I get tested for hiv for this instance as well?

[Tensed0389]

Thank you Vance for getting back I had anther quesiton as well which may have been overlooked HIV AG/AB, 4th Gen (through quest) this is FDA approved and same as DUO right?

[Vance2335]

Yes

[Tensed0389]

Thank you so much Vance and James for your prompt replies. I cannot thank enough on how much the replies have helped me.
Cheers!!

[JamesD1991]

Thank you for your kind words

[Tensed0389]

Oh and forgot to mention that the test was non-reactive a.k.a negative

[Tensed0389]

I had a qq that just popped up, it is as follows
Does 4th generation test, test for antigen for HIV-2 as well? Do HIV-2 produce antigens?
I am thinking what if HIV2 only antibody and that may not have been detected. This may be very naive but it had me wondering.
Thanks for looking into it

[Tensed0389]

Can anyone pls provide their feedback on this?