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Question about testing
Hi Dr. Hook, I received unprotected anal sex from a man that I was dating on two separate occasions in June of this year. On the first occasion, he did not ejaculate inside of me, however, he did ejaculate inside of me on the second time, which was a couple of days later. We are both 21 year old males, and he stated that he had only had sex two times prior in his life, both with the same partner. He was the first person I had ever had a sexual experience with at the time. I fully realize and take responsibility for my stupid mistake, and this has scared me so badly that I will never have unprotected anal sex again. My question relates to testing-- I used two OraQuick home oral swab tests 8 weeks and one day (57 days) following the last time we had anal sex. I tested twice in the same day because I thought that I may have swabbed my upper gum more than once on the first test, and the instructions said to only swab once per gum. Both tests were negative. Are these two tests at 57 days considered definitive/conclusive? Can I move on with my life? Also, is it safe for me to have protected anal sex with the man that I am currently dating? This whole thing has me very concerned. I really appreciate you taking the time to answer my questions!
MEDICAL PROFESSIONAL
If I were in your circumstance, I would not be tested. On the other hand, people who are worried about having HIV usually should be tested, even if the risk is little or none, because a negative test result is usually more reassuring than expert advice. So probably you should do it for that reason.
Your last question is splitting hairs. There is no difference in HIV test performance within a few days either side of 3 months.
Your last question is splitting hairs. There is no difference in HIV test performance within a few days either side of 3 months.
Just to clarify my question, I meant would you test again at the 3 month mark if you were somehow in my situation?
Dr. Handsfield, thank you very much for taking the time to answer my questions. Given the fact that you said there is likely zero risk involved and my two negative oral swab tests at 8 weeks, would you test again if you were somehow in my situation? I realize that you said it is up to me, but I wanted to get your opinion. In addition, does 3 months = 12 weeks = 84 days for testing purposes? Thank you again for all of your help!
MEDICAL PROFESSIONAL
It's up to you. See above.
MEDICAL PROFESSIONAL
Welcome to the forum. Dr. Hook and I take questions interchangably, without regard to specific requests. I'm on call at the moment. Dr. Hook and I have worked closely together for 3 decades; our styles may differ, but our basic opinions and advice do not.
This was a low risk exposure with regard to HIV, probably zero risk, since it is exceedingly unlikely your partner does not have HIV. Of course that assumes your partner's sexual history is accurate -- but most people don't lie in such situations. Therefore, while I understand your anxiety, you really needn't be worried. Your risk is low enough that I would not have recommended HIV testing.
In response to your specific questions: First, a negative rapid oral fluids test at 8 weeks is nearly proof positive you weren't infected. Most antibody tests are definitive at that time, but the oral fluids test takes longer to reach 100% certainty, about 3 months. As I said, I wouldn't have recommended testing at all -- but since you've started down that path, if you need 100% reassurance about the negative result, you'll need to have a blood test now, or another oral fluids test at 3 months.
In the meantime, however, you indeed can "go on with [your] life" without worry. The chance you have HIV is zero for practical purposes, and it is safe to have anal sex with your new partner, especially with condom protection. In fairness, however, you should tell him the situation and let him participate in a joint decision "To do what and with which and to whom" (to quote the closing line from an old limerick). (No male should ever have sex with another man -- even entirely safe sex --without first disclosing what each knows about his HIV status.)
I hope this has helped. Best wishes-- HHH, MD
This was a low risk exposure with regard to HIV, probably zero risk, since it is exceedingly unlikely your partner does not have HIV. Of course that assumes your partner's sexual history is accurate -- but most people don't lie in such situations. Therefore, while I understand your anxiety, you really needn't be worried. Your risk is low enough that I would not have recommended HIV testing.
In response to your specific questions: First, a negative rapid oral fluids test at 8 weeks is nearly proof positive you weren't infected. Most antibody tests are definitive at that time, but the oral fluids test takes longer to reach 100% certainty, about 3 months. As I said, I wouldn't have recommended testing at all -- but since you've started down that path, if you need 100% reassurance about the negative result, you'll need to have a blood test now, or another oral fluids test at 3 months.
In the meantime, however, you indeed can "go on with [your] life" without worry. The chance you have HIV is zero for practical purposes, and it is safe to have anal sex with your new partner, especially with condom protection. In fairness, however, you should tell him the situation and let him participate in a joint decision "To do what and with which and to whom" (to quote the closing line from an old limerick). (No male should ever have sex with another man -- even entirely safe sex --without first disclosing what each knows about his HIV status.)
I hope this has helped. Best wishes-- HHH, MD
Also, is there any need for additional testing? Thank you!
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