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HIV Test Accuracy for my Situation
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An_249117 posted:
Hi there,

I had a potential exposure in early October (received oral sex, gave oral sex for less than 15 seconds, was fingered in anus for extended periods of time, and the guy put his penis near/in my anus (can't remember if he penetrated, but I was diagnosed with Gonorrhea with an anal swab, and treated it).

I was put on PEP (Isentress + Truvada) within 24 hours and took the 30 day regimen as prescribed.

I subsequently took my first Rapid HIV Test (Antibodies) 6 weeks post exposure, but it was only 10-11 days after I was taken off the PEP, and the results came back negative.

I was wondering how accurate those results are, and I wanted to assess whether contracting Gonorrhea from this experience increases my chances of contracting HIV by a lot.

I am planning to go do another rapid HIV test in 5 weeks, but it is causing me a lot of anxiety as I read online that PEP might affect the "window period".

Any feedback on my current situation would be appreciated. Thanks!
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georgiagail responded:
No; the idea that PEP negatively affects the window period is inaccurate; the confusion occurs because the use of PEP is recommended for a SIGNIFICANT exposure risk to HIV where the CDC will recommend testing out to the six month mark.

http://www.thebody.com/Forums/AIDS/SafeSex/Q216377.html?ic=2003

In your case, the fingering in the anus (both giving and receiving; you did not indicate which took place) presents NO risk to you. Unprotected oral sex (both giving and receiving) carries an estimated risk of .5 to 1 per 10,000 exposures with a source KNOWN to carry the virus. If you are unaware of your partners status, the risk would be even lower.

If the anal contact involved only frottage, this is not considered a risk for HIV transmission.

Assuming that you picked up the gonorrhea (i.e., were not previous infected with this bacterial based STD) from the frottage is not unreasonable. These bacterial based STD's only require contact with mucous membranes for transmission as opposed to HIV which must enter body issues (typically through an open cut, tear, wound) for transmission to take place. This is why bacterial based STD's (gonorrhea, chlamydia) are FAR more prevalent issues than HIV.

The fact that you picked up this STD in no way increases your chances of contracting HIV.

I hope this helps to ease your concerns a bit as you wait for further test results.

Gail
 
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mtunes replied to georgiagail's response:
Hi Gail,

Thank you for your detailed response, it definitely has given me some reassurance on some of my concerns. I had a few other questions I wanted to ask you in regards to my situation, and whether you would be able to give any additional input:

1) I mentioned that I was treated for Gonorrhea during my PEP regimen (I took oral antibiotics); would this have any chance of reducing the PEP effectiveness or skewing the rapid HIV testing results? (I took these antibiotics around 15-18 day of PEP regiment)

2) In regards to the Gonorrhea exposure, I am fairly confident that I picked it up with this encounter, and I had not had sexual relations for more than a year before it. Additionally, I started having anal pains (a bump) as well as bowel pains around two weeks after the encounter. I read online that it could a symptom of gonorrhea? I went to the doctor during that time to get an anal swab done, and they thought it was hemorrhoids as well.

3) During my PEP regimen, I also took some other antibiotics (7 days) for hemorrhoids (my doctor prescribed it to me believing that my anal pains were from hemorrhoids). Once again, would this have any effect on the effectiveness of PEP and/or the rapid HIV test results?

4) You mentioned in your post that PEP doesn't have statistical proofing to delay the "window period". As such, what accuracy would testing at 6 weeks be?

Thanks once again for answering my questions. I know that I am asking very detailed questions, but any input on it would be fantastic.

I really appreciate the time you have put in answering this board's numerous questions, thanks!
 
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georgiagail replied to mtunes's response:
No, the antibiotics you took would not negatively affect the test results of your HIV screening test nor the PEP regimen.

With current screening methods. the majority (95 percent) of newly infected folks would have enough antibodies present 1 month after transmission to show a "reactive" (positive) screening result. At three months this percentage has increased to 99.9 percent. Six weeks would fall somewhere inbetween this. Thus, it would be highly, highly unusual that someone would test negative at six weeks and positive at twelve.

The very small percentage of those who would need to wait for final screening at the six month mark are those whose immune systems have already been damaged by other, very serious medical issues and who may be slower at producing antibodies since the screening tests do not look for the presence of the actual virus but rather antibodies the immune system begins to produce after transmission. This group could includes folks who have recently undergone chemotherapy or those who have received an organ transplant and are on immune suppressing medications.

Gail
 
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An_249117 replied to georgiagail's response:
Hi Gail,

My anxiety had subsided for a little bit after your post last week. However,it has come back as I have had a cold/sore throat, making me anxious of ARS related symptoms. Thought I could ask you a few more questions to see if I can get any further reassurance:

1) From your experience (on the board, etc.), have you seen any individual who tested negative at 6 weeks change results?

2) I mentioned in my original post that the activity consisted of fingering (I was the receptive person for this). I have never been anally penetrated before, and am now having doubts whether during the "fingering" session, if the partner had also penetrated me with his penis, which is causing me doubts.

3) Do you think there would be any benefits of getting testing again (9 weeks post-exposure, 3 weeks post-PEP) this week, or should I just wait it out for the 11/12 week post-exposure, 5-6 week post-PEP).

4) I also read online that PEP is around 80-85% effective, does that already remove individuals who have not taken it as prescribed, etc.? I have never missed a dosage, but the times I have taken it have not always been firmly "consistent". For instance, I would take my morning dose from between the time of 8-9am, and the afternoon dose from 5-6pm. Would the spacing of the medication be a problem?

Thanks once again, I really appreciate it.
 
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georgiagail replied to An_249117's response:
1. Nope.

2. I suspect it would be rather hard to miss being anally penetrated with a penis.

3. Medically there would be no benefit to getting a 9 week test.

4. You took your PEP quite accurately.

Gail


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