More testing needed?

[Banksc]

Hello,
I had oral sex with someone that told me they were neg and I swallowed. That same night he told a friend he was in fact positive. After finding this out I was unable to contact him so I went to the ER and was given PEP (truvada). Took it for the full 28 days, surprisingly with no side effects. After the pep I saw this guy out and confronted him and he apologized telling me that he is negative. Never gave a reason for why he said he was positive though. I just had my 3 month post exposure test and the result was neg. I see that there are conflicting opinions on testing after pep and just wanted some opinions on whether a 6 month test is still needed or if my 3 month negative is conclusive. I just would like to feel a little at ease. Thank you.

[Jeff G]

There are different views about when to retest after pep but the cdc still advises to test 6 weeks post pep and or at 3 months to confirm the results . I advise the conservative view of a 3 months post pep is conclusive .

I hope this helps . I think you are going to be OK and can fully expect  a negative result .

[jkinatl2]

Hello,
I had oral sex with someone that told me they were neg and I swallowed. That same night he told a friend he was in fact positive. After finding this out I was unable to contact him so I went to the ER and was given PEP (truvada). Took it for the full 28 days, surprisingly with no side effects. After the pep I saw this guy out and confronted him and he apologized telling me that he is negative. Never gave a reason for why he said he was positive though. I just had my 3 month post exposure test and the result was neg. I see that there are conflicting opinions on testing after pep and just wanted some opinions on whether a 6 month test is still needed or if my 3 month negative is conclusive. I just would like to feel a little at ease. Thank you.

Well, actually you didn't really need to test at all over the incident you described, let alone go through PEP.

Saliva contains over a dozen identified elements (proteins and enzymes) which disrupt the slycoprotein shell that not only protects HIV but supports it's ability to transmit the RNA code into receptive cells.

These receptive cells are NOT, by the way, found in any abundance in the mouth.
There are several long term studies of serodiscordant couples where, as a criteria, they used barrier protection (condoms) for penetrative anal and vaginal sex but NO barriers whatsoever for any form of oral sex. In these studies, which spanned ten, five and three years (and two continents) there were ZERO infections traced to oral sex.

While it is true that some extreme circumstances (chronic meth use comes to mind) which strips the body of it's ability to produce saliva (it's called "meth-mouth") combined with a person in the process of seroconverting who has likely the largest viral load he is likely to have for years, might explain the scant outliers we assume to exist.

We assume that because, in the absence of the notoriously unreliable patient report, we have not ethically reproduced those conditions in a peer-reviewed study (in vivo).


I am pretty sure you are not one of those outliers.

The window of testing, globally, is three months. Most people seroconvert within six weeks.

In areas still using HIV antibody stand-alone testing, the window period is extended for those who take PEP, as PEP acts specifically to lower viral load and thus, antibodies would not necessarily form in three months. That extension is the amount of time you were on PEP, which was a month.

Therefore, theoretically, IF you had a significant risk (you did not) and if you were given antibody-alone testing (in most of the developed world you were given a duo test) your window period would be FOUR months past exposure.

However, as I stated before, you did not have cause to take PEP over this incident, and I am sorry you put yourself through the unnecessary anxiety of both PEP and testing over this incident.

It is always a wise precaution to assume that your partner is HIV positive, even if he thinks or says he is negative, until and unless you enter a mutually monogamous relationship and get tested for STDs at the appropriate intervals.

Ironically enough, it is the people who have recently converted and are in the window period who tend to have very high viral loads. Even if someone is telling the truth, they might simply not know. And some people are reluctant to test. Some lie. If your sexual choices depend on the word of other people, you are consenting to the possibility of acquiring an STD.

[Jeff G]

JK , is correct . I got so caught up in talking about pep I neglected to mention you didn't have a risk .

[Banksc]

Thank you for the replies. So I can consider my 3 month post exposure test conclusive? This whole situation has opened my eyes to the decisions I make.

[jkinatl2]

Yes Absolutely. You are reliably HIV negative.