son disappointed me

[zach]

So my oldest son kind of disappointed me, he hesitated to drink a beer after me, asked if HIV could be transmitted that way. I said no of course not, then sent him to get his own damn beer.

But it got me to thinking, this is my fault. I thought I had adequately educated them on the transmission risks. So, in an effort to do better, I've been lurking in Am I? and compiling a "lesson" for them to read. For the most part, I like what I have so far.

Where I am now is "You may have had a high risk exposure, now what" and what I would ask yall for guidance on, what are the types and what is the order of testing and confirmation to conclude non-transmission? oral quick at home, confirmed by PCR test, confirmed by Western Blot. Am I correct in this, and what are the periods of time between these?

thanks

[intaglio]

Just send them the link to this site. Let them look it all over. Once they've done that, answer any questions they may have.

And if my kids touch my liquor, that's just askin' for a beatin'. 

[mecch]

Tell your son(s?) the economic statement on transmission routes - unprotected anal or vaginal sex, and blood transfusions on other such gross medical mistakes.

I am not sure the testing sequence for an HIV+ confirmation, is as important as telling HIV- people what a real risk is, and that they should know about PEP and where locally they can get it, and the window period....

[RapidRod]

Tell your son(s?) the economic statement on transmission routes - unprotected anal or vaginal sex, and blood transfusions on other such gross medical mistakes.

I am not sure the testing sequence for an HIV+ confirmation, is as important as telling HIV- people what a real risk is, and that they should know about PEP and where locally they can get it, and the window period....

Instead of blood transfusions how about telling him that sharing works with other IV drug users.

[mecch]

Sure fine by me..  Whatever the facts are and the shortest way to say them.

[Ann]

PCR tests (what we refer to as "viral load" tests) aren't normally used for diagnostics; DNA PCR test should NEVER be used for diagnostics, although we see uninformed doctors using them for this purpose over in Am I all the time. They're not approved nor licensed for diagnostic use as they have an unacceptably high rate of false positive results. 

Only RNA PCR tests are approved and licensed for diagnostic use but only in very specific circumstances, such as being the receptive partner during unprotected anal or vaginal intercourse with a person known to have untreated hiv. If the insertive partner is poz with an UD VL, any doctor worth his diploma would not waste the money and resources on what would very likely turn out to be a totally unnecessary test.

Even if the criteria for using RNA PCR have been met and the results show a detectable viral load, further confirmatory tests are still needed (antibody and WB testing) before a patient can be definitely diagnosed with hiv. There are simply no short cuts to hiv testing.

The earliest one should test following a risk is at six weeks. The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.

A six week negative is highly unlikely to change, but must be confirmed at the three month point.

A positive antibody result must be confirmed with Western Blot testing. This is usually done with a blood draw to do both an additional antibody test and the WB.

PCR tests are normally only done once a positive diagnosis has been confirmed with antibody and WB testing.

The oraquick in-home tests aren't quite a reliable as rapid tests done at a testing center when it comes to a six week negative. Where the in-home oraquicks are concerned, a six week negative is a good indication, but no where as good as other six week negative results on other rapid tests. For me, this is the scary part of oraquick in-home tests. They're more prone to false-negatives in the later weeks of the window period. They simply cannot be used to screen tricks, for example.

The usual choices for hiv testing at testing centers are rapid tests, using either saliva or blood from a pin-prick, or standard antibody testing where a proper blood draw is needed. They're all reliable and a six week negative with any of them is highly unlikely to change. It's just the in-home rapid tests that sometimes have false negatives before the three month standard end-of-window.

WB tests are not available for in-home use. If someone gets a positive result from an in-home rapid test, they need to go to a testing center. The testing center should run another rapid test and if that is also positive, they should take a blood draw to repeat the antibody test and also run a WB.

Does that answer your questions?

Did you get two of the main messages we write about there?

In adults, hiv is transmitted by;

Unprotected anal intercourse.
Unprotected vaginal intercourse.
Sharing drug injecting equipment.

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

[zach]

ok, heres what i put together, largely plagerized from Am I? let me know if thats a problem. i don't intend to pass this out on the street, or staple it to every phone pole. This is for my sons to read, it occurs to me my 15 has a better understanding than either my 23 yr graduate, or 19 yr deans list. Not surprising to me though. When I was diagnosed, their mother tested all three of them, I had very mixed feelings about doing that, it served more to freak them out than anything.

Here's what you need to know in order to avoid HIV infection:

HIV is transmitted by;
Unprotected penetrative anal and/or vaginal sex
Sharing IV drug needles immediately after use
Mother to child, during or shortly after birth
Very specific, and rare, healthcare situations.

HIV is NOT transmitted by;
Casual contact; hugging, kissing, trace fluids
Eating food prepared by a Positive individual.
Drinking after a positive individual.
At the barbershop.
HIV is NOT transmitted by almost every "what if?" situation that is not in line with the above warnings.

HIV is a very fragile virus and it does not survive outside of the host.  HIV transmission occurs within the bodies during penetrative sex and trace fluids are not infectious.
You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.
Do not have unprotected sex with anyone, your BF/GF included until you have both tested negative together and have been in a secure monogamous relationship for at least 3 months past a confirmed negative HIV test . To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but HIV is forever. Take personal responsibility in this. Protect yourself. No one gives it to you, you expose yourself.
Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to HIV testing, at least once a year and more often if unprotected intercourse occurs. By law, you have to ask for this test, do not assume, it is not a standard test.
Don't forget to always get checked for all the other sexually transmitted infections as well, HIV isn't the only STD out there, many others are easier to transmit and contract, and some are not as treatable as HIV. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test
Use condoms for anal or vaginal intercourse, correctly and consistently, do not share needle works, and you will avoid HIV infection.

You have had a high risk exposure, now what?
If you are concerned you have been exposed.  HIV Oraquick at home oral test is inconclusive, and has a high incidence of false positives. If you test positive with this test, go to a clinic and confirm those results. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result. If you were HIV positive you would have known by 3 months. If not, relax, you are reliably NOT POSITIVE.

You have conclusively tested positive, now what?
No one gave this to you. You exposed yourself. Accept that, so that you can move on. You are not a bad person, you are not being punished. It is not important how you were exposed, it is important how you will live with it. You are not dirty, you are infected with a virus. First you will have a series of bloodwork taken. Your positive result will be confirmed with a Western Blot Test. These labs will determine genotype and resistance profiles, Viral Load, and CD4. This serves to guide the medical decision of which med regimen to select, and a base line for VL and CD4 to work off of. Things like Liver and Kidney function may also be tested at this time. You and your doctor will then begin designing a treatment plan for a lifetime of good health.
HIV/AIDS is highly treatable. Do not despair. Calm down, take a deep breath. Take a few days to decompress if needed. Then approach this situation with a strong mind and open heart. You are going to be ok.

[RapidRod]

Any negative test done before the 3 month post exposure is inconclusive for the most recent exposure. That is any test. Other than that, you have it Zach.

[zach]

Just send them the link to this site. Let them look it all over. Once they've done that, answer any questions they may have.

And if my kids touch my liquor, that's just askin' for a beatin'. 

lol, no i don't think i'll be sending them here. and i only drink beer, my oldest two are my favorite drinking buddies, my youngest usually gets half a glass. but i prefer stout beers dad! none of em have ever got a beatin from me. when they were smaller, they used to come at me en masse, this was before billy passed. little billy would come in low, and just start speed bagging me. next older deathlock the leg so i couldn't escape, the two older boys could then take me down. gifts from hell i tell you.

i recently heard what i believe may be the best line of all time....

"the greatest weapons i have, call me dad"

[zach]

rod, i understand that, maybe i didn't write it best, i'll work on rewording it. thank you

[mecch]

You have had a high risk exposure, now what?
If you are concerned you have been exposed.  HIV Oraquick at home oral test is inconclusive, and has a high incidence of false positives.....

You are still not telling people that if they have a high risk exposure they should go to a doctor or emergency room for a risk evaluation and the possible PEP - Post-Exposure Prophylaxis.

A LOT of people who don't know much about HIV also don't know about PEP.  Which can prevent an infection!

[zach]

ok, i'll edit that in. but is this just a wording thing?

" HIV Oraquick at home oral test is inconclusive, and has a high incidence of false positives. If you test positive with this test, go to a clinic and confirm those results. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result. If you were HIV positive you would have known by 3 months."

i am still saying to go to a clinic, but will add information about pep

[zach]

does this read better?


If you are concerned you have been exposed.  HIV Oraquick at home oral test is inconclusive, and has a high incidence of false positives. If you test positive with this test, go to a clinic and confirm those results, have a risk evaluation and possible PEP - Post-Exposure Prophylaxis. Medications that can prevent infection if taken immediately afterwards. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result. If you were HIV positive you would have known by 3 months. If not, relax, you are reliably NOT POSITIVE.

[RapidRod]

Oraquick is known to give false negatives because people using the tests don't follow the instructions on the test kit.

A negative result with this test does not mean that you are definitely not infected with HIV, particularly when exposure may have been within the previous 3 months.

[zach]

tell you what, i'll strike out anything about an at home test

[mecch]

Zach, a person who has a risk isn't going to test positive for weeks. The instructions for  testing are independent of the small window for PEP.

If some thinks they have a high risk they can go to see a doctor or the hospital, get a risk evaluation, and maybe get PEP.  The window is 4 days - 72 hours.

So you see PEP is something someone might do right after a high risk. It is way before testing positive. 

Good luck with educating your sons!

[zach]

If you are concerned you have been exposed.  Go to a clinic. Have a risk evaluation and possible PEP - Post-Exposure Prophylaxis, medications that can prevent infection if taken immediately afterwards. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result. If you were HIV positive you would have known by 3 months. If not, relax, you are reliably NEGATIVE.



Better? Closer to a consensus?

[RapidRod]

The cut off on nPEP is 3 days not 4.

[RapidRod]

If you are concerned you have been exposed.  Go to a clinic. Have a risk evaluation and possible PEP - Post-Exposure Prophylaxis, medications that can prevent infection if taken immediately afterwards. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result. If you were HIV positive you would have known by 3 months. If not, relax, you are reliably NEGATIVE.



Better? Closer to a consensus?

On nPEP, your conclusive test result is 3 months post your last dose of nPEP. The above if testing without nPEP. Your getting it Zach.

[Ann]

Zach, did you not read what I wrote about the in-home Oraquick test?

The whole thing with six week negative results is purely a matter of degrees of confidence that a negative result is going to still be negative at the three month conclusive point. I'm always very confident telling someone in the Am I forum that their six week negative is highly unlikely to change when they've tested at a clinic or similar, but I'm not very confident telling them the same over a six week in-home Oraquick negative.

And just to point out something else you said about the in-home Oraquick test - it's no more prone to false positive results than any other rapid test (and they are all somewhat prone to them). However, from everything I read about them, they are prone to being a little slower in picking up positive results than other rapid tests.

And also as Rod pointed out, part of the problem during the trials period was people using them before the end of the three months and taking the (negative) results as conclusive, when they weren't.

There's also another in-home test - Home Access - but the Home Access test isn't interpreted by the patient, it's sent in to a lab and you have to ring them for the result. The HA test is also unlikely to give a false negative at six weeks like the tests used in clinics, UNLIKE the in-home Oraquick test.

I'm really not a big fan of the in-home Oraquick tests for many reasons, and I'm still not sure if the pros outweigh the cons.

[mecch]

The window is  4  days - 72 hours.

72 hours - 3 days.  Sorry, my bad.   Im not an expert nor mathematician.     Just piped in because PEP is really good to know about when learning how to stay negative and also calming fears.  Best thoughts....

[zach]

to make things simpler, i've removed all reference to an at home test. if things got to that point, they'd be talking to me anyway, and me talking to a ID for guidance.

the primary thing this grew out of, was realizing my oldest thought there was a possibility of infection from drinking after me. what i really wanted to explain to them, is what are and are not transmission risks.

i'm not even sure i should include the two "now whats?" i don't want this to be a definitive this is everything you need to know about everything hiv. what i want it to be is... this is what you need to know to not expose yourself to the virus, and to put you at ease around someone that is positive

[klassykitty]

I bet you are more worried then your kids.

 My question is how comes you were never my parent?  I was never allowed to drink underage in front of my parents much less share my vodka with them. lol

Michelle

[eric48]

Beer with son...

Priceless !

Mobile.Eric

[buginme2]

This is all so convoluted.  Why cant you just sit down and have a conversation?

"Hey, the other day you hesitated drinking out of my glass, do you have any questions about HIV and how its transmitted?" 

This whole thread is like your trying to kill a fly with a cruise missile. 

[zach]

we did have a conversation, at that moment. your question is sort of like asking why the Am I board exists, and why some keep coming back with little variations of "but what if"

how convoluted this thread got is exactly what i want to avoid with them, it has been a learning process just editing down what i was originally going to go with.

not really sorry if i offended by the thread, i didn't control its development, only its start

[Theyer]

Having no biological humans I am off course an expert in raising Children. Info off this nature is indeed needed but so is being pointed in the right direction and finding out for self or at least feeling that you have , Personally I would just copy the work Ann did for you .

You could add that since he said wot he said  your life has been dedicated to reserching ,composing , editing , fact check,  and this is the result off about 150 Hours off work.  Now its a good enough first draft  but hey Son that,s love for you.

 Then inquire about wether he knows about the pain his Mother went through the 9 months off preggers and how lucky to have a expert in surgery at the hospital where he was born........

[RapidRod]

I'm sure you'll do fine when you explain it.

[tednlou2]

I've heard several ask why can't saliva transmit the virus, if saliva is used for the oral tests.  I would have thought the same thing at 18-- probably even 25.  And, many cite what the CDC says about deep "French" kissing possibly being a vector for transmission. 

So, I think it is understandable that someone, especially someone young, would not have the information.  It is good you're having this discussion. 

All the best with the conversation.  Let us know how it goes.

[zach]

Your getting it Zach. Other than that, you have it Zach.

I'm sure you'll do fine when you explain it.

thank you rod, your confidence means alot to me. you've gone out of your way to not only educate me more here, but have been kind about it. i appreciate that

[RapidRod]

thank you rod, your confidence means alot to me. you've gone out of your way to not only educate me more here, but have been kind about it. i appreciate that

You're welcome.

[Giancarlo]

I think you should explicitly mention unprotected oral sex somewhere in the "HIV is transmitted by / HIV is NOT transmitted by" list.
Unless you consider it is included in "casual contact" 

[RapidRod]

I think you should explicitly mention unprotected oral sex somewhere in the "HIV is transmitted by / HIV is NOT transmitted by" list.
Unless you consider it is included in "casual contact" 

I'm sure he knows that HIV is not transmitted by oral sex.

[aaware72]

I've heard several ask why can't saliva transmit the virus, if saliva is used for the oral tests.  I would have thought the same thing at 18-- probably even 25.  And, many cite what the CDC says about deep "French" kissing possibly being a vector for transmission. 

So, I think it is understandable that someone, especially someone young, would not have the information.  It is good you're having this discussion. 

All the best with the conversation.  Let us know how it goes.

I think what we miss here is that an rapid HIV test is looking to antibodies and not the virus itself. 

[RapidRod]

I think what we miss here is that an rapid HIV test is looking to antibodies and not the virus itself.

Oral Rapid tests does look for antibodies but it doesn't use saliva, it uses oral mucosal transudate which is found in the cheek an gums.