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Author Topic: I'm Worried about a sex I had  (Read 1653 times)

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Offline anony6461

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I'm Worried about a sex I had
« on: May 05, 2021, 02:42:30 pm »
Hello everyone and thank you for your time and welcoming me on this forum.

I am someone who is worried about HIV transmission. In my case I decided to visit a commercial sex worker when I was very drunk about 3 days ago. This person is a prepoerative transexual sex worker and she tried to convince me to have anal sex without a condom but I used a condom for the short time it lasted.

The only other sex we had was I gave oral sex, rimming and anal fingering. There was no ejaculation for the oral, but maybe i came into contact with precum in my mouth.

The reason I am worried is that this person wanted to do sex without condom! This is crazy! It was not my condom we used but I think I remember everything being OK, it stayed on and it was very brief anyway.

Do you think I need a test for this. I am going to test for bacterial infections but what about HIV? Im in a relationship with a girl so want to be sure everything will be ok.

Thanks you for supporting me.

Offline Jim Allen

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Re: I'm Worried about a sex I had
« Reply #1 on: May 05, 2021, 02:52:00 pm »
Hi,

Fingering and rimming was no HIV risk.

As for giving a blowjob, the mouth generally lacks a route for HIV to infect, even if you had gaping holes in your mouth like meth mouth saliva also acts to neutralize HIV by damaging the receptors needed to infect human cells. It's such a minute risk that we don't even recommend specifically testing over it.

Now as for intercourse, HIV can't transmit through an intact latex or polyurethane condom. If a condom fails during the act of intercourse, it's obvious. There is no reason to stress or test outside of the standard yearly routine as long as this obvious issue did not happen.

So relax, move on with your life.

Quote
Im in a relationship with a girl so want to be sure everything will be ok.

Use condoms and test at least yearly. If you do engage in condomless sex with your partner, then you are obviously at risk. Often within relationships, condomless sex is based on trust or past test results. However, this does not prevent HIV, and any condomless intercourse is accepting the greater risk of acquiring HIV.

So if you do choose to engage in condomless intercourse, consider testing more frequently for HIV and far easier to acquire STI's. As a sexually active adult, it's would be recommended to test at least out of routine at least yearly for HIV & STI's.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse correctly and consistently, every time, no exceptions. Consider talking to your health care provider about taking PrEP in the future as an additional layer of HIV protection.

Keep in mind that some sexual practices which may be described as 'safe' in terms of HIV transmission might still pose a risk for transmission of other STI's, so do get fully tested regularly and at least yearly for all STI's including but not limited to HIV.  Test more frequently if unprotected intercourse occurs.

Also, note that it is possible to have an STI and show no signs or symptoms, and the only way of knowing is by testing.

Kind regards

Jim

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Offline anony6461

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Re: I'm Worried about a sex I had
« Reply #2 on: May 06, 2021, 11:56:43 am »
Thank you so much Jim. I think I’m able to relax and move on now so thanks again for my reply. The only other thing we did was really just rubbing - I masterbated while he was in front of me with his behind to me, and so my scrotum was in between the buttocks and rubbing his anus. I am assuming this is not a risk as the skin of the scrutiny is in tact. All I had was a spot of dried blood from a shaving nick I picked up about 5 days prior. No fresh wound.
Kind regards

Offline Jim Allen

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Re: I'm Worried about a sex I had
« Reply #3 on: May 06, 2021, 03:01:45 pm »
You're welcome.

So rubbing is not an HIV concern, not even with day to day cuts, nicks,scrapes or small wounds.

Best, Jim
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Offline anony6461

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Re: I'm Worried about a sex I had
« Reply #4 on: May 19, 2021, 02:59:33 pm »
Thanks again Jim. I actually tested partly to remove the stigma with testing - I did this only 11 days after my event, which was negative (at least I know this now to be true for sexual experience in previous months and years). The test I did was the antibody / antigen test called the combi test which looks for p24 antigens as well as antibodies so at the time I hoped after 11 days this p24 antigen might show positive if I were to be infected. I expected a negative result in any case as you’ve also put my mind at ease before.

The only thing that confuses me is I have read that some sources indicate that it takes 14 days for p24 antigens to be detected and other sources say it can happen after 11 days. Again other sources say antigens develop after 7 days.

Was just wondering if you knew much about this type of test.

This is my last post and so thanking you for your help.

Offline Jim Allen

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Re: I'm Worried about a sex I had
« Reply #5 on: May 19, 2021, 03:13:13 pm »
Hiya.

Look I'm not going to pretend what you posted here required testing outside of routine. Just to be clear!

I'll post a longer answer in an hour or so on you antigen test question as I am out walking in the park right now.

In short though it's between a week and couple of weeks for HIV 1 antigens but in terms of testing an 11 day result would not mean much if you had had a real risk to test for.

In the meantime you can check out this: https://i-base.info/guides/testing/what-is-the-window-period
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Offline Jim Allen

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Re: I'm Worried about a sex I had
« Reply #6 on: May 20, 2021, 07:22:13 am »
Quote
I hoped after 11 days this p24 antigen might show positive if I were to be infected.

Some people may have detectable levels of antigen for HIV 1 this soon, depends also on how sensitive the specific test is, However, for the majority of people it takes longer to have detectable levels. The same can be said for antibodies part of the test that checks for both HIV 1 & 2.

Although, again the encounter you are concerned about needs no HIV testing outside of the yearly routine STI & HIV screening.

What you need to know is the antibodies part of the test will screen against HIV 1 & 2 antibodies. The duo test also checks for p24 antigen in response to HIV 1 that is sometimes present at detectable levels sooner but can drop off rapidly, by six weeks, a blood-drawn antibodies test or duo test is at about 98%+ confidence.

If you had had a risk that required testing, as we are conservative with the testing guidelines issued, I would have said to test at six weeks post-exposure with a blood-drawn lab version, a negative result at that stage would rarely ever change. Retesting beyond that at three months for a definite result is mostly just for peace of mind.

If you had been testing with rapid tests post-exposure, they can be somewhat less sensitive to recent infections, and I would have said the rule of thumb is to wait and test at three months, and the result is considered conclusive.

Jim

2015
Taylor, D., Durigon, M., Davis, H., Archibald, C., Konrad, B., Coombs, D., et al. (2015). Probability of a false-negative HIV antibody test result during the window period: a tool for pre- and post-test counselling. Int. J. STD AIDS 26, 215–224. doi: 10.1177/0956462414542987

Patients typically want accurate test results as soon as possible while clinicians prefer to wait until the probability of a false-negative is virtually nil. This review summarizes the median window periods for third-generation antibody and fourth-generation HIV tests and provides the probability of a false-negative result for various days post-exposure. Data were extracted from published seroconversion panels. The median (interquartile range) window period for third-generation tests was 22 days (19-25) and 18 days (16-24) for fourth-generation tests. The probability of a false-negative result is 0.01 at 80 days' post-exposure for third-generation tests and at 42 days for fourth-generation tests.

Generation 3 & 4

http://i-base.info/guides/testing/test-accuracy-results-and-further-testing

http://i-base.info/guides/testing/appendix-1-different-types-of-hiv-test

Generation 4

2012
Rosenberg NE, Kamanga G, Phiri S, et al. Detection of acute HIV infection: a field evaluation of the determine(R) HIV-1/2 Ag/Ab combo test. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318673/

Results. Of the participants 838 were HIV negative, 163 had established HIV infection, and 8 had acute HIV infection. For detecting acute HIV infection, the antigen portion had a sensitivity of 0.000 and a specificity of 0.983. For detecting established HIV infection, the antibody portion had a sensitivity of 0.994 and a specificity of 0.992.

2011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222669/
Conclusions. Combo RT displayed excellent performance for detecting established HIV infection and poor performance for detecting acute HIV infection. In this setting, Combo RT is no more useful than current algorithms.

In total, 953 people underwent HIV testing. HIV antibody (Ab) prevalence was 1.8% (17/953). Four false positive rapid tests were identified: two antibody and two p24 antigen (Ag) reactions. Of participants diagnosed as HIV Ab positive, 2/17 (12%) were recent seroconverters based on clinical history and HIV antibody avidity test results. However, none of these were detected by the p24 antigen component of the rapid test kit. There were no other true positive p24 Ag tests.

https://www.cdc.gov/hiv/testing/clinical/index.html
2018
CDC recently published research findings that estimate the window period for 20 U.S. Food and Drug Administration (FDA)-approved HIV tests. The study showed that laboratory testing using antigen/antibody tests detects HIV infection sooner than other available tests that detect only antibodies. If a person gets a laboratory-based antigen/antibody test on blood plasma less than 45 days after a possible HIV exposure and the result is negative, follow-up testing can begin 45 days after the possible HIV exposure. For all other tests, CDC recommends testing again at least 90 days after exposure to be sure that a negative test result is accurate.

Bentsen C Performance evaluation of the Bio-Rad Laboratories GS HIV Combo Ag/Ab EIA, a 4th generation HIV assay for the simultaneous detection of HIV p24 antigen and antibodies to HIV-1 (groups M and O) and HIV-2 in human serum or plasma. Journal of Clinical Virology, S57-S61, 2011

Nick S Sensitivities of CE-Marked HIV, HCV, and HBsAg Assays. Journal of Medical Virology, S59-S64, 2007

Eshelman S Detection of Individuals With Acute HIV-1 Infection Using the ARCHITECT HIV Ag/Ab Combo Assay. Journal of Acquired Immune Deficiency Syndromes, 121-4, 2009

Speers D et al. Combination assay detecting both Human Immunodeficiency Virus (HIV) p24 antigen and anti-HIV antibodies opens a second diagnostic window. J Clin Microbiol 43:5397-5399, 2005

Ly TD et al. Evaluation of the sensitivity and specificity of six HIV combined p24 antigen and antibody assays. J Virol Methods 122:185-94, 2004

2020 http://www.bhiva.org/ https://www.bhiva.org/file/5dfceab350819/HIV-Testing-Guidelines.pdf
Recommendations (Grade 1A)

• Clinic policies and patient information regarding the HIV test window period should be based on 99th percentile estimates; where a test is undertaken sooner than this time interval, window period data should be used to counsel patients as to the likelihood of a false-negative result.

• Fourth-generation laboratory tests reliably exclude HIV by 45 days post-exposure, and this should be the window period applied when utilising these tests.

• Third-generation laboratory tests reliably exclude HIV by 2 months post-exposure, and this should be the window period applied when utilising these tests.

• POCTs reliably exclude HIV by 90 days post-exposure, and this should be the window period applied when utilising these tests.

2015 WHO http://apps.who.int/iris/bitstream/handle/10665/179870/9789241508926_eng.pdf;jsessionid=1F192FECF734A0DE7E2520864984AE63?sequence=1
In many settings post-test counselling messages recommend that all people who have a
non-reactive (HIV-negative) test result should return for retesting to rule out acute
infection that is too early for the test to detect. However, retesting is needed only for HIV-negative individuals who report recent or ongoing risk of exposure. For most people who test HIV-negative, additional retesting to rule out being in the window period is not necessary and may waste resources.

Generation 1/2/3

Pilcher CD et al. Performance of Rapid Point-of-Care and Laboratory Tests for Acute and Established HIV Infection in San Francisco. PLOS ONE, 2013.

Branson BM State of the art for diagnosis of HIV infection. Clin Infect Dis 45:S221-225, 2007

Coombs RW Clinical laboratory diagnosis of HIV-1 and use of viral RNA to monitor infection. In Holmes KK (editor), Sexually Transmitted Diseases. New York: McGraw-Hill, 2008

Maldarelli F Diagnosis of Human Immunodeficiency Virus infection. In Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases (sixth edition). Philadelphia: Elsevier Churchill Livingstone, 2004

Parry JV et al. Towards error-free HIV diagnosis: guidelines on laboratory practice. Comm Dis Pub Health 6:334-350, 2003

3rd gen testing accuracy Perry KR et al. Improvement in the performance of HIV screening kits. Transfus Med 18:228-240, 2008







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