anal fingering and masturbation

[jawser]

Hello,

On Aug 29 I had a date with a bisexual guy I met on a gay dating site. We went to his place, took our clothes off and started kissing. Before we took any further steps, I said it was 8 years ago I dated a guy (also  I am bisexual), that I tested 2 years ago hivnegative and that I was scared for hiv infection and other std's.
We were naked on the bed and he fingered my anus. First without lubricans, then with a bit a his saliva. I can't remember if he had precum on his finger(s) too, only that I had precum. I wanted to suck him off with a condom, but the condom didn't fit and so I didn't suck him. I remember during the kissing and fingering, he used a handkerchief for wiping his hands off. Was it  a clean handkerchief? I don't know. He also gave me a blowjob without condom, I know he had precum from me in his mouth.
Then we stood up, I behind him and gave him a handjob. I think he did the last bit till he came. He wiped his hands off the same handkerchief. Afterwards we went to the bathroom, he stood behind me and gave me handjob too till I came.
Before I went home, I told him again that I was scared for std's. He answered he too because he has a wife and 2 kids, and doesn't take cum in mouth and no anal intercourse without condom.
The day after we both were on the gay chatsite but I had a different alias and he didn't know it was me. I asked him if he had any form of unsafe sex and told me he had once cum in his mouth. His answer made me worried a lot and got me thinking. Day after I had terrible headache, then 3rd day bit sore throat and  itchy rash (looks like acne) on chest, upper legs and bit on back. Headache was just 1 day, throat only 2 days and rash increased a bit and diminished two days ago but still itchy. But until now no fever. Now a sore throat on day 11 but not sure if lymfnodes in throat are a bit swollen. After 2,5 weeks still itchy skin but no further increase in acne but I notice very very tiny petechiae. My glans penis looks a little bit red but no pain.
Luckily I have his phone number and he even told me where he works and lives. He told the thruth but on the gay chat he worried me with the answer of cum in his mouth. Then again on the chat he said he uses condom for anal intercourse. He blowed me without condom, so that's a risk too isn't it? I was stupid to let him suck me off without. I phoned him couple days after and asked him again for his hiv status. He said the same that he was scared too and tested 4 months ago and test came back negative. But a lot can happen in 4 months of course.

Question 1: Could I have hiv when he fingered me, even if there was precum on his finger(s)? I can't remember if his finger was deep in my anus.
Question 2: Could the handkerchief be source of transmission for hiv?
Question 3: If he is in the window period (don't know when he had cum in his mouth), was I at risk for the things we did?
Question 4: Was the handjob dangerous? Because before he used the handkerchief.
Question 5: Was the blowjob (I didn't cum in his mouth), a risk for me? He was neat, very nice teeth, nice clothes but that doesn't mean nothing of course. No appearance of skin disorders or anything else.

Regards,

Jawser

[Ptrk3]

Relax, none of these activities are risks for HIV infection. 

Answers to your questions:

1)  No, fingering is not risk for HIV infection.  The HIV is fragile and does not survive outside the body (if there were HIV-infected "pre-cum" on his finger).

Access this link to read and learn about how the HIV is transmitted:

https://www.poz.com/basics/hiv-basics/hiv-transmission-risks

2)  No, the HIV is fragile and does not survive outside the body so would not survive on a handkerchief.

3)  No, any "precum" in his mouth would not have active HIV in it in any viable way that it could be a threat to you.

4)  No, handjobs and handkerchiefs are not modes of transmission for the HIV.

5)  Receiving unprotected oral sex is not a risk for HIV infection but could be a risk for other STD's/STI's.

In summary, you are not at risk of HIV infections from the activities you have described in your post.

[jawser]

Hello,

I see on official prevention sites that hiv-infected precum could transmit hiv through fingering. On other sites the opposite. It is hard to believe who is right and wrong. I am so anxious. I didn't pay too much attention on his fingers. But if there was precum (or cum) on his fingers, could it not infect me through the mucous membrane of my anus? Or by he caused a little wound with his finger on my anus and was there a chance of transmission?
Also some sites say precum can have a high viral load. I have also read that there hasn't been an infection with hiv through fingering but I think that is hard to verify. Very strange that I have still itchy skin that began 3rd day and still continues. Symptoms are different from person to person and that is not very reliable either but still. Most hiv infected don't (1 at 3) show symptoms, so that worries me too.

Hope that my anxiety is unfounded.

Greetings,

Jawser

[Jim Allen]

HIV once exposed outside the human body it is no longer infectious. The receptors that HIV uses to infect other cells are exposed and corrode leaving them unable to infect.

This is backed up by the fact that after 40 years nobody has been infected this way or from fingering. Nobody!

I can't help that you are reading outdated or mistaken sites or reading things out of context thus fuelling your irrational fear. We can't address that issue here, other sites are free to say whatever they like, if you look long enough a few sites and people claim aliens did it.    The fact they can publish it on a website does not make it the truth.

All we can do is provide an assessment based on facts, not fears. That assessment is you had no risk and you need to move on with your life, there is nothing more we can do for you here.

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions.

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 please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and 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.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

Please Note.
As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.

Edit spelling.

[jawser]

Thank you very much Jim for the reassurance. I will certainly get tested for sti's. Glad there is this kind of support.

Greetings

[Jim Allen]

You're welcome.

[jawser]

Hello,

I had yesterday sexual intercourse with a top. He put on condom and used lube. I think  he let the air out of condom, can't say for sure. Then he tried to penetrate but without succes. Then we tried  a different position and with same condom on he penetrated me. But after  approximately  minutes he ejaculated. I am also not sure if he ejaculated when he was inside me or when pulling out. It happened so fast. I did see the condom but it was his condom. Expiry date was ok on condom but as it was his therefore I don't fully trust the quality. I am scared I might be infected from this event. We met online and I did ask about his status. He claimed to have always have safe sex, but he asked first to blow him without condom (which I didn't) and the fact that people can lie about their status made me worry too.

[jawser]

Hello,

I don't understand this. Same risk as I had before?

[Jim Allen]

Hiya,

Sorry to hear that you are stressing about this.  His status, what he does with other people or if he is telling the truth or not is all rather irreverent.

HIV simply can not transmit through an intact latex or polyurethane barrier, when an condom fails during intercourse its shreds leaving no doubt. As long as this obvious issue did not happen there is no reason to panic or stress.

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP as an additional layer of HIV protection going forward

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 please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and 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.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

Please Note.
As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.



 

[Jim Allen]

Hello,

I don't understand this. Same risk as I had before?

I merged your threads, see as a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter.

Jim

[jawser]

Hi Jim,

Thanks. I thought I could start a new subject. I am just scared because I have children but I always try to have safe sex. I just don't want to get for my children and I get easily anxiety driven. I'm just human and need for intercourse can be very urgent  .
Afterwards I get very anxious, also because I don't know the person but I try to apply human knowledge as far as that is possible.
No need for testing and time to move on for me Jim?

Kind Regards

[Jim Allen]

Hiya

No need to test specifically over this incident. Relax, Move on with your life.

I just don't want to get for my children

Not sure if I understand the concern, look I have kids, my HIV is simply not a risk to them, if transmission was somehow your concern. Its not transmitted through day to day contact situations.

Jim

[jawser]

Jim,

Can you have symptoms if it occured from last Thursday?

Kind Regards

[Jim Allen]

No, and on top of that your left testicle could fall off to be direct about it, it's not HIV from this incident. Understand?

Now if you are feeling unwell, I'm sorry to hear that and, hope you feel better soon, go see your GP and, let them treat whatever is making you sick.

Jim

[jawser]

Thanks Jim, you reassured me once again.

[Jim Allen]

You're welcome

[jawser]

Hi,

I just want to know something to keep in mind for the future. When a condom fails, it is said that's obvious. Does it always shred or not? When a condoms fails and the erection isn't very hard anymore, does it cause shredding? Can't the sperm slowly drip out?

Thanks in advance

[Jim Allen]

Hiya

During the act of intercourse, it shreds, being a tad soft at some point is not going to change this. Seriously no need to be overthinking this one!

Continue to use condoms for intercourse and, for everything else & out of standard routine test at least yearly. Consider PrEP as an additional layer of prevention if you are concerned.

HIV simply can not transmit through an intact latex or polyurethane barrier, when a condom fails during intercourse its shreds leaving no doubt. As long as this obvious issue did not happen there is no reason to panic or stress.

[jawser]

Hello,

I have a question about symptoms on early hiv infection. Can bell's palsy occur approximately 2 to 3 weeks after being infected without any other symptoms?

Kind regards

[Jim Allen]

No. Did the doctor diagnose Bell's palsy? 

Why are you asking about HIV symptoms, did you have a risk for HIV?

[jawser]

Yes, bell's palsy degree 1 which means only numbness on 1 side of my face but it's persistent for about 3 weeks now. Multiple sclerosis isn't completely ruled out because I didn't have MRI yet. But family doctor said it was most likely Bell's. I read that Bell's is an symptom which occurs in all stages of hiv infected people and that if you have this HIV testing should be done. It can also occur through HIV medication.
I had protected anal sex with 2 males  on different days approximately 1 month ago with 2 or 3 days between, once I was bottom and then top. I already posted my risk when I was bottom and I was told I had no risk but maybe there was semen on his fingers and he touched my penis afterwards . Not sure because can't remember well that last event. Other guy had syfilis before but was cured from it and he stated he had no hiv and again protected. Syfilis could give Bell's too. I had couple of weeks ago sex with 2 females, also protected but when pulling off condom I think some vaginal fluid came into my urethra.

Yesterday I did HIV selftest (CE labeled) after 27 days from 1st event. I know that p24 antigen isn't included in selftest and maybe waste of money because testing only antibodies now is too soon. Selftest came back negative. I also know that I have HIV anxiety but I feel tiny bit muscle pain in right arm from lifting practically nothing, slighty sore throat, light headaches which last only 5 minutes and the beginning of a cold since 2 days. Symptoms are not stress or anxiety driven. I based on scientific literature what the causes could be for MS and Bell's. Mostly viral cause, especially HIV.

[Jim Allen]

Hiya

It's normally a trapped nerve or nerve damage and, has nothing to do with HIV from the events posted here.

Fluids on someone's fingers or touching vaginal fluid exposure outside the confines of the human body are also not HIV concerns, keep working with your doctor on treating what is making you sick however unless you have had other encounters with real risks to discuss continued posting about it or in relation to no HIV risk events is going to lead to a ban.

Jim

[jawser]

Family doctor prescibed prednisolone but Bell's doesn't get worse. Normally I can't take this due to eye condition but doctor said Bell's has priority. Bell's can go away on its own and I have dilemma to take or not. Doctor was 95% sure because he doesn't have equipment to test.

 I will no more post events that were not risky for hiv. Just anxiety driven, very sorry. Believe me, Bell's is very strange feeling and I just have degree 1. One want an explanation and my explanation was hiv due to my sexual encounters which were the only ones that happened past month and nothing else.

And you were spot on Jim with Bell's. And thanks again.

[Jim Allen]

Hiya

I stubbed my toe this morning and nearly lost my balance, I did not stress afterwards that it's the initial noticeable symptom in some cases for Creutzfeldt-Jakob's or perhaps an incurable Brain tumour. No like most people I have toes & a working nervous system and, we end up bumping them from time to time.

If the doctor prescribed prednisolone I suggest you take it as directed. Please don't post about this again, I mean it. I don't know what has triggered this continued HIV fear but If you keep having so much fear about HIV I would suggest speaking to a therapist to help you cope with your thoughts.

Finally, use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP as an additional layer of HIV protection going forward and test out of routine at least yearly for STI's & HIV like everyone should.

[jawser]

Hi,

Jim, I posted before that I had numb feeling in face and thought it was HIV related. It wasn't Bell's palsy but latent hyperventilation. Dr said it is harmless but indeed a weird feeling.

I am working on my anxiety for hiv but it doesn't go away bi overnight. The thing is also that I am addicted to sex. That makes it so hard for me to fully enjoy sex.

On 31 August I went to csw and we had intercourse. Normally I ask everytime about their status, but this time I didn't. She used a condom to give oral and few minutes after we had vaginal intercourse with same condom. I pulled out and noticed that condom was bit hard to remove because it felt sticky but didn't se condom was broken. I was thinking if penis wasn't fully erected maybe condom was broken anyway and that's why it felt so sticky and bit hard to remove.
Couple days back I contacted her with text message to ask about her status. I asked "Do you have hiv or not?" She said yes. I was a bit frozen by anxiety. We texted further and she thought I meant I was talking about toys. There is a language barrier but still. The day after she texted me that she is always safe and uses everytime condom and that she takes care for herself. I don't know what to believe. And she doesn't receive at same address too. But apparently some csw move regularly. She used 2 different phone numbers too text me too and the other number was from another csw. I can't clearly know who texted me but she answered that she has 2 numbers. She just isn't reliable I think.

After 10 days I had sore throat, swollen lymph node and muscle pain but no fever. I went to doctor and she told me that it was faryngitis but I didn't want to talk about my visit to csw. I asked for duo test and negative but too early I know although p24 can be detected after 10 days.

1) Could condom be broken that it wouldn't be that obvious?
2) Are symptoms noticeable after 7 to 10 days?
3) I have about 5 bumps, pimples on my left arm too and some are itching very hard.
4) CSW is probably from Latin America or Spain and maybe HIV+, so chance of getting infected?

Btw, still working on my anxiety and posting helps me a lot.

Kind regards

[Jim Allen]

Hiya

Her HiV status is totally irrelevant and none of your business.

Working on the anxiety, glad to hear it but to be blunt if you keep having irrational thoughts & behavior towards others due to your fears or simply having fears evertime you have sex you should be speaking to a qualified mental health therapist.

1) Asked & answered previously already

You had intercourse, used a condom and HIV can't transmit through an intact condom. When condoms fail during the act of intercourse it would be obvious so as long as this did not happen move on with your life

2)3)4) irrelevant

No need for drama, move on with your life, keep using condoms for any intercourse and test out of standard routine at least yearly for HIV and far easier to aquire STI's

[jawser]

Hi,

I know an intact condom is not a risk. But how can you be sure that it was intact? Condom felt so sticky and hard to remove, so maybe there was  a tiny hole in it and came her vaginal fluid in my urethra?

Also timing of my faryngitis came inconvenient. Should I get tested over this you think? And what kind of symptoms should I experience then?

Maybe seeking professional help for my anxiety would not be a bad idea. I just can't live a monk either.

Kind regards

[Jim Allen]

Hiya

Your left testicle could fall off it's not going to be relevant to your risk assessment.

Condoms shred when they fail during the act of intercourse as in totally bust/torn hence the statement "obvious". Now as long this obvious issue did not happen there is no logical reason for concern and you need to learn to cope with your fears.  Tiny holes generally belong to myths & paranoia.

I wish you well but this continued paranoid posting can't continue, if you do it will lead to a ban as you have been warned before. I recommend you speak to a therapist to help you with your paranoia/Anxiety

[jawser]

Hi Jim,

Thank you again. I know I can't continue posting but it helps me greatly. You helped me again with information and with reassurance.

Also no need to test from this event I presume?

Kind regards

[Jim Allen]

Asked and answered.

No need for drama, move on with your life, keep using condoms for any intercourse and test out of standard routine at least yearly for HIV and far easier to aquire STI's

28 day ban to encourage you to speak to a therapist

[jawser]

Hello,

I had several intercourses.I was receptive anal partner and he used condom. That was 14th January. Got tested 11th February and negative. Meanwhile from 23rd January till 18 February I had contacts. A woman rubbing with her wet vagina against my penis on 23rd January, a guy gave me unprotected oral on 5th February, I gave protected oral to shemale 8th February (didn't understand I asked for condom) . 10th February I had protected sex with female from Brazil. 18th February I was again receptive anal partner, he used condom and stated he was hiv negative. Since a month now I feel tired, enlarged lymph node under jaw (is gone now I think) and sometimes muscles in arms and legs hurt and feel heavy. Today cold chills and pain in neck. I just don't feel good. Reading through posts I don't get smarter but more confused. Could my symptoms be hiv related and that in the heat of the moment I got infected? Shemale and Brazilian csw were both from Latin America I think and due to language barrier I could not say much. Indication for retest hiv?

[Jim Allen]

Reading through posts I don't get smarter but more confused.

There is nothing to be confused about. Use condoms for any intercourse and test yearly out of standard routine. Very simple, no confusion to be had unless you are looking to create drama

I have no idea why you think a language barrier would create an HIV risk or be relavent to your risks.

[jawser]

Hi,

Normally I ask about hiv status but shemale didn't speak any of my languages. She wasn't very fast to take condom too, I took a while to figure out what I was saying. So the language barrier could be dangerous because if I was aroused too much and she is infected then it could have gotten more than oral. Brazilian csw said she was clean but I don't know if she comprehended I meant hiv status. I don't know if I was at risk from previous events. Was I?
Also posts from the past regarding symptoms like my muscle pain etc could fit hiv infection, others say symptoms don't matter. That is confusing. I function but feeling sick and I was thinking maybe I have mild symptoms of hiv infection.

[Jim Allen]

Normally I ask about hiv status

Irrelevant and answered previously

She wasn't very fast to take condom too, I took a while to figure out what I was saying.

I don't get the concern ... As long as you ended up using one it doesn't matter how fast she was

So the language barrier could be dangerous because if I was aroused too much and she is infected then it could have gotten more than oral.

So your saying you can't control yourself or might not enough if aroused to put on a condom and if that happens although it didn't, it would be her fault or due to language barriers? Seriously, this is something you should really discuss with a qualified therapist before you end up hurting someone. It's a major red flag.

Brazilian csw said she was clean but I don't know if she comprehended I meant hiv status

I don't know what she comprehend depends maybe on what you asked her? Anyhow it's
Irrelevant and I've answered already regarding asking about people's HIV status.

Also posts from the past regarding symptoms like my muscle pain etc could fit hiv infection, others say symptoms don't matter

Also answered already previously when I told you that your testicle could fall off it would not change how HIV is it is not transmitted

I don't know if I was at risk from previous events. Was I?

 You mean what you posted in September and got a ban for? I've been very clear on those events and if you apply the information already provided then to today's question you already have your answers

[jawser]

No, I don't want to accuse others for my actions. When I read your replies it was rude of me. With my previous events I meant my events I had from 23rd January till 18th February this year. Yes I got a ban. That was unfair because I paid for 7days and after a day you banned me. If you pay you can stay. On the other hand thank you for your advice. So there were no risks from my events.

[jawser]

In the future I shall reread my posts. If I had offended in some way, my apologies. Thanks for helping me Jim

[Jim Allen]

Life so often is unfair, but I think the ban was very fair last time. What might seem unfair is that our decision is not open to debate here.

I will comment so it's clear that you had been warned to move on several occasions before being banned. Paying POZ.com to post doesn't change the forum rules or the terms of the service provided by the volunteers here and, in my judgement allowing you to continue to post wouldn't be helping you to move forward with your life then or now.

 

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.

If I had offended in some way, my apologies

Offended, no. I am very serious though, that you should at least consider speaking to a therapist about your ongoing thoughts & fears. It's not something I can help you with in this setting.

Move on with your life, keep using condoms for any intercourse, consider PrEP as an additional layer of protection against HIV and test out of standard routine at least yearly for HIV and far easier to aquire 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 starting PrEP going forward as an additional layer of protection against HIV

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 easier to transmit STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and 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

Please Note.
As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.

[jawser]

Hi,

In another post you stated today to someone to test for hiv antibodies at 6 weeks post-incident. I thought you could test for hiv antibodies and p24 antigen at 28 days post -incident and be sure about it.

[Jim Allen]

Hiya

I don't care about what you think. Someone else's risk assessment doesn't concern you.

I have no idea why you are still posting?

[Jim Allen]

Seriously, you have been posting about your no-risk fears both here and in other forums.

For the final time, nothing you mentioned warrants testing outside of standard yearly routine. I have been pretty clear I am not interested in pretending you had a real exposure and hence I am not interested in pretending you need testing for HIV over your irrational fears either!

If you ever do have a real risk, here is the short version, the median time to have detectable levels of antibodies is 20-28 +- days and a true 4 weeks + duo test does provide high confidence with most estimates in the 90-95%+ range, although some people take slightly longer.

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 often present at detectable levels sooner but also can drop off rapidly, by 6 weeks a blood-drawn antibodies test or duo test you are asking  about has about a 98%+ confidence.

We are conservative with the testing guidelines issued, hence the recommendation to test at 6 weeks blood-drawn lab version, a negative result at that stage would rarely ever change. People can retest for a definite result for the rare/odd outlier at 3 months if they like for peace of mind.

If testing with rapid tests, they can be somewhat less sensitive to recent infections and the rule of thumb is simply to wait and test at 3 months and the result is considered conclusive.

Jim :


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 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

Generation 3 & 4

2015

https://www.ncbi.nlm.nih.gov/pubmed/25033879
(Blood drawn tests)
Abstract
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 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

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http://www.bhiva.org/
Testing guidelines bhiva "British HIV association" : Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.


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.


Consider the topic of testing and your no-risk situations closed!

[jawser]

Hello,

I was tested negative for hiv may 18th. I had several encounters the last 2 months with partners I slightly know: a gay couple and a gay guy.
On May 19th and June 24th I had sex with the guy; protected anal and unprotected oral.
On June 8th and July 9th I had also protected anal and unprotected oral with gay couple.
What worries me is when I gave oral with the guy, is that I had blood in mouth. I don't really know from who the blood came. Did it happen during deep French kissing, but when bj was given by me, I sure had blood in mouth. Now I seem to have for more than 2 months sometimes blood in mouth, especially when I brush (slight gingivitis). Was a wound in mouth induced by kissing and still vulnerable wound in mouth? I really don't know. When I had sex with couple, then I had blood mouth too.
I had also received prostate massage with handjob and 2 days ago I had protected vaginal sex with csw.
What is risk from giving bj unprotected with bleeding gums or wound in mouth? Is my risk more from massage or csw or by receiving protected anal because maybe I am more vulnerable since I have sometimes blood in mouth.

Regards

[Jim Allen]

Giving a bj is a near negligible HIV risk that doesn't warrant testing outside of standard routine. Nothing you mentioned changes that.

The massage, handjob was no HIV risk to you and we have discussed intercourse previously.

Jim

[jawser]

Hi Jim,

I followed your previous advice but it was was the presence of blood in mouth that was scary and that it is a port to get infected. Also I used intermittent prep but I took a pill 1,5 hour too late (my 2nd dose). I didn't use intermittent prep for massage of course and not for protected vaginal intercourse.

Regards

[Jim Allen]

Okay, well glad i was able to clarify things.

Giving a BJ is a near negligible HIV risk that doesn't warrant testing outside of standard routine.

Best, Jim

[jawser]

Hi Jim,

Forgot to mention that prep makes me less scared but still being cautious. So I wait for my yearly routine to test next year.

Grtz

[Jim Allen]

We have been over fingering before. Its not an HIV risk.

As for spitting, saliva it's hostile towards HIV and so is exposure oursids the confins of the human body. You can't get hiv from someone spitting on your ass

[jawser]

Hi Jim,

Thanks. I know saliva on its own isn't infectious but it was Dark in the room and was wondering  if there was blood mixed with saliva. Thanks for pointing out.

Kind regards

[Jim Allen]

Hiya.

Not an HIV issue. You're welcome

[jawser]

Hello,

End of August and beginning of September I had 2 encounters with 2 males. Each time I received a rimjob and was fingered. I gave blowjob with condom. My worries are that when I received rimjob that they infected me in some way or when they fingered me they had (pre)-cum on their fingers. On 12 september I had an Alere hiv combo test which returned negative. I tested 18 days and 7 days after my encounters (too early). Last week I developed pneumonia. I had sweats, chills, fever, headache, hypoxia and had to go to hospital where they diagnosed me with pneumonia. I had to stay in hospital and they gave me intravenous antibiotics. I got better but not fully recovered yet. I read that pneumonia could happen in all stages of hiv infection and on other sites that rimming/fingering can be a risk. But on other sites that when condom is used there is no risk and other activities are regarded as safe. I am confused. Is my pneumonia sign of hiv?

Thanks in advance

[Jim Allen]

My worries are that when I received rimjob that they infected me in some way or when they fingered me they had (pre)-cum on their fingers

No HIV exposure, no HIV risk, no specific testing outside of standard yearly HIV screening needed.

Your adult risks of acquiring HIV are limited:

- Sex; Condomless intercourse & a minute HIV risk when giving a blowjob.
- Sharing IV drugs rigs (Syringes)
- Blood transfusions (Rare thanks to screening in most nations)

So no more questions about fingers rimming or blowjobs as it will lead to a ban.

I read that pneumonia could happen in all stages of hiv infection

Non-HIV pneumonia (PCP), caused by a bacterial infection
that HIV negative people get, it's not HIV specific

Anyhow, It has northing to do with HIV from the encounter posted here, as you had no HIV exposure and you had a negative result. If you had HIV related issues your antibodies result would have been reactive regardless of the window.

Hope you feel better soon, keep working with your doctor, please don't post about this again.

Move on with your life, use condom for any intercourse and as you are sexually active get an STI & HIV screening yearly out of standard routine.