Unclear positive

[falsopositiveworried]

Hi,

I am a gay man with a very active sexual live. I am mostly bottom. I use condoms consistently and during the intercourse I check that the condon is in place, and when finish, I check the condon is not broken when he takes it off. I have unprotected oral sex and I even receive cum in mouth and sometimes I swallow.

This morning I went to a gay community health center to take the usual test (which I do every six months) for hiv and syphilis. They use the usual reactive strips where a drop of blood is put on the strip and you wait for a few minutes.

To my surprise and horror, the guy said that a faint line was showing. I got very nervous and he repeated the test and the same faint line appeared. The guy said he was unsure and sent me immediately to take a Western Blot test. He says those strips are very thin and sensitive and talked about a false positive.

He also said a possible reason for a false positive was that I might have been in touch with the virus and had neutralize it, and therefore some antibodies were present.

I am in panic right now and have to wait til Thursday for the final result. I am beginning to convince myself that I am positive and how that is gonna change my life. Besides, a few weeks ago a had a skin rush and fever one night. The rush disappeared after a couple of days. That reassures me it has something to do with hiv.

I know false positives (or false reactives, as you call it) exist, but they are very very rare, so I don't think I'll be lucky to be one of them. I am feeling a lot of rage because I always have condoms with me and use them consistently.

Can you tell me about your experience with false positives?

Sorry for my English, it's not my mother tongue.

Thanks!

[Jim Allen]

He also said a possible reason for a false positive was that I might have been in touch with the virus and had neutralize it, and therefore some antibodies were present.

This part is just nonsense.

Anyhow look a reactive result means nothing more than that, reactive.
False reactive results happen all the time, and we see it here plenty, now I understand its stressful but the tests are sensitive by design and sometimes antibodies in reaction to other infections or post infections can stick to the solution on the dipstick causing false reactive.

If used correctly all they do post the window period is confirm a negative status and any reactive result is not a diagnosis it just means more accurate testing is needed to confirmed your status.

The followup testing protocol will confirm your status and again don't stress because we do see false reactive results here. Testing should begin with a combination immunoassay that detects HIV-1 and HIV-2 antibodies and HIV-1 p24 antigen. commonly called a 4th gen test, all specimens reactive on this initial assay undergo supplemental testing with an immunoassay that differentiates HIV-1 from HIV-2 antibodies. Specimens that are reactive on the initial immunoassay and nonreactive or indeterminate on the antibody differentiation assay would then be tested with HIV-1 nucleic acid testing to determine the presence of HIV infection.

Look take care when retesting but keep in mind no need to panic, the test you took is designed to be hyper sensitive and false reactive happen all the time. It just means retesting or further testing is needed at the correct time.

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.

[falsopositiveworried]

You say "...don't stress because we do see false reactive results here". Do you mean that you see a false reactive result in my specific case?

Could the faint line mean it is a false reactive? Or maybe the fact that I have not reported unprotected anal sex? My concern is whether at any time the condom broke and I was not aware of it. I do not take drugs, so I am always careful about condons and never loose control of myself. I am also starting to think that the unprotected oral sex could lead to hiv infection, or maybe fingering if there were wounds on the fingers...

I forgot to mention that I used to have an undetectable VIH+ boyfriend, though we broke 3 months ago. He was undetectable (he has been consistently undetectable for four years) because I saw his analytics with my own eyes, he takes his medication consistently and we went together to his doctor and he saw no problem in having unprotected sex. We had unprotected sex for two years in a monogamous relationship and I always turned out negative.

Thanks for your help

[Ptrk3]

I presume, because of the entire context of his response, that Jim meant see "false reactive tests here" as "here" on this forum.

As he advised, a "reactive" test simply means follow-up testing is needed.

A number of folks on this forum have had positive reactive tests, presume that they have contracted the HIV, only to conclusively test negative for HIV antibodies with further testing.

Jim (and I) are attempting to convey to you that you should not presume anything--get follow-up testing and work with your healthcare provided to conclusively determine your HIV status.

[Jim Allen]

Try to relax, as a whole we see reactive results here on this forum and in my life all the time even from people who have risks like unprotected intercourse such as yourself and they go on to confirm a negative status. As Patrick said keep working with your doctor and test, that is the only way to know.

Fingering is not a risk, there has never been a case it lacks all the requirements for transmission.

Focus on living your life as normal, get the results and if needed the doctor will advice you if further testing is than needed.

Jim

[falsopositiveworried]

Do you expect a false positive, based on your experience?

[Jim Allen]

Most of the people posting initial reactive results here are in fact negative, test to find out. Its the only way of knowing, I've watched you read about a dozen such threads here and in the Spanish section, being nosy is part of my job and I hope the threads were reassuring. 

Giving oral is such a near negligible risk we don't even recommend testing over it, to start with the human mouth lacks the cells for HIV to infect so there is no route unless the mouth is damaged and even than the environment in the mouth is hostile, still do test at least yearly if not more frequent if possible but its not reason to panic. 

If your test are negative than what you do need to know is unprotected intercourse is a very real and primary transmission route in adults, it meet all the conditions needed biologically for transmission. Agreeing to unprotected intercourse is basically agreeing to a higher risk of STI's and a HIV risk.

Now as for your ex-bf's VL or UD status, I can't guarantee he is truly undetectable even if you know his VL or read a report on it, as it's just a snapshot
moment from the past. I have no way of knowing if he is continuing to be adherent to his meds, neither can you.

See I know truly that I am as example UD and adherent to my meds and it gives me like many others additional reassurance, I can vouch for my behavior and trust towards my partner,  but I can't vouch for anyone else and we see people go off meds or being flaky with adherence all the time not only here but also in studies and clinical follow-ups.  So as a negative person relying on UD status to remain UD status as only protection is a big leap of trust/faith in your partner and up to your own risk acceptance level, its not something i would recommend a HIV negative person to go out and do without serious thoughts.

To be honest if you turn out to be negative you should consider safer sex options going forward with everyone no matter what the status, condoms is a good place to start. HIV can not transmit through an intact condom. PrEP is also an option you may want to consider depending on your situation as it does not offer any protection against other STI'S or pregnancy as example.

Now as educational piece only, if your ex-BF's claims to be on treatment (TaSP - Treatment as prevention) and undetectable for more than 6 months well that would be good as TaSP is pretty excellent when it comes down to reducing HIV transmission risks.

I wish you all the best with retesting and no offence but if I do not see you again ill take it as good news.

Jim

For your information/education only:
Treatment-as-prevention (TasP) this is use of antiretroviral (ARV) medication to decrease the risk of HIV transmission. Treatment-as-Prevention (TasP)
HIV TasP

This has been studied at length and to mention 1 of the studies as an example the "Partner" study is a major study looking at the chances of transmitting HIV with an undetectable viral load, there have been no transmissions between either gay or heterosexual serodiscordant partners.

Partner study
transmission-zero

More recent: Zero, No Linked HIV Transmissions in PARTNER Study After Couples Had Sex 58,000 Times Without Condoms: Click here for more information

Finally the consensus statement http://www.preventionaccess.org/consensus

People living with HIV on ART with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV.  Depending on the drugs employed it may take as long as six months for the viral load to become undetectable. Continued and reliable HIV suppression requires selection of appropriate agents and excellent adherence to treatment. HIV viral suppression should be monitored to assure both personal health and public health benefits.
​
NOTE:   An undetectable HIV viral load only prevents HIV transmission to sexual partners. Condoms also help prevent HIV transmission as well as other STIs and pregnancy. The choice of HIV prevention method may be different depending upon a person’s sexual practices, circumstances and relationships. For instance, if someone is having sex with multiple partners or in a non-monogamous relationship, they might consider using condoms to prevent other STIs.