Repeated low-positive / equivocal results

[leicestershireboy]

Hi all,

I’m looking for some advice (and hopefully reasurrance!)

I’m a gay man who has always used condoms for anal sex but never for oral sex.

In 2020 I had a routine screening in a clinic in the uk and it came back indeterminate (they said it was a ‘low positive’ on the first 4th gen and then negative on the second 4th gen using the same sample.

I had to wait for 2 weeks and go back again where they did the more detailed tests, which came back negative. I was obviously quite nervous at the time. They did warn me that it might happen again as some people for unknown reasons get these kind of results. They also told me not to do the postal tests as these may come up reactive and I would be referred to the clinic anyway.

I then had another routine screening in 2021 at the same clinic and this came out negative.

I became a blood donor in 2021 when they relaxed the rules for MSM and have donated a few times, most recently in august 2023. All donations were used and sent to hospitals. During this period I wasn’t really sexually active apart from some insertive oral. So I’m confident that my status was negative as recently as august 2023.

Since the august 2023 blood donation I’ve had anal sex once (in October), where I was the top and used a condom. I’ve done insertive oral a few times too, as recently as Jan 2024 with the same person.

In January 2024 I did a postal test (mainly for the other tests as I hadn’t done these for a while) but it came with a finger prick for hiv and syph too). A week or so later they came back to me to say everything was negative except the HIV which was a low-reactive - apparently anything over 1.0 is reactive, mine was 2.56 and they class anything over 30.00 as a high reactive.

They referred me to my local clinic (different to my previous clinic as I’ve moved house) where I had the more detailed tests. 2 weeks later I got the results which they said was ‘insufficient’ due to the clinic only sending them enough blood to do the 2 antibody tests but not the confirmatory tests. Apparently the antibody tests came back as equivocal (first one reactive and second one non-reactive).

Part of me isn’t too worried and I consider my behaviour to be fairly low-risk, and also given that the same thing happened before. Obviously though it’s in the back of my mind. I’ve had to come away for business for a couple of weeks so won’t be able to go back for the retests for a little while. It’s also frustrating that the clinic messed up with the size of the samples.

I do have various allergies and also psoriasis which I’ve had for years. Whilst these are classed as immune disorders, I don’t think they are known to cause these false positives. I did also have covid in December (confirmed with lateral flow) and the clinic said it could be that. I’ve not had any noticeable seroconversion symptoms.

What are my risks here? Anyone else experienced similar? 

[leatherman]

HIV is mostly transmitted through unprotected anal/vaginal sex or through sharing injection needles. Neither of which you claim you have done, so your risk was zero.

I consider my behaviour to be fairly low-risk

your behavior has actually been excellent and NO risk. Sorry that you seem to give an odd result with the less effective testing; but keep up the good work on using condoms and expect a negative result.

Have a great day,
Michael

Reducing Your HIV risks:
With no exceptions, use condoms correctly and consistently for anal or vaginal intercourse
Talk to a healthcare provider about PrEP as another layer of protection

Get tested yearly for HIV and other STIs.
If you don’t use condoms and/or PrEP, test more frequently

Some sexual practices described as safe in terms of acquiring HIV still pose a risk for other more easily acquired STIs. It is possible to show no signs or symptoms from an STI so testing is the only way to know.

Get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

What’s the ONLY way to know if you’ve been infected by HIV or an STI?
Get tested.


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[leicestershireboy]

Thanks for coming back to me

Quick update, I went back to the clinic a week ago for the follow up tests so should have the results soon.

I know the guy who I had protected anal with back in October quite well, so I spoke to him about it and he has tested negative and sent me the screenshot from the testing service.

So that leaves one other guy I’ve had any sort of sexual contact with - he’s given me a few unprotected blowjobs between November and January but that’s it. I didn’t suck him and we didn’t do any anal or anything else.

Whilst waiting for my results from the clinic I’ve also done 3 home testing kits (one was an oral swab and the other two were single blood drops) and these were all negative which is somewhat reassuring.

This is reassuring but I’ve got in the back of my mind that these have longer window periods and I somehow could have become infected by the insertive oral with the other guy more recently. Looking at various topics on here I can see insertive oral isn’t classed as any risk at all, however other sources say it’s a theoretical risk if there is blood involved. I don’t know much about the oral health of this guy, but he does have a tongue piercing. I didn’t notice any blood during any of the blowjobs - would it need to be super obvious and pissing out of his mouth for it to be a risk?

Sorry for being one of those people asking these questions. I wouldn’t be concerned about it at all if I hadn’t had these reactive results. Although it is worth noting I had a false reactive a few years ago and they did warn me that it could happen again in future. Doesn’t stop it worrying me though.

To confirm these are the tests I’ve had results of so far:

Home sampling kit taken early Jan and tested in lab - low reactive elisa
Clinic test taken 19th Jan - first elisa reactive (they don’t give a figure) and second elisa non-reactive

Home testing kits taken on 21st feb - oral swab negative, 3rd gen blood drop negative, 2nd gen blood drop negative.

Even though the window period on the home test kits is longer, I’m assuming that if my January tests were genuine positives, even these would have picked something up a whole month later?

I know there isn’t a lot I can do about it now until I get the extra clinic test results, but just wondering if this extra info changes anything.

As I said, I do suffer from psoriasis which is classed as an auto immune disease, although it’s not listed anywhere as causing false reactives. I did also have covid in December, which the clinic initially said may have caused a cross-reaction on the first one.

Thanks and take care 

[Jim Allen]

I don’t know much about the oral health of this guy, but he does have a tongue piercing. I didn’t notice any blood during any of the blowjobs - would it need to be super obvious and pissing out of his mouth for it to be a risk?

So if he needed urgent medical care, like you beat him to a pulp or stabbed him in the face and instead of calling him an ambulance you put your penis in the knife wound that theoretically might do it but HIV would also be the least of your concerns.

As Micheal explained it's not an HIV risk.

Despite that some blood presence is pretty common in the month, receiving a blowjob lacks the conditions required for acquiring HIV; thus, it makes sense that after 40+ years of this pandemic in terms of BJs, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked"), and you will not be the worlds first.

So stop asking or bringing up, consider the topic of getting a blowjob closed.

I know the guy who I had protected anal with back in October quite well, so I spoke to him about it and he has tested negative and sent me the screenshot from the testing service.

It's irrelevant as there was no HIV risk and screenshots of stuff mean nothing.
This has been addressed by Micheal, so consider the topic closed.

Hi all,

I’m looking for some advice (and hopefully reasurrance!)

I’m a gay man who has always used condoms for anal sex but never for oral sex.

In 2020 I had a routine screening in a clinic in the uk and it came back indeterminate (they said it was a ‘low positive’ on the first 4th gen and then negative on the second 4th gen using the same sample.

I had to wait for 2 weeks and go back again where they did the more detailed tests, which came back negative. I was obviously quite nervous at the time. They did warn me that it might happen again as some people for unknown reasons get these kind of results. They also told me not to do the postal tests as these may come up reactive and I would be referred to the clinic anyway.

I then had another routine screening in 2021 at the same clinic and this came out negative.

I became a blood donor in 2021 when they relaxed the rules for MSM and have donated a few times, most recently in august 2023. All donations were used and sent to hospitals. During this period I wasn’t really sexually active apart from some insertive oral. So I’m confident that my status was negative as recently as august 2023.

Since the august 2023 blood donation I’ve had anal sex once (in October), where I was the top and used a condom. I’ve done insertive oral a few times too, as recently as Jan 2024 with the same person.

In January 2024 I did a postal test (mainly for the other tests as I hadn’t done these for a while) but it came with a finger prick for hiv and syph too). A week or so later they came back to me to say everything was negative except the HIV which was a low-reactive - apparently anything over 1.0 is reactive, mine was 2.56 and they class anything over 30.00 as a high reactive.

They referred me to my local clinic (different to my previous clinic as I’ve moved house) where I had the more detailed tests. 2 weeks later I got the results which they said was ‘insufficient’ due to the clinic only sending them enough blood to do the 2 antibody tests but not the confirmatory tests. Apparently the antibody tests came back as equivocal (first one reactive and second one non-reactive).

Part of me isn’t too worried and I consider my behaviour to be fairly low-risk, and also given that the same thing happened before. Obviously though it’s in the back of my mind. I’ve had to come away for business for a couple of weeks so won’t be able to go back for the retests for a little while. It’s also frustrating that the clinic messed up with the size of the samples.

I do have various allergies and also psoriasis which I’ve had for years. Whilst these are classed as immune disorders, I don’t think they are known to cause these false positives. I did also have covid in December (confirmed with lateral flow) and the clinic said it could be that. I’ve not had any noticeable seroconversion symptoms.

What are my risks here? Anyone else experienced similar? 

So a few years back, you took a screening test had a false reactive result.

Its just a seening test, not a dignosis, and we see reactive results commenly engough, no drama needed. False reactive results can happen due to cross antibodies reaction, other past infection, solution/buffer interacteration depending on the test etc.

A reactive result simply means further testing is needed to exclude an HIV infection and, the clinc also informed you this could happen again and not to take the tests by post.

2020:

They also told me not to do the postal tests as these may come up reactive and I would be referred to the clinic anyway.

2024:

In January 2024 I did a postal test

Don't do postal tests for HIV, yet you did and it's reactive. Now it simply means further testing is needed to exclude an HIV infection.

Stop messing about with home test kits, rapid tests or postal tests. Next time just go to the clinic and what you posted here about the sex wasn't an HIV risk, as Micheal has already mentioned.

I wish you well but please don't post about this again. Thank you.

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.

[Jim Allen]

We explained the false reactive results and why they happen, the need for you to stop using OTC (Rapid) or Postal tests, the lack of HIV exposure or the need to test outside of routine, the need to test at a clinic, safer sex and PrEP.

The only thing we did not reply to was your blood donation history as those results are irrelevant.

There was nothing missed and there was not even a need for this drama to start with as the clinic had previously informed you not to piss around with postal tests, yet despite being told this, you did it again.

You do not have HIV, and you were warned not to post about this situation again, you did, it got removed and you have a 28-day ban as warned. Ignoring the clinic is one thing, they will not ban you, ignore me and I will.