Testing conclusiveness

[superscaredgirl1234]

Thank you for providing this service.

I am writing to ask about the conclusiveness of the Oraquick oral fluids test. I have seen experts here say that this test is conclusive after 3 months. However, Dr. Hook and Dr. HHH from ask the experts have said recently that this test can miss up to 2-5% of infections in hiv positive patients no matter how long after exposure. They say that if the exposure was high risk, the Oraquick must be followed up with a lab based blood test, since a small percentage of  infected people will never develop positive oral fluids tests.

I have seen community leaders from medhelp say that the test has become more accurate over time, but haven’t found any evidence to support that in my research.

I also saw in a recent post that you said that reports of false negatives are out of date, CYA, or due to  improper testing procedures, prior to the 3 month period etc. so, I was just wondering if you could explain your reasoning behind disregarding the test insert’s warnings of 1 out of 12 false negatives. It would really help me move on!

My exposure was receptive unprotected sex with a person who is hiv +. I experienced severe ARS symptoms. My digestive system has never been the same.

I had a chembio finger prick 1 month after exposure. I took 6 oraquicks  after the 3 month mark up to six months and then self administered two Abbott determine ag/ab tests. I have read in the training manuals that the Abbott test does not have  internal controls to ensure that enough blood has been added to the test strip and that the control line will appear with the addition of the buffer solution, regardless of whether or not the correct amount of blood specimen has been added, thus leading to false negatives.

All of my tests were negative. I have had so much anxiety, it has taken my life away from me.

Would love to read any articles or studies that you know of that debunk the false negative oraquick reports.

I am scared bc Dr Hook and Dr HHH have said that Oraquicks are not reliable after a high risk exposure. And bc I may have administered the Abbott test incorrectly. I am scared to get tested again.

What is your expert advice? Thank you for sharing your wisdom.

I don’t understand why everywhere else in the world has reliable hiv home tests, such as the Insti and the VIH auto test  and the US only has the oraquick test. I had to get my Abbott tests shipped in from the UK!

[Jim Allen]

Hiya,

I have had so much anxiety, it has taken my life away from me.

What is your expert advice?

It sounds like you have been reading a lot of nonsense, outdated or out-of-context stuff, and it's making your fears worse.

The results are reliable and it seems you deep down already know this.

Stop reading stuff and if you can't move on with your life then go to a clinic and get a lab test done instead, it's that simple.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless 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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[superscaredgirl1234]

Well I am not challenging your opinion at all, I have the utmost respect for your work and dedication. I am just wondering if you could explain why you know that reports of false negatives are complete nonsense and out of context. I just don’t know why the Doctors/researchers over at ask the experts say that oraquick can never be considered conclusive but everyone else here on Poz and medhelp says that they are in fact conclusive after 3 months when performed correctly.

People from all over the world trust in your advice here on Poz, and I know that you know that there could be tragic consequences if a person did get a false negative oraquick and didn’t get timely treatment. You are in a position of power which also comes with great responsibility, so I know that you would not give advice that would hurt anyone  since your main goal is to help and educate people.

So, if you wouldn’t mind elaborating on why you are confident that no further testing is needed beyond the oraquick test after 3 months, it would be really helpful for people like me who are confused by the false negative reports. I think that it scares a lot of people and makes them doubt their results.  I just need help believing that I can trust the test with some sort of evidence. I will be grateful for anything that you can provide.

Thank you so much!

[Jim Allen]

Well I am not challenging your opinion at all

I appreciate that you are concerned; therefore, I politely and clearly answered your initial post and now I will answer this post.

However, yes, you are challenging my opinion, I did not say it but now that you mentioned it.

You are also, as we would say in Dutch, "sticking a feather in my ass" Giving me false or over-the-top praise to try and profit from it later, I don't like it, and it feels manipulative as does most of your post. Stop doing that, there is no need for it and you will not gain from it, nor will it change the assessment. thank you.

I am just wondering if you could explain why you know that reports of false negatives are complete nonsense and out of context. I just don't know why the Doctors/researchers over at ask the experts say that oraquick can never be considered conclusive but everyone else here on Poz and medhelp says that they are in fact conclusive after 3 months when performed correctly.

People from all over the world trust in your advice here on Poz, and I know that you know that there could be tragic consequences if a person did get a false negative oraquick and didn't get timely treatment. You are in a position of power which also comes with great responsibility, so I know that you would not give advice that would hurt anyone  since your main goal is to help and educate people.

So, if you wouldn't mind elaborating on why you are confident that no further testing is needed beyond the oraquick test after 3 months, it would be really helpful for people like me who are confused by the false negative reports. I think that it scares a lot of people and makes them doubt their results. I just need help believing that I can trust the test with some sort of evidence. I will be grateful for anything that you can provide.

Thank you so much!

You already have read the reasons why and the advice I provide. You even mentioned part of it in your first post.

Generally, we have three types of posters questioning testing. The two main ones are, those wanting to test early whose healthcare providers have considered 90-95% conclusive and those seeking results that are 98%+.

Between 2014-2019, a dozen or so studies included the version of the Oraquick saliva HIV test you are using. Generally, basic user error is up to 5%, with that being lower on administered testing in studies, instead of self-administered tests and administered testing in studies show generally a higher specificity, most recently with a specificity of 99.5% testing over 400 people, but even looking back at 2014 studies whereby the test as administered it scored 99.1%

Although, this does not mean I believe this version of OraQuick has a true specificity of 99%. However, taking into account high-quality studies, the results are considered reliable if used correctly and outside the window period.

Generally, my advice to anyone, regardless of a non-reactive result or if someone is in a committed relationship or not, is to always use condoms for any intercourse, no exceptions, consider PrEP and test out of standard routine yearly for STIs & HIV.

You have tested nine times already. Odds would be astronomical tiny that HIV was missed, but you are on the merry-go-round of unnecessary repeat testing with the same results and often the same test type. You test, stress again and test some more with the same outcomes.

So my advice to you is slightly different. If you can't move on, then go to a clinic and test, and then put this behind you and remember to use condoms for any intercourse, consider PrEP and test out of standard routine yearly for STIs & HIV.

I wish you well, and hopefully, there is no next time, but if you do have condomless intercourse again, then go to a clinic and test instead of using OTC tests, as I would hate for you to end up stressing like this again.

P.S To be fair towards others and consistent.

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.