Is a 4th-generation HIV test reliable after completing PEP?

Question

Hi doctor,

I am a 29-year-old male. I had a very brief unprotected encounter with an escort. I do not know her HIV status. I did ask her afterward, and she told me she was clean of STDs (Sexually Transmitted Disease). I offered to pay her well just to get an HIV status, and she has not responded. I do not know if this is because I annoyed her or because she is hiding something. I am not someone who participates in high-risk sexual activities.

I understand that this situation is low risk. I have spoken to an HIV (Human Immuno Deficiency Virus) specialist. I am on PEP (post-exposure prophylaxis) because of nervousness. I cannot sleep or relax. I am in a constant state of panic. I would like to know your personal experience on this subject.

How would it be possible to get HIV from a positive person performing oral sex on a man? Do you think I will be fine based on what I have told you? Will a fourth-generation Ag or Ab (Antigen or antibody) test immediately post-PEP be a good indicator of my status? In the past I did have anxiety and may have been considered a hypochondriac.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Your exposure was not sufficient to acquire human immunodeficiency virus (HIV). Frankly speaking, I have not seen a single case of HIV (Human Immunodeficiency Virus) with such a short exposure. Oral sex, particularly from the donor point of view, is considered the safest sexual practice as far as HIV is concerned. Various studies have shown that the amount of HIV in saliva is almost nil.

Therefore, in many countries, it is not even considered a potential exposure for post-exposure prophylaxis. I am quite sure that you will not acquire HIV with such a brief exposure. Further, you are taking post-exposure prophylaxis (PEP), which will also decrease the chances. But I would not have prescribed the one for such exposure. So, be assured of your being HIV negative. Go for the fourth fourth-generation test if you want. Two fourth-generation tests from two different laboratories in a gap of two weeks are considered confirmatory.

I hope this helps.

Answer 2

Hi,

Welcome back to icliniq.com.

I said that in my country we do not provide PEP (post-exposure prophylaxis) for such exposure with urine, nasal secretion, saliva, sweat, and tears, as these secretions contain negligible HIV virus. Once PEP starts, you should continue the course. I have already explained that there is nothing absolute in medical science. It works on probability. So, your chance of acquiring HIV is negligible. Yes, it does affect the virus proliferation, so testing is done after two weeks of completion of post-exposure prophylaxis (PEP) and the next one after three months (according to guidelines).

I hope this helps.