Question: hey i had protected oral sex with a sex worker 3 days back, she gave me a blowjob and i was wearing condom all the time. before wearing the condom she did touch my penis with her bare hands for 4-5 seconds.. only after i wore a condom did she start the blowjob..... no vaginal or anal intercourse,no kissing, i just spanked her behind once and rubbed my penis while wearing a condom with her vagina for 2-3 seconds.. no vaginal penetration.... she sucked my nipples for around 30-45 seconds.... i just kissed her neck and some parts of the stomach and once the nipple but didnt suck it.... she also sat on my stomach once while she was naked and not even once did i penetrate her even with a condom on... also after i asked her to make me ejaculate by masturbating me she removed my condom and tried to masturbate for 15-30 seconds with her bare hands but no unprotected oral sex even then... ... i didnt feel like doing it later and didnt ejaculate... after that she lied naked beside me(i was completely naked too) for 15-20 minutes.... i just chatted and asked her to go...... i got paraphimosis(foreskin stuck behind glans) which i showed to the doctor next day and he corrected it by bringing foreskin back to normal position... also asked abt std risk and he said no need to worry as no sexual intercourse and oral sex was done with condom therefore no need for any test....do i need to test for any std risk here? is there any possibility of std transmission because she touched my penis with her hands or because she sucked my nipples?

thank you doctor so you would not recommend any kind of testing for this incident i mentioned. i was planning to go for an hiv duo test after 4 weeks of the incident in first week of may. is the 4 week hiv duo test conclusive? i need peace of mind coz i have been having bad thoughts that i may have got hiv through her sucking my nipples if she had bleeding gums or mouth ulcers and i have been checking my nipples since then and i havent observed any cut mark or injury mark or wound... or if my condom had a hole and during oral sex the virus could have travelled through the hole to the urethra and given me hiv or if her vaginal fluids may have come in contact with my penis when she tried to mastrubate me with her bare hands...also i have been pretty much googling hiv all day and it seems i am suffering from an hiv hypochondria so much so that i keep asking others to touch me and tell me if they feel if i seem feverish or not... please help doctor... lets assume that even if she was hiv positive the incident i described puts me at absolutely no risk for hiv transmission and i dont need any testing watsoever?

hi doctor thanks for ur reply i was thinking of getting the sex worker i had protected sex with tested for hiv? if she is hiv negative then i dont think i need to worry however i am concerned if she comes out to be positive.... then i could be in trouble... i know you are probably right but if she is hiv positive then the activities i described dont put me at any risk of any kind... i am only concerned abt her sucking my nipples and her touching my penis with her bare hands... i was protected by condom when having oral sex.... has there ever been any case of hiv transmision in this manner... touching penis with bare hands and nipple sucking?

thanks doctor. i know i am probably panicking. is there any way i can contact u over the phone or thru skype and have a 5 minute discussion over the phone. i would be extremely grateful. if i am required i'll make the necessary payment thru health care magic.
i will definitely go for hiv duo test after the 28 day period just for peace of mind. dat test wud be conclusive or should i go for another one after 3 months?

hi doctor,

its been 10 days since the event and as such i havent had any such symptoms like fever,diarrhea, headache etc. sometime i feel like i have fever but when i ask others to touch me and check there isnt anything. my diet has reduced a bit probably due to stress and tension.

the only thing i am concerned about is when the sex worker sucked my nipples, i keep wondering if she had mouth ulcers or bleeding gums and while sucking what if her blood came in contact with a small microscopic cut that i cud not see, although i admit when i checked my nipple later i did not see any cut or wound or blood flowing through my nipple and there was no cut or wound around my nipple before the event.

also if she had a open cut or sore in her hand when she touched my penis with her bare hands cud that put me at risk? i did not have any cut or sores on my penis.

i was protected by the condom when i twice got oral sex from her and also when i rubbed my penis over the top of her vagina but did not do any penetration. i did not even come near the anal region so that rules out any infection coming through anal. also touched her vagina once but i had no cut on my fingers.

lying naked beside her and kissing around the abdomen, neck and stomach while i was wearing a condom does not put me at any risk since it is all skin to skin contact. also touching her breasts and licking the nipple just for a second also doesnt put me at any risk.

i was planning to undergo the following 2 tests. please confirm if they are ok?

1.HIV RNA PCR Testing

Better2Know offer a 10 day HIV RNA test that can detect the presence of the HIV virus just 10 days after exposure. The test is available on its own, or part of the Better2Know Early Detection Screen, which also detects Hepatitis B and Hepatitis C.

The Better2Know 10 day test uses a PCR (Polymerase Chain Reaction) testing method, detects the genetic material of the HIV virus. The viral RNA (viral genetic material) is reliably detectable at 10 days post exposure and beyond, so the window period is shorter compared with other types of HIV testing which typically rquire up to 28 days to have passed before testing.

The 10 day HIV test is slightly less sensitive than the 28 day HIV Duo test so we do recommend that if you do take this test, you consider having a follow up HIV Duo test after waiting the 28 day period.

You can have the 10 day test individually or as part of our Early Detection Screen which tests for HIV, Hepatitis B and Hepatitis C. The results of the 10 day HIV test and of the Early Detection Screen will be ready just 3 working days from when your sample is received in our laboratory

2. HIV Duo Test

Better2Know offer a HIV Duo test that can detect an HIV infection from 28 days after exposure. The test detects antibodies to the HIV 1 and 2 strains of the virus, and also detects the p24 antigen. This antibody / antigen detection is why it is called a “Duo” test.

An antigen is a foreign substance that triggers the body to create antibodies. During a HIV infection, the foreign substance is the p24 antigen released into the body by the HIV virus. This antigen will trigger the creation of antibodies that will try to fight the infection. The p24 antigen becomes detectable in the infected persons blood during the first two to three weeks after exposure. The p24 antigen is the first marker of HIV being present in the body. Because of its ability to detect the p24 antigen, this test is used for diagnosing HIV much earlier in the course of an infection, as it can detect signs of an infection before any antibodies appear.

Better2Know's HIV Duo test is a fourth generation test and is considered to be 99.8% accurate at 28 days, and this accuracy increases to 99.9% at 90 days after any potential exposure.

Our clinician will send your blood sample to our laboratory and the results are usually available the same day as the sample is received in the laboratory.

the website of this clinic says that 90 days is not required and 28 days is fine. is it ok? please confirm.

hi doctor i did not get your brief answer? you said:- 'Your activities have negligible risk for HIV and you need to test for HIV.'

Do you mean i dont need to test for HIV at all? I think u may have written 'to' instead of 'no' in the last sentence.

and if I do I should i test tomorrow for HIV RNA PCR or wait 28 days for HIV DUO....

Doctor i just wanted to know is HIV transmission possible if while sucking, licking,biting my nipple i got a microscopic cut on my nipple and she had bleeding gums,mouth sores or ulcer in her mouth. is dat a mode of transmission? has it ever taken place before coz this is the only scenario i am concerned about... as i told u earlier i did not have any open sores or cuts on my nipple before she sucked,licked and bit and after she sucked i did not have any pain in the nipple and atleast cud not see any small cut or blood flowing from the nipple thru the naked eye.. i know hiv cannot go beyond intact skin

hi doctor,

i went for the hiv rna pcr testing after 10 days of exposure this monday and the result has just come out now as 'target not detected'. i have also attached the report for your reference. can u please tell me what is the accuracy of this test after seeing the report. which is the next test i should undergo and at what time for conclusive results?

hi sir,

i completely understand sir when u say i dont really need a test. but i need peace of mind and that can only come when i am 100% sure that i am negative. what is the sensitivity of this rna pcr test that i undertook. the agency i got it through said it is 96%, what is the number u would say? some of the others doctors said it is more than 99% accurate.... can u give me a clear number? i will take the duo test in 1st week of may which is probably 99.8% accurate and if that is negative then another test at 3 month mark in july. is rna pcr used for early detection? is is reasonable reliable at 10 days after exposure? what is the number you will put? does it conclusively rule out hiv 1? and will the duo test cover both hiv 1 and hiv 2?

hi doctor,

i went for an hiv duo test yesterday 28 days after potential exposure(event occurred on april 7, i went for duo test on may 6) and got the result today. it says non reactive. please find both my hiv rna pcr test and hiv duo test report attached. what is ur interpretation of the result? is this test conclusive for both hvi 1 and hiv 2?

thanks for your reply doctor. so i would need to go for a rapid or elisa test 90 days after the event in order for the results to be conclusive? once dat is negative dat means there is neither hiv 1 nor hiv 2 ? please confirm or do i need to go again for this duo test at 90 days? please confirm the test i should take at 90 days to rule out hiv 2.
duo test, elisa test or rapid test? which one will be 100% conclusive for the antibodies of both hiv 1 and hiv 2 90 days after exposure?

hello doctor,

you have been great help to me till now. i am grateful to you. i took 2 other tests hiv-2 real time pcr detection on may 14(day 37 after risky act on april 7) and hiv 1/2 & p24 combo test(CMIA) today on may 21(day 44 after risky act on april 7) from dr.lal path labs in XXXXXXX I tested negative on both tests. I have attached the reports of both tests for your reference. (the reports are 0000.pdf and 0000_xjmc31eolm0rfy5524a0jpup.pdf).

Also the reports of earlier tests I had taken the HIV-1 real-time PCR (10 days after act on April 18) and another HIV 1/2 & p24 combo test(CMIA) on May 6(29 days after risky act) are also attached.

I needed your confirmation if the HIV 1/2 & p24 combo test(CMIA) is the same as the HIV duo test which checks for both antigen and antibody? I have read on many online forums that this test is considered conclusive by HIV specialists for HIV-1 at 6 weeks as either the antigen or antibody will be detectable if a person is HIV positive and once a person tests negative on this test after 4 weeks of risky act there is no need for further testing. There can not be a case where a person is HIV positive but neither the p24 antigen or the antibody is not detectable at 4-6 weeks since its the antibody which makes the p-24 antigen undetectable, one of the 2 will always be detectable during the first 4-6 weeks if a person is HIV positive. am i right in what I have said.

Please confirm if can I consider my self now free of both of HIV-1 and HIV-2 and put an end to my anxiety or whether I should go for another duo or elisa test after 90 days of risky act in 1st week of july to just confirm this negative result. Are my results till now 100% conclusive for both HIV-1 and HIV-2?

I know I was always nearly zero risk and these tests weren't really needed but I need to put an to end my anxiety, this has been a learning experience and I will never put myself in such trouble again.

hi doctor,

i think there is a misconception. I took the hiv-2 pcr after 37 days not hiv-1 pcr.
i took the hiv duo test after 44 days, both of which are negative. I think you may have mistaken the hiv-2 pcr after 37 days as hiv-1 pcr..
these are my test results:-

risk event- april 7
hiv-1 rna pcr on april 18- negative target not detected (10 days after exposure)
hiv duo test on may 6- index value- 0.07 negative(28 days after exposure)
hiv-2 pcr detection on may 14- target not detected(37 days after expsoure)
hiv duo test on may 21- index value- 0.11 target not detected(44 days after exposure)

all reports are attached for your reference.

thanks doctor for your help.

I am really thankful for your help during this traumatic time. I will never repeat same mistake again.I had some queries regarding HIV transmission which I wanted to ask you so that I dont face the same situation again.
1.) Are latex condoms 100% effective against HIV virus and all others STD's. I mean if an hiv negative person has protected sex using a condom with an hiv positive person, and condoms are correctly used... there is absolutely no way that the virus could be transmitted?can someone get HIV/STD despite using a condom?
2.) I have also read that HIV can be transmitted through open cuts,sores and broken skin which are actively bleeding and if this bleeding came in contact with infected fluid like semen, blood and vaginal fluids. Can HIV also be transmitted through small razor cuts or minute cuts which we men get sometimes while shaving because these cuts heal almost immediately after bleeding and dont feel painful at all?
3.) Can breast milk cause HIV infection in adults if it accidentally enters the mouth during sexual activity?

hi doctor,

thanks for your help till now.

In order for a final confirmation of my negative status i went for an hiv-1 rna QUALITATIVE PCR test on day 46 after the risky act and the test has come back as negative. Please find the test report attached as well for this(75208rahul XXXXXXX image.marked.pdf). Please have a look at all my test reports till now.They are all attached.

these are my test results:-

risk event- april 7
hiv-1 rna pcr on april 18- negative target not detected (10 days after exposure)
hiv duo test on may 6- index value- 0.07 negative(28 days after exposure)
hiv-2 pcr detection on may 14- target not detected(37 days after expsoure)
hiv duo test on may 21- index value- 0.11 target not detected(44 days after exposure)
hiv-1 rna QUALITATIVE PCR- negative(46 days after exposure)

Can I now be 100% sure without any doubt that I am free of both HIV-1 and HIV-2 and I can go back to leading my normal life again without any HIV anxiety what so ever?