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Need advice please.
Sep 21, 2011

Good day Dr.

My exposure was unprotected insertive oral sex (receiving only) with a SW, nothing else, no kissing or vaginal/anal sex. I am unaware of the HIV status of the other person, however lets assume that she was positive. I am a South African heterosexual male, and I am am now approaching 14 weeks post exposure. Thus far I have been tested as follows: 2 weeks - negative 6 weeks - negative 8 weeks - negative 12 weeks - negative 13.5 weeks - negative All the above HIV test was done using the rapid anti-body test here in SA at a leading pharmacy.

My question is, do you recommend any further testing or should I regard the tests performed as conclusive? I am aware that the risk related to the exposure is very low, but not non-existant. I know that the option of testing out to 6 months is available, however is it medically necessary?

Finally what are the common reasons for late seroconversion? I have read that a suppressed immune system is one possible reason, how do I determine if my immune system is suppressed? I feel normal, and have not experienced anything out of the ordinary. Can a topical steroid cream such as Betnovate have an impact on the HIV tests? I have used this cream intermitently for a seasonal back rash, but stopped when I realised that it may impact the test. I stopped the cream at 8 weeks post exposure.

Thank you for your time, I look forward to hearing from you soon.

Response from Dr. Young

Hello and thanks for posting from South Africa.

I'm not sure why you're testing as frequently as you are (though the anxiety is understandable). IMHO, testing more often that at month 1, 3 (and maybe 6) only raises the apprehension, since what's really needed is time to determine if a person is to develop HIV antibodies. A test at 12 weeks (3 months) is my usual stopping point if there's been no other possible HIV exposures or concern.

Late seroconversion is very, very rare and usually only present in cases of profound immune deficiency (or simultaneous illness). Topical steroids will not impact the test.

From what I can tell from your description, you're done testing. Your negative.

Be well and stay well. BY



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