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OraQuick Test Interpretation Uncertainty... Can I Woo-Hoo?
Nov 29, 2007

Dear Dr. Bob, Happy Holidays to you and Dr. Steve. My question is the following: 87 days ago (12.5 wks) I had unprotected insertive anal sex with an unknown status male. I tested NEG at 6.5 wks via OraQuick Rapid Advance. Today, I tested myself using an OraQuick Rapid Advance testing packet I took from work (I am a healthcare worker). The test result was non-reactive after 20 mins with only 1 line appearing at the control line. I checked again at 40 mins and the result was the same. I then removed the swab stick from the developer solution and placed both separately back in the packet and threw away. Hours later, I was curious and grabbed the packet from my wastebasket to take a look at the swab stick again. This time, there was still a line at the control line but there was also a very faint line at the "T" line. Should I consider this test to be NEG or POS? Please help clarify. Thank you in advance.

Response from Dr. Frascino

Hello Healthcare Worker,

Your situation provides an excellent example of why healthcare workers (including doctors, by the way) should never ever try to diagnose or treat themselves!

Let's assume instead of stealing that OraQuick Rapid Advance testing kit from your place of employment you did the more logical (and ethical) thing and presented yourself for HIV testing either at your place of employment or anywhere else that runs OraQuick rapid HIV tests. You would have had the test and the 20-minute result would have been non-reactive (just as it was when you ran it on yourself). You would have yelled WOO-HOO and very appropriately believed the non-reactive test result. End of story. In fact a very "happy ending" of the story. But instead you continued to check your test result swab at 40 minutes (still non-reactive) and then again hours later (after rummaging in the garbage to retrieve it) after it had been removed from the developing solution and disposed of. This hours-later and totally inappropriate reevaluation of the swab showed a very faint line at the T line. So now you want to know if you should consider the test positive or negative. Do you see where I'm going with this? These test kits are designed to be read at 20 minutes, not monitored repeatedly for hours! So your first mistake was having unprotected insertive anal sex. Your second mistake was trying to test yourself. Your third mistake was not interpreting the test properly.

Your OraQuick test is negative. (Only the 20-minute reading is valid.)

My advice is simple:

1. Use a latex condom for all future episodes of penetrative sex to avoid situations like this in the future.

2. Despite your healthcare worker status, never try to diagnose (or treat) yourself.

Happy Holidays to you too!

Dr. Bob



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