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oral swab- this question's never been asked!!!
May 10, 2010

Hi, Dr. Bob, After a couple hours of scouring through all the posts on this wonderful forum, I found no posts that pertained to my own question(s).

I am a 22 year old female living in Georgia in the United States. I had unprotected sex with a total of 4 guys- ranging from 4 years ago to about 7 months ago. I got tested for HIV with an oral swab antibody test about 6 months after the last exposure- the results came back negative. This is why I am worried- The person administering the test was only a CNA, and she did not herself administer the test! She handed me the oral swab out of the package and instructed me to "get it really wet with a good sample." So, I took the swab and just rubbed it all around my mouth, my cheeks, my tongue, making sure to get it "really wet." I licked it a lot with my tongue as well. She sent it in to a lab and a week later the results came back as nonreactive.

I have read online that the correct way to administer the conventional oral swab test is to swab around the upper gums once and then around the lower gums once and that is ALL! This is because (correct me if I am wrong) the test is designed to test for HIV antibodies in the oral fluid, which is completely different from saliva. Oral fluid is found on the gums, saliva is found on the tongue. My question is this- would the results be affected because the test was not performed correctly?? I used saliva/tongue to wet the swab rather than oral fluid from my gums! I feel like this would indeed affect the results of the test. In your opinion, should I get retested with a conventional blood test?

And lastly, how common is it for a lab to make a mistake with an oral swab that has been sent in for testing?

Thanks so much for your time, Dr. Bob. I am so so so so extremely worried!!

Response from Dr. Frascino

Hi,

What you read online regarding the proper way to conduct an oral swab HIV test is correct. I would suggest you go back to the site that improperly collected the specimen and talk to whoever is in charge of the laboratory. They should rerun your test free of charge and also re-instruct the CNA in proper testing techniques.

Good luck.

Dr. Bob



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