Email 459: Worried Boyfriend

Posted by Pozziepinoy on 5:59 PM

Hi!

My girlfriend recently tested reactive to HIV while being screened to donate blood. I was previously in the healthcare field while she is currently still in it. I have had my share of needlepricks before and so did she. When she told me about the result I felt really scared. I am studying for the biggest exam of my life but now I feel like there is no point.


Before we met, we both had our share of sexual partners and none of them are in the "high-risk" group for HIV, if you will. We have been together for two years and have been exclusive ever since. We have no idea why she tested reactive and I am feeling depressed.  I feel like there is no more point in everything. She is confident that she has a false positive and is telling me to get a screening test as well.

Right now, she is waiting for the results of the confirmatory test which supposedly takes months as the testing center is all the way in Manila.

Her lab results show she got a 1.58 from a cut-off of 1.00. The doctor and medical technician told her that "most likely", the result is a false positive as it has happened before and the value is too low and probably caused by something else. Meanwhile, as we await the results of the confirmatory test, I don't know what to do. We have not engaged in sex ever since. I am praying that it is really a false positive but at the same time, too scared to take a preliminary screening test.

What do we do from here?


CONTRIBUTOR'S RESPONSE

Hi XXX,

Thanks for your email and for reading this blog.

You haven’t stated whether either of you have been tested for HIV before or not so I am going to assume you haven’t. 

Firstly, HIV can be transmitted via needle stick injury.  The risk of HIV infection from any single needlestick injury where HIV-contaminated blood is involved is around 0.32%.  

However, there are 4 factors that can increase the risk.  The first three of which depends on factors that influence exposure to a greater volume of blood. 

1) The depth of the injury.  
2) Visible blood on the device which caused the injury.   
3)  Injury with a needle which had been placed in a source patient’s artery or vein.   
4)  Terminal HIV-related illness in a source patient who is not on therapy and has a high viral load.  In this case, it is in increased amount of virus present which increases the risk. 

There is no risk of HIV transmission where intact skin is exposed to HIV-infected blood.

Given that you have both been subjected to needlestick injuries, you should both be tested for HIV.

You have said that you have both had sexual partners in the past but haven’t said if the sex was safer sex or not.  ALL unsafe sex puts you at risk of exposure to HIV and other STIs.  As far as your previous partners not being in “high-risk” groups is concerned.  That is irrelevant.  It is the activity that puts you at risk not the gender of the person you have the unsafe sex with.  Anal sex, regardless of the gender of the receptive partner, is estimated to be 18 times higher than the rate during vaginal intercourse.  Also, please remember, that every time you have unprotected sex with a person, you are potentially having unprotected sex with every person they have had unprotected sex with.  It is virtually impossible for most people to know the sexual history with absolute certainty of all their sexual partners, including their current one.  This is yet another reason for you to both be tested for HIV.

Regarding your girlfriends recent possible “false positive” result.  False positives do occur for both the enzyme-linked immunosorbent assay (ELISA), and the rapid antibody test.           

Depending on the prevalence setting, 0.2 to 1.5% percent of ELISA tests give a false positive HIV test result.  Autoimmune diseases, recent vaccinations, multiple pregnancies or prior infections with hepatitis B, malaria or tuberculosis can stimulate the production of antibodies that cross create with HIV antigens, thus producing a false positive HIV test.  The number you’ve quoted for your girlfriend does seem low but, only a confirmatory test will indicate whether or not the first test is a false positive or not.  The Western Blot is the confirmatory test most frequently used.  The combination of ELISA and Western blot used for the diagnosis of HIV is remarkably accurate, with very low false-positive and -negative rates.  It is understandable that, out of fear, you don’t want to be tested.  However, it is the only way you will be able to put you mind at ease for once and for all.  In the meantime, there is no need for you and your girlfriend to cease having sex.  In fact, irrespective of the result, you can continue to have a healthy and loving sex life.  All that is required is the correct and consistent use of condoms.

I hope you have found this answer helpful.

Credits:  http://www.livestrong.com/article/166602-causes-of-a-false-positive-hiv-test/
                http://annals.org/article.aspx?articleid=718529
                http://www.aidsmap.com/Risk-of-infection/page/1324549/

As usual readers, get tested, stay healthy and, if you’re on ARV, compliant with your ARV regimen.

Malcolm Brown. 
International Contributor








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