A friend just tested HIV indeterminate. What are his chances?

[marylander1940]

A friend on PrEP just tested indeterminate. He got tested again and he’s waiting the new result.

 

What are the chances of him becoming positive?

[+ keroscenefire]

Very very little. There appears to only have been six people who have been regular adhering to PrEp that became HIV positive. http://www.aidsmap.com/Another-rare-PrEP-failure-reported-in-San-Francisco/page/3350434/

[Guest]

I guess he'll find out soon. Instructions for Truvada are that it be used with condoms. Do you know if he uses condoms in addition to Truvada? If so, I would think the chances are nearly zero. I can't remember the efficacy rates for Truvada alone. Maybe someone can remember the string where this was posted? I seem to recall something on the lines of 96% efficacy, but I'm on a cruise with my partner, and don't want to research... If I bottomed with partners I couldn't feel sure about their status, I would use both Truvada and condoms.

[marylander1940]

Very very little. There appears to only have been six people who have been regular adhering to PrEp that became HIV positive. http://www.aidsmap.com/Another-rare-PrEP-failure-reported-in-San-Francisco/page/3350434/

 

I edited the name of the thread. My question is about the word indeterminate and how common that result is not so much about PrEP.

 

I guess he'll find out soon. Instructions for Truvada are that it be used with condoms. Do you know if he uses condoms in addition to Truvada? If so, I would think the chances are nearly zero. I can't remember the efficacy rates for Truvada alone. Maybe someone can remember the string where this was posted? I seem to recall something on the lines of 96% efficacy, but I'm on a cruise with my partner, and don't want to research... If I bottomed with partners I couldn't feel sure about their status, I would use both Truvada and condoms.

 

He didn’t wear a condom.

 

As a Dr. how common is for someone to test indeterminate?

[Guest]

I edited the name of the thread. My question is about the word indeterminate and how common that result is not so much about PrEP.

 

He didn’t wear a condom.

 

As a Dr. how common is for someone to test indeterminate?

Well, in my experience, about 70% of indeterminate results end up positive. Of course, the facts in this case are important in giving odds for this particular case. Since he wasn't wearing a condom, I think it's more than 2/3 likely that follow-up results will be positive. If condoms had been worn, I'd estimate the probability of this ending up positive would be less than 10%. The patient in this case could call the lab and ask them what percentage of their indeterminate results end up positive, but again, one has to take those figures into context of this particular situation.

[+ BenjaminNicholas]

This is a medical question that only medical professionals, especially those in the ID field, can answer.

 

Here, you get wild speculation, sex shaming, PrEP is amazing/terrible, etc.

 

... Basically, the same debate we've had here since PrEP was introduced.

 

 

 

EDIT: All of this said, my hope for your amigo is that he's fine. The worst thing in life is not knowing.

Edited January 15, 2019 by Benjamin_Nicholas

[marylander1940]

Well, in my experience, about 70% of indeterminate results end up positive. Of course, the facts in this case are important in giving odds for this particular case. Since he wasn't wearing a condom, I think it's more than 2/3 likely that follow-up results will be positive. If condoms had been worn, I'd estimate the probability of this ending up positive would be less than 10%. The patient in this case could call the lab and ask them what percentage of their indeterminate results end up positive, but again, one has to take those figures into context of this particular situation.

 

He stopped by Whitman-walker on Friday and tested negative but that was the basic test they do taking blood from a finger. They told him “as of October 11th you were negative”. That’s three months from the Friday test.

 

He has been on prep for 2 years.

 

I won’t tell him what you just told him or I will scare the hell out of him. Thank you so much for the information I truly appreciate your point of you is a frequent poster and specially a a Doctor.

 

My friend just can’t be one of those unlike guys to get HIV while on prep!

[marylander1940]

This is a medical question that only medical professionals, especially those in the ID field, can answer.

 

Here, you get wild speculation, sex shaming, PrEP is amazing/terrible, etc.

 

... Basically, the same debate we've had here since PrEP was introduced.

 

 

 

EDIT: All of this said, my hope for your amigo is that he's fine. The worst thing in life is not knowing.

 

Well, he's almost 65.

 

Worst case scenario his insurance and taxpayers will help him stay as healthy as possible.

[+ nycman]

“Odds” are meaningless when the N=1.

 

If he’s a virgin nun living deep in the black forest and he hasn’t even seen a man in over 10 years.....the odds are nearly zero percent.

 

If he’s a was the piggy bareback bottom cum slut at last weeks POZ conference in San Fransicsco....it’s nearly 100 percent.

 

Like most of us....I’m sure he’s “somewhere” in between....and thus his odds are “somewhere” in between.

 

The answer lies in his follow up test....not in guessing the “odds”.

[marylander1940]

“Odds” are meaningless when the N=1.

 

If he’s a virgin nun living deep in the black forest and he hasn’t even seen a man in over 10 years.....the odds are nearly zero percent.

 

If he’s a was the piggy bareback bottom cum slut at last weeks POZ conference in San Fransicsco....it’s nearly 100 percent.

 

Like most of us....I’m sure he’s “somewhere” in between....and thus his odds are “somewhere” in between.

 

The answer lies in his follow up test....not in guessing the “odds”.

 

Thank you for posting!

[+ WilliamM]

Maybe you should tell him. If he’s lucky with this outcome, the risk is that he continues to feel invincible. Maybe he needs to be a little scared

 

I agree with @marylander1940. His friend should consult someone with an extensive medical background.

[marylander1940]

Maybe you should tell him. If he’s lucky with this outcome, the risk is that he continues to feel invincible. Maybe he needs to be a little scared

 

Bingo!

 

I know some people out there who can’t remember taking a pill a day

[+ BenjaminNicholas]

Bingo!

 

I know some people out there who can’t remember taking a pill a day

 

This. I have several friends who routinely tell me they forgot to take their PrEP.

 

It's one fucking pill. It's not reading Proust or rocket science.

 

 

 

[TruthBTold]

This. I have several friends who routinely tell me they forgot to take their PrEP.

 

It's one fucking pill. It's not reading Proust or rocket science.

 

 

 

 

Scientists depend on the honesty and the reliance of their patients. Unless a patient drops by a practitioner's office every day and takes the Truvada it would be hard to be absolute about any study. It is always good to have data but studies can't be sure unless the practitioner is absolutely sure that the client has taken all the doses. The first thing I noted in the study that the article was about is that it relied on the word of the client.

[+ BenjaminNicholas]

Scientists depend on the honesty and the reliance of their patients

 

So, what you're really saying is the study results are problematic (ie, questionable) from the get-go.

 

Far too many people aren't brutally honest with their Dr about themselves and practices, which makes it difficult for a medical professional to care for them. I don't understand that kind of relationship when you're relying on someone to help you be the healthiest version of yourself.

[+ sniper]

If someone tests indeterminate is there any benefit to going on POST-exposure Prophylaxis just in case?

[+ nycman]

If someone tests indeterminate is there any benefit to going on POST-exposure Prophylaxis just in case?

No.

 

Too late.

[rvwnsd]

This. I have several friends who routinely tell me they forgot to take their PrEP.

 

It's one fucking pill. It's not reading Proust or rocket science.

 

 

 

I started taking PrEP while under the care of a physician who treated me for other conditions (asthma being the primary condition) for fifteen years, so he knew me. He also knew that I followed my asthma treatment protocol, which requires using an inhaler twice a day that if skipped results in immediate effects including shortness of breath. While he would ask if I missed a dose, he knew I hadn't.

 

I've only seen my current physician for a little over a year and in that time he has implemented a PrEP clinic and first now has permanent staff. They do not know me and, frankly, have been just a bit heavy-handed on grilling me about whether I was certain that I took my Truvada every day. On my last visit the topic came up and I said something to the effect of "I know some people find it difficult to take a pill every day. I've been inhaler-dependent for twenty years and have missed one dose and the effect taught me the importance of adhering to a schedule." The guy asked if he could quote me. I might speak at their next PrEP orientation.

 

As you said, @Benjamin_Nicholas it ain't that hard!

[+ keroscenefire]

So, what you're really saying is the study results are problematic (ie, questionable) from the get-go.

 

They actually are able to do hair samples to see if there is Truvada in your tissues to see if you've been actually taking the medication regularly or not. One of case-studies of a man on prep who became HIV+ actually even admitted it was impossible to tell whether the man got a Truvada-resistant strain because they man admitted to somewhat inconsistent use and he recently shaved his hair so they couldn't tell how long he had even adhering. So one of the six cases should be treated incredibly skeptically as to whether Truvada failed or not. https://www.poz.com/article/new-case-apparent-prep-failure-comes-hazier-details

[marylander1940]

If someone tests indeterminate is there any benefit to going on POST-exposure Prophylaxis just in case?

 

He is still taking his PrEP daily just like before. He told me is just part of his routine and leaves the pill every night near the place where he gets his coffee.

[rvwnsd]

If someone tests indeterminate is there any benefit to going on POST-exposure Prophylaxis just in case?

PEP is only effective if administered within 72 hours of exposure. Its purpose is to prevent infection after being exposed to the virus. If someone is concerned that they might already be HIV positive it is too late for PEP.

[LookingAround]

So....what is the final word on this guy? It doesn’t take that long to get a final confirmation or not.

[+ Gar1eth]

They actually are able to do hair samples to see if there is Truvada in your tissues to see if you've been actually taking the medication regularly or not. One of case-studies of a man on prep who became HIV+ actually even admitted it was impossible to tell whether the man got a Truvada-resistant strain because they man admitted to somewhat inconsistent use and he recently shaved his hair so they couldn't tell how long he had even adhering. So one of the six cases should be treated incredibly skeptically as to whether Truvada failed or not. https://www.poz.com/article/new-case-apparent-prep-failure-comes-hazier-details

 

Did you read about the hair in another article because that's not what this one says?

 

Gman

[marylander1940]

So....what is the final word on this guy? It doesn’t take that long to get a final confirmation or not.

 

He got tested on Monday 14th and he's waiting for his results.

[LookingAround]

Strange. Today is Thursday.