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HIV Prevention (Expert Forum)
'95 Sero ab negative, yet HIV positive?
Answered by
University of Washington
Seattle - WA
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No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
'95 Sero ab negative, yet HIV positive?
by tra96, Oct 13, 2006 12:00AM
Dear Dr. HHH
I’m writing with regard to a sexual experience that has caused me a great deal of concern and I believe that I may have acquired HIV as I have a menagerie of symptoms that are experienced by HIV positive individuals. I would kindly like to ask your assessment with regard to the probability of infection. My first concern is that I let a complete stranger perform oral sex on me with no protection; I am a male. My second concern is that he then proceeded to masturbate and he came on my chest, which poses no risk as HIV will not permeate intact skin; however, I used the same wet towel to wipe his semen off my chest that I used to wipe my semen off my penis. Transmission is certainly possible given the routes of exposure I describe, but is it very probable? I tested negative with Home Access antibody testing twice at 28 days, once at 48 days, and once at 65 days. It is my understanding that these tests are extremely sensitive and will on average detect infection as early as 28 days but a negative test at that point would not be considered definitive and that testing would be recommended out to three months. Would you say that my low-risk exposure coupled with the high accuracy of the testing I’ve done to date is mathematically so unlikely that I’ve acquired HIV that I can feel comfortable moving on with my life? Intellectually, I know the answer is yes but emotionally I can let go.
Incidentally, I read an article from the American Medical Journal about a man who in 1995 tested sero ab negative on 5 different ELISA’s despite being HIV positive (ab neg. years after having been infected by his wife). Could my testing to date be as unreliable as his?
Jim
I’m writing with regard to a sexual experience that has caused me a great deal of concern and I believe that I may have acquired HIV as I have a menagerie of symptoms that are experienced by HIV positive individuals. I would kindly like to ask your assessment with regard to the probability of infection. My first concern is that I let a complete stranger perform oral sex on me with no protection; I am a male. My second concern is that he then proceeded to masturbate and he came on my chest, which poses no risk as HIV will not permeate intact skin; however, I used the same wet towel to wipe his semen off my chest that I used to wipe my semen off my penis. Transmission is certainly possible given the routes of exposure I describe, but is it very probable? I tested negative with Home Access antibody testing twice at 28 days, once at 48 days, and once at 65 days. It is my understanding that these tests are extremely sensitive and will on average detect infection as early as 28 days but a negative test at that point would not be considered definitive and that testing would be recommended out to three months. Would you say that my low-risk exposure coupled with the high accuracy of the testing I’ve done to date is mathematically so unlikely that I’ve acquired HIV that I can feel comfortable moving on with my life? Intellectually, I know the answer is yes but emotionally I can let go.
Incidentally, I read an article from the American Medical Journal about a man who in 1995 tested sero ab negative on 5 different ELISA’s despite being HIV positive (ab neg. years after having been infected by his wife). Could my testing to date be as unreliable as his?
Jim
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 13, 2006 12:00AM
, Oct 13, 2006 12:00AM
Oral sex is very low risk for HIV transmission, and everything else you describe is zero risk. Your symptoms are meaningless; only the test result tells the true story. You do not have HIV.
You say yourself that you already know the answer "intellectually" but can't emotionally let it go. My nearly universal experience with such persons is that there are no facts that resolve the the fear of being infected, no matter how assertively those facts stated and no matter how much the person believes them intellectually. In other words, I doubt my reassurance is going to be enough, and I strongly suggest you seek counseling inability to emotionally accept the only rational conclusion. I suggest it out of compassion, not criticism.
Good luck-- HHH, MD
You say yourself that you already know the answer "intellectually" but can't emotionally let it go. My nearly universal experience with such persons is that there are no facts that resolve the the fear of being infected, no matter how assertively those facts stated and no matter how much the person believes them intellectually. In other words, I doubt my reassurance is going to be enough, and I strongly suggest you seek counseling inability to emotionally accept the only rational conclusion. I suggest it out of compassion, not criticism.
Good luck-- HHH, MD
I think...no...I believe you are "grabbing at straws" on this incident.
Your risk was no "real" risk at all.
(1)HIV doesn't live well outside the body.
(2) The person(s) had to have HIV.
(3) The blood/semen would have to have direct route to your bloodstream (via head of the penis.....NO WAY!)
(4) Sufficient virus would have to migrate to your bloodstream and infect you.
(5) I think you are experiencing regret....like most of us.
It takes time and emotional enerfy to come to terms realizing that you had NO real risk.
Consider this a learning lesson.
If you tested negative @ 4 weeks, from what I have read on here, that is a VERY good indicator. Also, if you test @ 6-8 weeks and the test is negative, which I will bet my mortgage it will be, you ARE FINE. A test that is negative at 6 weeks would be 95-97% accurate. On top of that, you need to consider the factors above I had already stated.
The person stated in the American Medical Journal was there for a reason....he was an abnormality in the medical community. You also stated that it was his wife....therfore he could have infected her at any given time. Do not go by those accounts.....nobody really knows whether these individuals really "did" what they did or what they did. They only tell researchers "their" version.
I hope peace follows you through with this advice.
Good Luck....and....let it go.
B.
Is it considered a "modern" HIV testing kit? Is it the same as testing at a testing center?
I have searched the archives numerous times and found no answer. PLEASE shed some light on this if you would....it would be greatly appreciated.
Thanks.
HHH, MD
I was questioning the reliablity of the test.
I often wonder if certain factors that exist outside a testing center environment hinder the tests validity.
But then again, blood is blood isn't it?
Thanks for the reflection on this issue MD HHH.
HHH, MD