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Window period and HIV testing questions, am I conclusively negative?
I had sex with a female commercial sex worker in a message place in China. It was condom protected vaginal and oral intercourse. I didn't check the condition of the condom afterwards, She also wiped me off with a wet paper tower/tissue kind of thing after both oral and vaginal exposure. I've been having anxieties of contracting HIV for 4 months now since my exposure date of August 2nd. After I came back to the states, I went to see a doctor, actually a nurse practitioner and he ordered me three HIV antibody test via LabCorp, panel 083824, HIV 1/O/2 antibodies. My 5 week (35 day) and 12.5 week (88 day) test were both non-reactive. I am a married man with a 1 1/2 year old daughter and my wife is pregnant with our second baby. She got pregnant before my encounter and I have not had any sexual contact with her since my exposure date. I have several questions to ask you:
1) Is my antibody only tests conclusive at 12.5 weeks? I've read that you mentioned there are someone cannot produce antibodies and therefore the test will not be able to detect the virus, should I go do a combo test to rule out this possibility? I will definitely do another test at 6 months.
2) I'm still concerned about me being the 3% left in the statistics of U.S. HIV testing guidelines which states 97% people will seroconvert within 3 months, and what if I'm the "very rare" person that seroconvert later?
3) This might be a silly or irrational question but here it comes anyway: Can I get infected for HIV while testing for HIV?? What happen if they use a infected needle or the tubes they use to draw/collect blood are infected with HIV?
4) I've tested negative for Syphilis, gonorriae, Chlymidia and Hepatitis C at 12.5 week as well, should I get tested again for Hep C and Hep B and Herpes 1/2 at 6 months or any other STDs?
5) Let's say I'm the unlucky one who got HIV, can I transmit it to my beloved wife and kids and family without any sexual contacts, just casual kissing and hugging?
Thank you very much for your post. I will answer each of your questions here below:
1.) Your negative antibody test after 12 weeks is final and fully conclusive. You DO NOT need any further tests.
2.) I would disagree with those statistics. In my opinion, the relaibility of these tests at 12 weeks is over 99.9%. As an individual who is otherwise healthy without any serious health issues, we can rule out that you would have had any problems with sero-conversion by 12 weeks. I do not believe that you need to be concerned.
3.) That is absurd and totally irrational, I do not believe that anything like that could happen.
4.) Those tests are all conclusive and cover practically all relevant STDs. No need to have any more tests.
5.) Not at all. Impossible. In any case, I can assure you that you are HIV negative without any doubt. After all, you did not put yourself at risk in the first place as it was protected.
Thank you for your answers doctor, that was really comforting. I still have concerns on how can I know for sure that I'm not one of those infected person who never produce antibodies?
Do you also think I should be tested for herpes 1 and 2 and hepatitis B? Thank you.
I honestly would doubt that very much. It is something that we really never see in clinical practice. However if you still have your doubts, you could always have a HIV Duo or Combo test, which tests for the p24 antigen, or a PCR RNA test. These tests are totally independent of your immune system and would always be detectable in the unlikely case of no sero-conversion.
Your encounter was protected. Therefore there would be no riks or very little risk. Certainly no risk of Hepatitis B and I would not recommend testing.
Herpes can still be transmitted even when using protection. However if you have not had symptoms, it is quite unlikely that you have contracted it. However if you wanted testing, the serology test can be considered conclusive, if negative after 12 weeks. If positive for HSV-2, one could not tell if this has been contracted in this episode or before, unless you had had a negative serology previously. It is very possible that you might be positive for HSV-1 already as most people are anyway. Therefore a herpes test would have certain limitations as mentioned here.
Hi Dr. Garcia,
Thanks for your response, I will ask my doctor if he can order me a duo test at 6 month, maybe its an overkill, but I just want to be 100% of my status. I've heard somewhere that duo test's sensitivity is a little less than stand along antibody test, is it true? If so, what are the chances of false positive on the duo test compare to just the antibody test?
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