41 Day Test Conclusive?

[anomboyboy]

Hello Doctors,

I did something I terribly regret recently. I had un-protected sex with a stripper at a club in nyc. I've been living with anxiety for the entire time since then. I just got an hiv antibody test at 41 days that came back negative which gave me some relief. I attempted to search the forums for definitive test reliability comments but hearing a personal answer from one of you would give me greater reassurance.

My question is: Can I accept my 41 day antibody test result as conclusive and put this behind me? Do I need to take another test at 8 weeks? 12 weeks?

Thank you doctors.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  We get many questions about the meaning of HIV test results at different time points.  This is now confused by the availability of a variety of different types of tests.  The traditional and most widely used tests for HIV are tests for antibodies to HIV which are available both as so-called "rapid" or point of care tests which can be done in the clinic and laboratory based antibody tests. For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The scientific literature indicates that at 4 weeks (28 days) over 90% of currently used antibody tests will be positive and that at 6 weeks (42 days- 41 is close enough) well over 95% of persons will have positive tests for HIV if they are going to develop them but that results are not definitive until 8 weeks.  

Practical purposes when you consider that more commercial sex workers/strippers do not have HIV and that the chances of getting HIV from a single unprotected sexual encounter is less than 1 in 1000, IF your partner was infected, your risk of infection at 41 days is less than 1 in 100,000 at least but not a sure thing.  For me if the chance was 1 in 100,000 that would be good enough for me and I would not worry further since your risk of getting hit by lightening more likely than your chance of having HIV.  If you wish to be completely sure however, the scientific literature suggests you should have another test at 8 weeks (56 days)

The “official” recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel they cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.  


I hope this is helpful and provides some perspective.  I urge you not to worry.  EWH

[anomboyboy]

Thanks but I spent money on this forum to hear the doctor's advice.

[killingme12]

3 months is conclusive