HIV - Prevention Expert Forum
6 week test
About This Forum:

This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

6 week test

Hi Dr's

I had unprotected sex with a heterosexual male 6 1/2 weeks ago. I took an oral swab rapid antibody test at 6 weeks (monday). It was negative. The same day my throat started to hurt, today, 3 days later and 45 days post exposure, I woke up and my throat is hurting a lot worse and is accompanied by all over body aches and two swollen and painful glands on either side of my neck. No fever, I never typically get a fever when I am sick (my body temperature is normally very low between 96.5 and 97.9).

1. Is this too late for ARS symptoms to begin?
2. Is my 6 week test very accurate?
3. Should I feel very confident in my 6 week test?

I look forward to your response.
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

With rare exceptions, a negative HIV test 6 weeks or more after the last possible exposure is very reliable evidence no infection occurred.  So based just on the title of your question, you have little if anything to worry about.  To your specific questions:

1) Yes, this is too late for ARS symptoms, which almost always start 10-20 days after exposure.  The absence of fever is also strong evidence against ARS. You have a cold or maybe strep throat, not HIV.

2) The oral fluids tests take longer to become positive than the lab-based tests or the rapid tests on fingerstick blood.  At 6 weeks, your negative oral fluids test is around 90% reliable.

3) You should feel very confident about your HIV test result.  The 90% reliability I just quoted doesn't mean a 10% chance you have HIV.  The average chance a woman will catch HIV from a single unprotected vaginal exposure, with a known infected male partner, averages around 1 in 1,000.  So even if your partner had HIV, a 90% reliable test reduces the chance you are infected to 1 in 10,000.  And if you don't have particular reason to suspect your partner has HIV -- e.g., he isn't bisexual or an injection drug user -- then the chance he is infected is no higher than 1 in 1,000.  This drops the chance you have HIV to the range of one chance in 10 million.  In other words, zero for practical purposes.

Given the "only" 90% performance of the test you had, for additional reassurance I would recommend another test.  You can have a rapid blood test or a lab based test at any time now; or have another oral fluids test 8-12 weeks after the sexual exposure.  You can definitely expect it to remain negative.  The chance you have HIV is virtually zero for practical purposes.

My last advice is to a) consider testing for other STDs (chlamydia, gonorrhea, syphilis) if not yet done; and b) please get in the condom habit for future non-monogamous sex!

Best wishes--  HHH, MD
8 Comments
Blank
Avatar_m_tn
Thank you Dr. Handsfield,

I did also have a rapid blood test at 38 days post exposure, this was 4 days short of 6 weeks that is why I performed the 6 week oral swab test as well.

Does this rapid blood test at 38 days make my negative reliability closer to 100%?
Blank
239123_tn?1267651214
Actually, your rapid blood test just short of 6 weeks probably was more reliable than the oral fluids test a few days later.  This information makes me even more confident you were not infected.

If you're confused by the common advice you will find that testing isn't definitive until 3 months, take a look at the thread linked below:

http://www.medhelp.org/posts/show/1704700
Blank
Avatar_m_tn
Dr. Hhh

Thank you for you help. I was reading through your past posts and there was a couple of things I was confused about. In this post you said that blood and oral antibody tests are the same
http://www.medhelp.org/posts/HIV---Prevention/Does-this-mean-possible-HIV/show/1884730#post_8767168

Is there any way you could clarify this for me.

Also there have been other posts where you said a 4 week rapid antibody test is almost 95% accurate. Would this make my almost 6 week test the same if not higher?

Thank you for being so patient.
Blank
239123_tn?1267651214
Nothing dramatic.  Just that the oral fluids tests (especially the home self test) are new and clinics and other providers are still learning.  Very recent research -- not yet published -- indicates slower seroconversion (longer window period) with the oral fluids tests.  However, it makes little difference in your case, given the low risk of your exposure.

It's often a mistake to spend lots of effort searching other threads on this forum once you have a reply to your own question.  Each question is handled individually, and not every response to similar questions is the same.

Anyway, read all my comments above and do your best to stop worrying.  In the nearly 9 years of this forum, not one user has acquired HIV following an exposure they asked about.  You won't be the first.  If and when it happnes, it isn't likely to be a very low risk scenario like yours.  So do your best to accept the reasoned, science-based reassurance I have tried to give you.  You don't have HIV.
Blank
Avatar_m_tn
Dr. Thank you for your reply.

I went to see my primary care physician today to get tested for strep. the rapid test came back neg, another one was being sent out. She said there was puss in the back of my throat, which is very visible, so she prescribed an antibiotic. I have also developed rash under my arms along the top part of my rib cage, worse on one side than the other. Feels very rough and with some pink bumps. And some pink bumps on my left arm. I had a slight temperature last night, but it went down with tylenol and has not come back since. I know you say they are not as sensitive, but I took another oral rapid test today at 49 days post exposure, and as you probably expected it was negative.

1. Are any of these additional symptoms suggestive of ARS at 6 1/2 weeks?
2. Would my 49 day test have been positive since I have been experiencing a sore throat for a few days now?
3. With all of this can I still be pretty confident I did not contract HIV?

I am very sorry to hassle you with these questions, these will be the last ones I promise.
Blank
Avatar_m_tn
I'm sorry I mean... 2. would my 46*** day test have been positive since I have been experiencing a sore throat for a few days now?
Blank
239123_tn?1267651214
None of this changes my opinion that you do not have HIV.  Feel free to get tested yet again if you wish, perhaps with a proper test like a lab-based one.  If you do, you can continue to expect negative results.

That will wind up this thread.  If you remain nervous, I would suggest you re-read all my replies above.  I've given several reasons that you should not be nearly as worried as you are.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank