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7 Week Negative HIV Antibody Test After Condom Broke
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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.

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7 Week Negative HIV Antibody Test After Condom Broke

Hello Dr. HHH,

Seven weeks ago, I was the insertive partner during anal sex.  Everything was going smoothly, but then the condom broke and I quickly removed myself (1-2 seconds unprotected) and washed my genital area with warm water and soap.  After the incident, I asked my partner when was the last time he was tested for all STIs, including HIV, and he stated that he tested negative for all of the common STIs, including HIV antibodies, a week before our encounter.  I wanted to really believe him, but I suffer from anxiety...I even thought about getting PEP after the incident, but I did not.

After stressing out one week after the incident, I started feeling really nauseous, which scared me!  So, I got tested for Gonorrhea and Chlamydia, and the results were negative, but the nauseous feeling continued.

3 weeks after the broken condom, I had the following test done:

(1) 23 day HIV-1 DNA PCR Test (Negative)
(2) Elisa HIV 1/O/2 Antibody Test (Negative)
(3) OraQuick Rapid HIV 1/2 Blood and Oral Fluid Tests (Negative)
(4) Clearview Rapid HIV 1/2 Advance Blood Test (Negative)
(5) Gonorrhea, Chlamydia, RPR (Syphilis), Hep C (All Negative)

I thought that with all these negative results, I would stop stressing, but I did not and the nauseous feeling continued and I have continued to test for HIV:

*Week 4: OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 5: OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 6: Two OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 7: Two OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)

Testing wise, should I feel confident in my HIV test results thus far, especially since I had a 3 week negative HIV-DNA PCR and an antibody test at 7 weeks?  I talked to another HIV specialist about my situation via the telephone and he said that I am conclusively HIV negative from the incident 7 weeks ago.

Any advisement, suggestions, and/or feedback will be greatly appreciated.
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Welcome to our Forum.  As you probably know, Dr. Handsfield and I share this forum.  today you got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I'm sorry that you experienced condom failure- unfortunately this does occur about 1% of the time that condoms are used and when it does, testing is a good idea.  You can now be entirely confident that you did not get HIV, gonorrhea, chlamydia or hepatitis C from this exposure. As regards your major concern, HIV, the combination of your negative PCR and multiple negative HIV tests provide assurance that you did not get HIV.  Optimally, we would have wanted a PCR test at 4 weeks but you multiple antibody tests over the past 7 weeks provide assurance that you were not infected even though your PCR test was done a bit sooner than I would have preferred.

At this time you should be confident you did not get HIV from the exposure you have mentioned. There is no need for further testing.  EWH
5 Comments
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Avatar_m_tn
Thank you so much for the reassurance, Dr. Hook.  This has been a stressful 7 weeks, and even though I was using protection, I have learned from this incident and I am very grateful.

As for the PCR HIV-1 DNA test, I too felt that I should have waited until 28 days (4 weeks) instead of taking it at 23 days (3 weeks and 2 days; 5 days short of 28 days).  However, the testing site I went through informed me that the PCR DNA test will give relaible/conclusive results between 21-28 days, so I went ahead and took the test at 23 days...Labcorp draw my blood sample and tested it.

Thanks again for your feedback.
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Avatar_m_tn
Hello Dr. Hook,

I just wanted to let you know that I received a NEGATIVE 8 week HIV antibody results via OraQuick’s Rapid HIV 1/2 Oral Fluid test.  I know sometimes you mention 8 week testing, so I wanted to comply.

On another, as I expressed to Dr. Jose, I wanted to take the 4th generation Eilsa (antibody and p24) test at the 7th week mark, but it is extremely difficult to utilize such a test in the United States.  Alere Determine HIV Rapid Combo test has not been approved by the US FDA.  The US FDA has approved a laboratory 4th generation (ARCHITECT HIV Ag/Ab Combo) test, but when you ask some doctors here in the US about this test, they look at you crazy and act like they don’t know what the blazes you are talking about; this reaction is very irritating and saddening.  Why won't the FDA fully support p24 testing?
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I can't answer why the FDA has been so very slow to approve 4th generation tests- I agree with you that it is a great source of frustration.  the folks at the CDC have been pushing as well.  

Glad to hear (but not suprised) about your negative test.

Take care. EWH
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Avatar_m_tn
Hello Dr. Hook,

I just wanted to let you know that I tested for HIV 1/2 antibodies during the 10th week and just now (12th week)...the results were/are NEGATIVE!  Thank you so much for the support and advice, and I continued to test just for peace of mind.

Thanks again!
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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