9 years post exposure, tested negative, possible false negative?

9 years ago I had unprotected sex with 3 women(6 exposures total).I had never tested until about a month ago. I took 4 Oraquick home tests and I went to Planned Parenthood to do a Uni gold recombigen test. All came back negative. My questions are can I trust my results due to it being so long post exposure? Would I still have detectable antibodies? I have done a lot of reading about the rapid tests and realize the Oraquick only tests for Glycoprotein 41 and the uni gold tests for glycoproteins 41 and 120. I have also read about false negatives in long term infections mostly due to a strong reaction with Glycoprotein 160 which is in neither test I took. Should I be concerned? Basically this has occupied my mind for the last few months. Any help you can provide is greatly appreciated.

[Edward W Hook, MD]

Welcome to the Forum. I hope that i can put your concerns to rest- your results are conclusive.  Your risk for HIV from the exposures is quite low since the frequency of infection among heterosexual women in North America who do not use drugs is less than 1 in 10,000 and since only 1 in 1000 exposures lead to transmission of infection even if your partner did have HIV.  Further, had you become infected, you would have developed antibodies and tests for antibodies would remain positive from that time forward.  HIV tests do not become less accurate with infections of longer duration.  Given the timing of your exposures and testing, you should have complete and absolute confidence that your test results are accurate and that you did not become infected with the encounters you have mentioned.

I hope my comments are helpful. there is no reason for concern and no reason for further testing. EWH

[Jeff327]

Thank you sir, I appreciate your response. Reading case studies about false negatives really scares me. It seems they occur either in the window period or in someone with a long term infection. 2 more questions if I may, since these tests were created 10+ years ago, are they ever modified or updated to include new strains of the disease? Also are rapid test used more now a days nationwide than the Lab based Elisa? From the clinics I have talked to it seems that is all they offer.

[Edward W Hook, MD]

You need to stay off the internet which is I suspect, the source of the case studies you mention.  HIV tests are continuously evolving and being updates. Nonetheless, I have great confidence that your tests 9-10 years ago are accurate.  

At the present time current rapid tests are no less accurate than the lab based tests once a person is more than 8 weeksbeyond their last expsoure.  They are held to the same standards by the FDA.

EWH

[Jeff327]

I apologize for being back, but I have had some symptoms for the last few months. Whitish tongue( the whole top of the tongue is really lighter color than the sides and tip), really dry mouth, and diarrhea) My mouth seemed really dry when I did the Oraquick tests, is it possible to not have enough fluids on the test stick? The tests seemed to work correctly with the test strip turning pink. The Uni Gold test I took at Planned Parenthood after drawing blood with a finger prick he took the test cartridge into another room to conduct the test and came back 10 minutes later to tell me I'm negative. I guess I can assume it was done correctly?  
The rapid tests just seem so simple can it really be that easy? I was diagnosed with Low Testosterone and Vitamin D Deficient at my last physical (i'm 35) Can all this somehow be connected with Low T?

[Edward W Hook, MD]

No change in my assessment or advice. EWH