Clarification on past events

[clear_mind]

Dear Dr,

I have recently started a serious relationship with a new girlfriend and we want to have unprotected sex, thus we wanted to clear the past events, and we both took 4th generation DUO Ag/Ab test from Labcorp. Both came back negative. However, my recent events' dates are confusing my girlfriend and she wanted me to ask this here. My past events relative to the DUO test are:

6 months and before: protected vaginal sex with several women.
6 weeks before: unprotected receptive oral sex from an unknown white woman.
24 days before: unprotected handjob (lasted 15 min) from an asian in a massage parlour.

Now, we know that you take a DUO at 28 days as conclusive. My girlfriend thinks that I took the test so soon considering the handjob performed on me 24 days before. Here are our related questions, and we will be glad if you can comment on these:

1- I read that even an antibody test is around 90% sensitive around 24 days, what is the sensitivity of a DUO at 24 days?

2- considering I am a healthy male and my immune system response should not be delayed, is the 24 day DUO as good as 28 day DUO?

3- does the DUO clear me from all these events, including the handjob, and can I safely engage in unprotected sex with my girlfriend?

4- lastly, as an expert in this field, would you be 100% comfortable if you were in my situation with these events and test result, and would you forget all and comfortably engage unprotected sex with your girlfriend?

Thanks a lot for your answers beforehand, we both appreciate the work you do here.

[ktakeat123]

A related discussion, HIV test was started.

[Edward W Hook, MD]

There are not day-by-day data on when HIV tests become positive.  As I already said however, your results are conclusive.

I see no reason related to possible HIV that your should worry about unprotected sex with your new partner given the facts and figures in your post.

Take care.  EWH

[clear_mind]

Thank you for your answers Dr.Hook. Just to learn, and get information:

what would your guess be for the sensitivity at 24 days?

and we will be glad if you can answer the 4th question as well.

Thanks a lot.

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment. your current DUO test results are conclusive and indicate without doubt that you did acuire HIV from the encounters you describe.  HIV is not transmitted through masturbation or or from recipt of oral sex.  

As for your specific questions:
1- I read that even an antibody test is around 90% sensitive around 24 days, what is the sensitivity of a DUO at 24 days?
There are no day-by-day data on how quickly DUO tests become positive in infected persons.  Most DUO tests would be positive by 24 days but precisely how many is difficult to say.  

2- considering I am a healthy male and my immune system response should not be delayed, is the 24 day DUO as good as 28 day DUO?
Almost.  You need not focus on the 24 day time point however since receipt of masturbation is NOT a risk for HIV.

3- does the DUO clear me from all these events, including the handjob, and can I safely engage in unprotected sex with my girlfriend?
See above.

4- lastly, as an expert in this field, would you be 100% comfortable if you were in my situation with these events and test result, and would you forget all and comfortably engage unprotected sex with your girlfriend?

As I've already mentioned, the data are conclusive that you did not get HIV from any of the encounters you describe.  EWH