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HIV test at 4 weeks
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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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HIV test at 4 weeks

Hello Doctor,

Im a 30 years old male and have always used protection somehow the sequences of events one night led to me making a horrible decision. I have been terrified for the past 7 weeks, I met a woman in a party the same night and had unprotected vaginal sex at her house. i dont know much about her or if she is csw. We had too many drinks at her place and then resulted to this chaos. Since I was unprepared, I asked the woman before the intercourse if there was anything i need to worry about, referring to STD, she said no its ok. Therefore, i went head and after 15 minutes pulled out did not ejaculate in her. After this horrible incident 8 -10 days passed and i began to experiance some possible ARS symptoms. Had swollen glands in the neck, diarrhea, aches, stomach pain, nausea, headache, oral thrush appeared, and  night sweats accompany by pinching numbness feeling in the hands and feet at night. After about 2 weeks these symptomes dissappeared. I never get sick, therefore i know this has to be related to ARS. I have been living in hell this past 2 months as i know I've really contracted this virus. I called the woman several times to ask her but claims shes not infected, but her responses seem questionable she can either be lying or unaware.

So i took the antibody test at  2nd week - the result came negative then i tested on the 4th week about 31 days since exposure and that came negative.According to CDC guidelines and everyone on the internet is stating only 3 months is conclusive. Testing is done at 4th week followed by 3rd month then 6 months. Most being the average test positive at 25 days. Then I hear my doctor  telling me something different. My doctor tells me  im ok i should move on, and that my 4th week is  conclusive and guarantee to not change. i dont know how this could be true.I think there is a good chance of turning positive later, due to symptoms experianced. I hear 1 of 1000 real exposure lead to infection could that be the reason?
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239123_tn?1267651214
Welcome to the forum.  However, this thread belongs on the HIV Prevention forum; see the welcome message above.  Therefore, my reply is brief and there won't be an opportunity for follow-up comments.

Your doctor is correct.  Here are two threads that describe the current status of the HIV testing window period, including the reasons CDC and many other agencies continues to advise testing at 3 months even though it's actually rarely if ever necessary.

http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755
http://www.medhelp.org/posts/HIV-Prevention/Need-your-help/show/1345664

In addition, you had a low risk exposure.  The chance a woman like you describe has HIV is very low, and even if she had it, the transmission risk for a single vaginal sex exposure averages once for every 2,000 events.  Finally, test results always overrule symptoms.  Your results prove that HIV was not the cause of your symptoms.  Of course "I never get sick" is not a logical rationale to assume HIV was the cause.

Bottom line:  You were at low risk, had some sort of non-HIV viral illness, and can definitely move on with 100% certainty you didn't catch HIV.

Regards--  HHH, MD
9 Comments
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Avatar_m_tn

Thanks for your response doctor.

Your advice surely helps me alleviate the stress i have been going through the past 2 months. The threads did provide some good insights, however, I just need some clarification as the test described in the thread  is a DUO(P24/Antibody) in which P24 levels seem to detect infectection earlier while the antibody levels are lower. My test was not a DUO but only an antibody test and according to the thread you mentioned 6-8 weeks would be conclusive, would 4 weeks make it to early?
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239123_tn?1267651214
You correctly understand the advantage of the duo test, which is why it is now the test of choice for people concerned about a possible HIV exposure, especially if they want reassurance earlier than 6-8 weeks.

Still, you can be 100% certain you didn't catch HIV.  The antibody-only tests are at least 90% reliable at 4 weeks.  If you assume 1 chance in 1000 your partner had HIV and 1 in 2000 transmission risk if she had it, the pre-test probability you caught HIV was 0.001 x 0.0005 = 0.0000005, or 1 in 2 million.  If you add a test result with 10% chance of being negative, at this moment the odds you have HIV are around 1 in 20 million -- which can be considered zero for practical purposes.  Personally, if it were me, I would not have felt a need to be tested at all, and certainly would not need another test.  However, if you want a test that itself has virtually 100% reliability, have another antibody test at least 6 weeks after the event, or a duo test at any time.
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Avatar_f_tn
Hello doctor Hansfield. Got one opinion, i believe it could be helpfull for other posters. I am worried well. I had 9 negative DUO tests after exposure at 3,4,5,6,7,8,10,11 and 11 weeks+4 days. I know you think that I am insane :-)

Today I have chat with director of the best microbiological laboratories in my country, doctor Hanzen. I asked him about quality, sensitivity and specifity of the HIV tests they are using in their labs and also we talk about "HIV Window period". He tells me that 4th generation tests (Elisa+p24, CMIA Combo tests or DUO tests) are so good that NBTS-"National blood-transfusion servise" in many countries in Europe are using this tests for screening of blood donors today because they are comparable with more expensive NAAT tests in many abillities. DUO test are cheaper, faster and have excelent qualities. He also told me that from the beginning of epidemy, microbiologists and other scientist worked very hard to create better and better tests to detect infection much sooner. In his opinion, one DUO test at 4-5 weeks is sufficient and 6-8 weeks test with 3rd generation elisa is sufficient too.

I asked him also about standard 12 weeks (or three months) window period and he told me that 3 months are very very conservative and that it never takes that long to detect infection if person is trully positive.

Do you agree doctor Hansfield?

Sorry for my bad english.



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239123_tn?1267651214
Although I am not aware of Dr. Hanzen, I agree 100% with expendable's excellent summary of the performance of the current HIV diagnostic tests.  I have bookmarked this thread as an one to aid in responding to similar questions in the future.
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Avatar_f_tn
I'm glad I was helpful.

Wishing all the best doctor.
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Avatar_m_tn

Thanks for all the helpful information Doctor, much at ease knowing the numbers are on my side. However, i do still find it difficult  to move on. My biggest fear is that the person may have not known their infected which means they can Possibly be in their window period which the viral load are higher, transmission is at its most highest. In the odds of 1-2000 is this stage accounted?
I will take my 9th week antibody test, this should hopefully give me the peace of mind i need. Considering my 4th week test im  hoping i can get over this hurdle.
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239123_tn?1267651214
Re-read my replies above from start to finish and pay close attention.  You didn't catch HIV.  Believe it.  If you find yourself still obsessed with this, counseling may be in order; it isn't normal to be so resistant to the facts and to the unequivocal, reasoned reassurance you have had -- from your own doctor as well as me.  I suggest it from compassion, not criticism.

That will be all for this thread.  I will have no additional comments or advice.
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Avatar_m_tn

you are right Doctor im obsecessing over this. Reason for this is because i find my situation to be alittle different then many others in this forum. I find most to have low risk exposure with 1 or 2 possible signs. I believe i took a high risk and all  symptoms and signs were visible. However, having taken your advise iam much less stressed. And will be going next week to confirm a conclusive test.

Thanks for all your advise and help.
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