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How can I get a conclusive test quickly
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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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How can I get a conclusive test quickly

Dear Doctor,

Two weeks ago, I have two unprotected vagina sex with my friend. Yesterday, She said she got a test on Monday, the result was positive. I am so afraid. I want to make sure as soon as possible whether I get infected. I have read a lot of post in the  forum. Now I make a test plan.
1. 3 weeks.  a COMbi test and a pcr rna hiv1 test(virus load test <20 copies)
2. 4 weeks   a duo test
3. 8 weeks   a duo test

If I get the test on week 3 and 4, the result is negative? Can I get a conclusive result?  and make sure I don't get HIV1 ?
After the 3 weeks and 4 weeks test, I wil  make the 8 weeks test. If the result is negative, Can I get a conclusive result ? and make sure I don't get HIV 1 and Hiv 2. I read in the post,  the duo test is test P24, which is refer to HIV1. So the combi test and the duo test can't test HIV 2 more quickly than the 3rd Generation. Do I need a test on 12 weeks in order to  exclude HIV 2 infection ?

I want to make sure whether I got it and ceclude it as soon as possible. If my test plan can't get a 100% conclusive, Can you recommend a seris of test.
239123_tn?1267651214
Welcome to the forum and thanks for your question.

I understand your concern; it's undoubtedly alarming to learn that a recent sex partner has HIV.  Still, you are overracting.  I would advise you to skip the tests you are planning at 3 weeks.  The RNA test is very expensive and really won't help resolve your fears; even if negative; you will still need to wait for later testing to be sure you weren't infected.

Instead, I recommend a duo test at 2 weeks.  If the result is negative, which it probably will be, it will be 80-90% reliable -- not quite as good as a negative RNA test, but very reliable and much less expensive.  Then you can have another duo test at 4 weeks, which will be definitive.  The 8 week test really won't be necessary.  There's a lot of misunderstanding about the time for reliable testing.  All the debate about 3 months versus earlier testing is relevant only if antibody testing is all that is done.  With the combination of p24 antigen plus antibody, 4 weeks is definitive.  For more discussion of this, see the thread linked below:

http://www.medhelp.org/posts/show/1704700

As for HIV-2, you needn't worry. If your partner is not an immigrant from east-central Africa (Cameroon, for example), the chance she has HIV-2, and not HIV-1, is close to zero.  Why not just ask her which virus she has; almost certainly it's HIV-1.

Finally, remember the average risk of HIV transmission by vaginal sex, if the woman is infected:  about once for every 2,000 exposures.  (That's why many male spouses of HIV infected women never catch it, even after years of unprotected sex.)

So don't panic; almost certainly you're fine.  Feel free to return with follow-up comments to let me know your test results.  But in the 9 years since this forum started, there hasn't been a single case of new HIV from someone who posted a question about their risk.  You aren't going to be the first.

Best wishes--  HHH, MD
7 Comments
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Avatar_n_tn
Dear Doctor,

Thank you. I will ask my friend which type of HIV she got. After I got it, I will feedback.

For the test, is rna test on two weeks more reliable than duo test, and the rna test on three weeks more reliable on two weeks? when is the best time to get a rna test?   I need to get a reliable test.

And if 4 weeks duo test negative, Do I need a duo retest on 6 weeks in oeder to move on 100%. I read the answer before, the duo test is over 99.8% on 4 weeks.


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239123_tn?1267651214
You're re-asking the same questions in different words.  I haven't changed my mind since yesterday, when I gave the estimated reliability of a duo test at 2 weeks and the reason I would recommend that instead of RNA, even though it is slightly more sensitive than the duo test at the same time.  And I already said there is no need for additional testing after a negative duo test at 4 weeks.  I would consider 99.8% to be equivalent to 100%.  The data do not allow any more precision than this, but  to my knowledge there has never been a reported patient with negative duo test at 4 weeks who turned out to actually have HIV.
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Avatar_n_tn
Dear Doctor,

I will take your advice, and take a 4 weeks duo test directly. I contact with the hopital in my city they said it is Roche chemiluminiscence combi test there. The other hopital which has duo test is in another city near my city. Is the roche combi test also conclusive at 4 weeks?

By the way, I tried to contact with my friend. But her mobil is turned off, I knew her from my friend's party. So , I don't  know which type of HIV she got. If I want to exclude HIV 2, even very low odds, When should I get the antibody test?  Also I will continue to contact her about it, i knew it was a hard time for her.

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239123_tn?1267651214
HIV-2 is virtually absent in the US, except rarely in immigrants from the parts of Africa where that virus is more common.  In any case, the Roche combi detects HIV-2; even for that virus, the negative result at 4 weeks will be conclusive.  (My comments above about "duo" test refer to all 4th generation tests for both HIV antibody and antigen.)

Anybody who has been sexually exposed to a known infected partner should be getting in-person medical evaluation by an expert.  My advice above is a starting point, but from here on out you should be seeing a professional and following that advice.  Feel free to return with a comment to post your test results, but I won't have any further advice for you.  Good luck.
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Avatar_n_tn
Thank you doctor. I am not in US . I am in Guangzhou, a big city of China. There are many immigrants from Africa. That is why I am so concerned about Hiv2.  I also consulted the doctor in the hospital ,But He said it was a high risk , and i need to take the test after 3 month, 3 month is the window periods our goverment gave. He just emphasized the goverment window periods which made many years ago.
.I think you are the most specialize doctor I can get advice.

Thank you again for your help. Forgive my repeated question.
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239123_tn?1267651214
Thanks for the clarification.  I would guess that HIV-2 is rare in China, just as in the US, but anyway I already told you it doesn't matter, since the Roche test will accurately detect HIV-2.

Otherwise, you're STILL asking the same questions in different words.  Re-read my initial reply about the times to reliable HIV testing, including the link that I provided there.  I have not changed my mind, regardless of what your doctors believe or the official advice in China may be.  Pay attention to the difference between combo tests and antibody-only tests.

That will end this thread.  I won't have any more comments or advice.
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