Still worried from Jamaican exposure

[sundus405]

Hi Doctor,

I know you may not take this lightly.
You already answered my concern in this thread: http://www.medhelp.org/posts/HIV---Prevention/Condom-break-with-Jamaican-stripper/show/1909994
The reason I’m still worrying is because all the testing is happening in a 3rd world country in the Middle East and not really in advanced countries like USA or Europe.

Initially when I called the clinic at 4 weeks, I asked if their test is both Antigen and Antibody, they confirmed it is.
When I arrived there, the nurse who drew blood told me it’s antibody only, but told me to re-test one month later and then “forget about it”.

At the 8 weeks mark and when I arrived at the clinic, another nurse told me 8 weeks is too soon, and that I have to test at 6 months and 12 months to confirm I’m negative! That drove me nuts.

Interestingly, the report for both test labels the test name exactly as “HIV-Ag/Ab”.

My questions/concerns:
1- I really still don’t know what type of test I took. The paper says “HIV-Ag/Ab”, but the nurses there provide conflicting information.
Is that normal? Who should I believe? Can clinics put the label “HIV-Ag/Ab” if this was an old generation test?
Note that the result was simply “negative” with no visible “index” values.

2- Considering this is an antibody test, would the 8 weeks mark apply even if this is very old generation testing?

3- Should I worry about HIV-2 ? Is it prevalent in Jamaica?

I would like to forget about this once and for all. I am 14 weeks past exposure and I don't know if I need to re-test or whether I should try a different clinic.

Thank you for your patience.

[Edward W Hook, MD]

Yes, your question is  a repeat of what I said above.  Believe your test results.  EWH

[sundus405]

Thank you for reply.

So you believe older inaccurate testing techniques (or machines) are no longer to be found anywhere in the world, and there are standards applied in all clinics and hospitals for that purpose?

Again, I thank you for your help.
I feel much better now and this should be my final question.

[Edward W Hook, MD]

I'm sorry to hear that you continue to worry about your possible exposure in Jamaica.  The evidence is overwhelming that you did not get HIV- your partner was tested and found to be negative and you have now been tested, twice with 4th generation tests and found to be negative.  You need to believe your results.  The tests for HIV are generally checked using global standards which are the same in the U.S. and in developing nations.  

1- I really still don’t know what type of test I took. The paper says “HIV-Ag/Ab”, but the nurses there provide conflicting information.
Is that normal? Who should I believe? Can clinics put the label “HIV-Ag/Ab” if this was an old generation test?
Note that the result was simply “negative” with no visible “index” values.

When I see my patients, I do not provide index values either- they are technical reports which can vary from day to day and this sort of variation is a source on unnecessary anxiety for my patients.  Further, I would believe the written report over the information provided by nurses who may be giving you out of date information.  If the report says Ag/AB, this was a 4th generation, DUO test which provides definitive information 4 weeks after exposure.   Believe your results.  

2- Considering this is an antibody test, would the 8 weeks mark apply even if this is very old generation testing?
This was not an earlier generation test but, if it were an antibody only test, it would provide accurate information on your infection status at any time more than 8 weeks after exposure.

3- Should I worry about HIV-2 ? Is it prevalent in Jamaica?
No, HIV-2 occurs in West Africa, not the Caribbean.  further, most HIV-2 infections are detected through testing with DUO tests.

There is no medical reason for further testing.  Your results are definitive and will not change, really.  EWH