Aa
Symptoms and their Relation to the Window Period
Thank you for taking my questions doctor. First, I must tell you that I have been helped in an extraordinary way by this site and your work. I truly thank you for your help.
Anyway, on to the questions:
1) Assuming that a person is suffering from symptoms that are HIV related, would this have any effect on the Seroconversion window period?
In other words, would a person showing symptoms necessarily test positive for antibodies sooner than a person that showed no symptoms?
Also, I have read that you recommend a test at 6 to 8 weeks. Just to clarify, I wonder why you give this two week range.
2) Why do you not just recommend a single 8 week window?
3) Is an antibody test more accurate at 8 weeks than it is at 6 weeks?
4) If so, is the difference in accuracy significant?
5) If so, how significant?
Thank you for your time.
Anyway, on to the questions:
1) Assuming that a person is suffering from symptoms that are HIV related, would this have any effect on the Seroconversion window period?
In other words, would a person showing symptoms necessarily test positive for antibodies sooner than a person that showed no symptoms?
Also, I have read that you recommend a test at 6 to 8 weeks. Just to clarify, I wonder why you give this two week range.
2) Why do you not just recommend a single 8 week window?
3) Is an antibody test more accurate at 8 weeks than it is at 6 weeks?
4) If so, is the difference in accuracy significant?
5) If so, how significant?
Thank you for your time.
MEDICAL PROFESSIONAL
Thanks for the thanks about the forum. That's the goal and I'm glad you have been helped.
1) I am unaware of data that compared seroconversion time between symptomatic and asymptomatic initial HIV infection. I doubt there is a difference, but if so, it must be small, maybe a couple days. But that's only an educated guess.
2-4) The data just aren't that preceise. To know the exact rates of seroconversion at various intervals, a study would have to include at least 1,000 people (mabye 10,000 or more) who had only a single exposure at a precisely known point, then were tested every 2-3 days for 3 months. Obviously that study never will be done, but without it, there is no precision. The collective experience suggests that with modern tests almost everybody is positve by 6-8 weeks. Why the variation in my responses? Because I'm not an automaton and do not strive for precision that doesn't exist! The lower the risk, the more reliable an earlier test result; the higher the risk, the more important to have later testing. (That's a difficult concept to understand, but I don't have time to explain it again. It has been addressed several times and you should be able to find discussions of it.) So I suppose I might have a tendency to use shorter intervals (e.g., 4-6 weeks) when responding to obvously extremely low risk situations, and 6-8 weeks for higher risk ones. For the highest risk, I recommend a 3 month test.
On top of all those considerations, there is the anxiety factor. A relaxed, mellow person who wants to know but isn't particularly worried (that is, most people at risk for HIV) might as well wait a bit longer and get tested at 6, 8, or even 12 weeks. Others (the minority overall, but most people who ask questions on this forum) can't stand the wait and would rather be tested twice, say at 3-4 and 8 weeks--and we have all seen the questions by people already tested 5 times over 3+ months and still aren't satisfied! Anyway, the level of fear implied in a particular question also influences the interval I might suggest for testing.
The point is that it's all pretty general. Everybody should remember that the sort of precision you ask about simply does not exist, and never will. These identical debates and questions are likely to be just as common in 2020 as they are today. In any case, don't look to me for an automatic, perfectly consistent response!
Thanks again for the thanks-- HHH, MD
1) I am unaware of data that compared seroconversion time between symptomatic and asymptomatic initial HIV infection. I doubt there is a difference, but if so, it must be small, maybe a couple days. But that's only an educated guess.
2-4) The data just aren't that preceise. To know the exact rates of seroconversion at various intervals, a study would have to include at least 1,000 people (mabye 10,000 or more) who had only a single exposure at a precisely known point, then were tested every 2-3 days for 3 months. Obviously that study never will be done, but without it, there is no precision. The collective experience suggests that with modern tests almost everybody is positve by 6-8 weeks. Why the variation in my responses? Because I'm not an automaton and do not strive for precision that doesn't exist! The lower the risk, the more reliable an earlier test result; the higher the risk, the more important to have later testing. (That's a difficult concept to understand, but I don't have time to explain it again. It has been addressed several times and you should be able to find discussions of it.) So I suppose I might have a tendency to use shorter intervals (e.g., 4-6 weeks) when responding to obvously extremely low risk situations, and 6-8 weeks for higher risk ones. For the highest risk, I recommend a 3 month test.
On top of all those considerations, there is the anxiety factor. A relaxed, mellow person who wants to know but isn't particularly worried (that is, most people at risk for HIV) might as well wait a bit longer and get tested at 6, 8, or even 12 weeks. Others (the minority overall, but most people who ask questions on this forum) can't stand the wait and would rather be tested twice, say at 3-4 and 8 weeks--and we have all seen the questions by people already tested 5 times over 3+ months and still aren't satisfied! Anyway, the level of fear implied in a particular question also influences the interval I might suggest for testing.
The point is that it's all pretty general. Everybody should remember that the sort of precision you ask about simply does not exist, and never will. These identical debates and questions are likely to be just as common in 2020 as they are today. In any case, don't look to me for an automatic, perfectly consistent response!
Thanks again for the thanks-- HHH, MD
Thank you for your thorough response doctor. It essentially sums up what I had suspected, that precise data do not exist on the subject, and your 6-8 week "conclusive" window is an estimate based on your years experience in the field.
Personally, I am a worrier. That's why I'm on the forum. I had a condom break during vaginal sex with a prostitute. I pulled out right away, but I was still worried. Throw in some symptoms about a week later and I became a nervous wreck. I tested negative with an OraQuick Advance at 6 weeks and 1 day. So, it is comforting to know that the odds are strongly in my favor. However, I guarantee you that I will be testing again at 8 weeks, and probably 3 months. I'm just too anxious over the matter.
Hopefully then, I can put my anxiety to bed and really get on with my life. Thanks again for your help!
Personally, I am a worrier. That's why I'm on the forum. I had a condom break during vaginal sex with a prostitute. I pulled out right away, but I was still worried. Throw in some symptoms about a week later and I became a nervous wreck. I tested negative with an OraQuick Advance at 6 weeks and 1 day. So, it is comforting to know that the odds are strongly in my favor. However, I guarantee you that I will be testing again at 8 weeks, and probably 3 months. I'm just too anxious over the matter.
Hopefully then, I can put my anxiety to bed and really get on with my life. Thanks again for your help!
MEDICAL PROFESSIONAL
Your anxiety-driven questions have been answered repeatedly and I deleted your new thread-jump attempt. Go away.
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
