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Test results and symptoms after 24 days
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Test results and symptoms after 24 days

Thanks for your patience with all of us likely anxiety driven individuals. Below you'll see details of my potential exposure, potential ars symptoms, and test results. After doing as much research as possible the last several days, I'm aware of the low risk associated with my encounter, but I'm seeking some answers regardless.

Exposure: gave and received unprotected oral sex with another homosexual man. My mouth and throat (deep throat) definitely were exposed to some pre-cum, but no post-orgasm ejaculate. After possible exposure, I had dinner, got something stuck in my teeth and noticed gum swelling where food was stuck that night when I flossed to remove food particle. I generally take care of my mouth, but do get mouth ulcers (I guess that could be oral herpes..). My gums near a permanent retainer are somewhat unhealthy.

Symptoms: mostly ongoing from 21 days to present (28th day post possible exposure). Noticeable fatigue (my most prominent symptom), headache behind eyes and ears, muscle fatigue, sore throat, mouth and throat ulcers, some diahreah and soft stool, bad nausea and indigestion, slightly swollen lymph nodes (less sure about this.. Parts of neck tender to touch, no visible swelling), rash on neck, sore/stiff neck and shoulders, tension/soreness in muscles in hands and feet, stomach tender to the touch (swollen spleen??). NO FEVER.

Tests: blood specimen provided at 24th day after exposure. Results say this:
HIV-1 = negative
HIV 1/0/2 Abs, Qual = negative
HIV-1 DNA = negative.

1) I'm having trouble understanding the differences between these tests (it was advertised as "early HIV detection" from stdtestexpress.com).
2) how reliable are these tests between 3-4 weeks after exposure (24 days)
3) given my exposure, symptoms, and current test results, what should my next step be?
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Welcome to the Forum. I'll try to help.  Perhaps the best help I can provide however is to suggest that you be cautious in your research. Much of the information available on the internet is incorrect and/or overly conservative.  I recommend against using the internet for information on issues such as you are asking here.

As for your exposures- they are very low risk. You do not know that your partner had HIV and chances are he did not.   There are no cases of proven HIV transmission with receipt of oral sex butt here are a very few cases in which it appears the infection MAY have been transmitted by performance of oral sex (fellatio).   The estimated risk is less than 1 in 10,000 (the equivalent of having sex once a day with an infected partner for over 27 years).  Thus, particularly since you do not even know that your partner had HIV, it is unlikely that you have acquired HIV on a purely statistical basis.

Your symptoms.  As we have said repeatedly, symptoms are not a good indicator of HIV infection and when tests and symptoms disagree, the tests are always right.  The reason this is relevant to you is that your tests are negative and if your symptoms, which began about 3 days before you tested were due to HIV, your test probably would have been positive (the DNA test)

As for your tests/questions- the tests suggest you do not have HIV however the correct time for a test is no sooner than 4 weeks and that would be the case if you were tested with a DUO (combined HIV p24 antigen/HIV antibody) test.  In some instances the HIV DNA test can take the place of the p24 antigen test but this is not an approved test, despite what the people who sell it say.


1) I'm having trouble understanding the differences between these tests (it was advertised as "early HIV detection" from stdtestexpress.com).
The first two tests are antibody tests.  They are negative and at 3 weeks would detect about 65-75% of recent infections.  the other test is a PCR test- not approved for HIV diagnosis but your results strongly suggest that you are not infected.

2) how reliable are these tests between 3-4 weeks after exposure (24 days)
See above.

3) given my exposure, symptoms, and current test results, what should my next step be?
At 28 days, my suggestion would be to seek testing with an HIV DUO or COMBO test which tests for both HIV antibody and the p24 antigen at the same time. If it is negative, you can be confident that you did not get HIV.  

Hope this helps.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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