HIV - Prevention Expert Forum
WORRIED ABOUT HIV!
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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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WORRIED ABOUT HIV!

Hello Doctors,

I made a big mistake, I had unprotected sex with a sex worker in a sauna club (LONDON) and she was from North Korea, then I became extremely worried about HIV, then I went for several test, PCR RNA at 16 days, DUO Test at almost 5.5 weeks, DUO test at exactly 9 weeks,  2 INSTI tests at 13 weeks, INSTI test at 17 weeks and another INSTI test at exactly 19 weeks. All were negative.

I read a lot about HIV through the internet and I am going crazy with it!

I read about the rare subtypes of HIV like "O group and N" and it says that INSTI test does not detect these groups, I am really going crazy with it!

- Do you think think I need to go for DUO test? Because it says that this test detects the rare groups.
- And what do you think about my tests, are they enough?
- And why some experts says that PCR RNA is useless and does not diagnose HIV infection? if it useless why they provide it in the STD's clinics?
- How accurate my tests are and do I need to have an ELISA test or any kind of HIV tests to confirm my result?

Regards,
300980_tn?1194933000

Welcome to the Forum.  I'll address your questions but to provide you with a summary of the main message, you can be completely confident that you did not get HIV from the exposure you report.  It is unlikely that your partner had HIV and even if she did, the risk for infection is quite low.  So called "rare types" are not an issue and should not concern you.

What you do need to do however is to stay off of the internet.  While there is much useful information available on the internet, much of it is also taken out of context or a bit unbalanced and some of it is just plain wrong.  Among the most common examples of this are the myth of "delayed seroconversion' (it does not exist) and of "rare" HIV types not detected by standard tests.  

In answer to your specific questions:
Do you think think I need to go for DUO test? Because it says that this test detects the rare groups.
No, you already have definitive results from your DUO tests.  The DUO tests provide definitive results four weeks following exposure.

- And what do you think about my tests, are they enough?
Actually you have had more tests than you need.  You can and should stop wasting your time and perhaps money on further testing.  Be confident that you did not get HIV from the exposure you mentioned.

- And why some experts says that PCR RNA is useless and does not diagnose HIV infection? if it useless why they provide it in the STD's clinics?
The HIV PCR is popular because many people incorrectly believe it provides "definitive" information about infection at about 2 weeks. This is incorrect and simplistic- the PCR test has not been formally studied like the other tests licensed for HIV diagnosis (the PCR is not licensed for diagnosis- it is meant to be used to follow the course of established infection and response to therapy).  In addition, it has more false positive results than approved tests like the DUO or INSTI.

- How accurate my tests are and do I need to have an ELISA test or any kind of HIV tests to confirm my result?
See above.  You have tested more than is needed to be completely confident that you did not get HIV from the exposure you described.  

I hope my comments are helpful. EWH
3 Comments
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Thank you very much Dr Hook for your fast reply,

Your answers are really helpful, I have 3 questions if you don't mind, is there any difference between having DUO test at 9 weeks and having it at 13 weeks because I'm thinking of having another one at 6 months? and do you think the antibody INSTI test (finger prick) I had is a good test and could give me a definitive results? and why you told me I should not be concerned about the rare types of HIV like O group?  

I would really appreciate it if you could answer my questions.
Regards,
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300980_tn?1194933000
No, there is no difference in DUO testing at any time more than 4 weeks after an exposure. Thus testing at 9 or 12 weeks will give the same result.  Repeat testing at 6 months is a waste of time and money.

Yes, the INSTI is an excellent test.  The results should be believed.

The so called rare types are seen only in limited georgaphic areas such as West Africa and even there they constitute only a tiny fraction of all HIV infections.  Further, even when they are present they often give at least indeterminant test results.  

You need to relax.  EWH

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This Forum's Experts
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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