HIV - Prevention Expert Forum
Waiting on HIV test results and worried
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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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Waiting on HIV test results and worried

DR. HHH,

I am a 21yr old Female who had sex with an 18yr old Male. There were 2 incidents with this partner. The first being unprotected oral sex (brief and he didn't ejaculate) and then 4 weeks later being (protected) vaginal intercourse. There was a point mid-way through the act where he stopped because he wasn't fully erect, then he continued until ejaculation. I didn't see the condom post-sex so I can't say with certainty there was no tearing or if the condom had slipped a little during sex.

2 weeks after vaginal intercourse I developed a very painful sore throat accompanied by swollen lymph nodes and white, puss-like spots on my tonsils and in the very back of my throat. This lasted exactly a week and went away on its own without treatment. I did not have any other strange symptoms like flu, chills, or anything of that nature.

The guy I slept with has had one male partner I know of (he insists there has only been one but I can't say I believe him) and that partner, whom I know personally, had tested 3 months after their encounter and tested negative.

I also tested after this, 9 weeks from oral sex, and 5 weeks after vaginal sex, and came out negative. I took a blood antibody test but I'm not sure of the generation of the test but I know it was tested at a national testing facility. I feel I may have taken the test too prematurely to have gotten a reliable test result. (I also had them run a regular blood test which showed I did have some sort of virus- I had high lymphocytes.) I just went in for another test yesterday- at 11 weeks, 2 days and am worried about my result.

1) Was my sore throat possibly an ARS symptom?

2) What kind of risk am I at?

3) Was my first HIV test reliable judging by the time frames? Were my regular blood test results an implication that I may have HIV, especially considering I had some sort of ailment?

4) What kind of results should I be expecting in your honest opinion?

Please, and thank you :)
Tags: test
Related Discussions
239123_tn?1267651214
Well, your partner certainly was high risk.  But the negative test results, with the last one 5 weeks after your last exposure, is strong evidence you weren't infected and that something else caused your sore throat and other symptoms.  But to be 100% certain, have another test 3 months after the last exposure.  (You could also be tested again at 6-8 weeks; if negative it will be 99% certain you weren't infected.)

1) It is unlikely that your sore throat was due to ARS, and ARS usually includes fever, not sor throat alone.  But I cannot say for sure that it wasn't.

2) Low risk; see above.

3) See above.

4) You can expect continued negative results on follow-up testing.

Good luck---  HHH, MD
18 Comments
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79258_tn?1190634010
I'm surprised to hear this assessed a high risk encounter. Unprotected oral and protected vaginal with someone seems pretty low (no) risk to me. And you don't even know whether he's HIV positive... I personally wouldn't stress out about it :-)
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Avatar_n_tn
It may have been classified that way because there was evidence of at least one male-on-male partner prior to her encounter.  If there was one, there could have been more and possibly put him in a higher risk category.

Other than that, I think you are right.
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Avatar_n_tn
My brother is gay and has been in a monogomous relationship with his partner for more than ten years. Neither has cheated...at least not that I know of.
All too often on this forum I see that MSM is high risk.
However it seems that the people that post on here are persons who are having anonymous sex partners , whether male or female.
However, believe it l or not, there are SOME gay men and women who are monogomous and do not sleep around.
Such rash generalizations should not be made.
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Avatar_m_tn
I agree, the good Doctor as of late seems to be more conservative with his testing opinion. He has stated many times especially in 2006 that even a 4-week test is a great sign.  As of late he has mentioned 3-month a lot and always gives 6/8 week instead of his past 6-week assurance. Has he got new evidence that these test are not providing as early detection as first though?
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Avatar_n_tn
Thank you :)
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Avatar_n_tn
I agree with longone-HHH MD has changed his testing recommendations.  In 2005 and 2006, he frequently cited 4-6 weeks is more than sufficient.  He now is stating 6-8 weeks with another test after 12 weeks.  Given you close association with the good doctor-do you have any comments on this given that Dr HHH has not responded to these quesitons.
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Avatar_m_tn
I think you guys are, basically, looking way way waaaaaaaaay too deeply into things. The doctor's advice has largely stayed the same.
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Avatar_n_tn
Obviously you have not read the historical posts on "time to positive hiv tests" because they have changed in 2007 versus 2006 and 2005.  Thats the bottom line!
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79258_tn?1190634010
First of all, I don't have any association at all with Dr. Handsfield. I just read and post here, just like everyone else. I appreciate his knowledge and advice--and think he's awesome--so once I found this board I never left.

On that note, I've been here forever and I don't see where his advice has changed at all. He's always given different times based on the risks involved. He's always said that you should test at 3 months for high risk events (unprotected receptive anal with known HIV positive partner), as well as potentially higher risk events (MSM, etc.). But for 99.9% of the posts here, 4-6 weeks is more than enough. And for 99.9% of that group, testing isn't even warranted, despite what they may believe. The risk of contracting HIV from oral, fingering strippers, deep kissing, whatever, is virtually nil. This board just draws highly anxious people who feel the need to test repeatedly and who consistently overthink everything. Like the time-to-test responses :-)
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Avatar_n_tn
thanks so much for your comments but just take a look at most of the recent posts  and you will notice that they are all now 6-8 weeks even for low risk exposures where they used to be 4-6 weeks.  We are all just wondering if there has been some new information that prompted the change.  A number of posters have asked this same question but have not received a response with the exception of simply review "time to positive hiv test" which is where the confusion clearly lies.
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79258_tn?1190634010
I just skimmed back over a year, and he consistently said something along the lines of after six weeks. Again, I think you and many others are totally overthinking this. It isn't some kind of mystery or a conspiracy to keep new information from you. What on earth would be the point? My guess would be he isn't responding because he already has responded to the exact same question about 8 zillion times. There's only so many times you can repeat the same answer to the same irrational question without going insane. I quit reading or posting on the support board for that reason. So all I can say is, Dr. Handsfield is a freaking saint.

I think it might be important to realize that in the real world, people with real risks generally only test once a year. There just isn't this constant worry about testing windows and all that. On that note, I think that if you're worried sick, the issue isn't whether you have HIV or any other physical illness. You would probably benefit from medication to help you control those thoughts, and therapy to help you work through the issues around them. Rather than make another appt to test for HIV, why not make an appt to discuss your feelings about it.
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277836_tn?1359669774
Sorry but is there a way you can clarify this thread to ease the concern or is monkeyflower right you said it so many times they dont need to be repeated
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Avatar_m_tn
Man, I can kind of see why Dr. H gets frustrated now.

I don't think the good doctor has to clarify anything. He's posted 2,273 responses on the exact same topic for 2+ years -- his stance hasn't ever changed, and likely never will. You can cut and paste his various posts into a Word document and compare/contrast the minute differences in them until the apocalypse destroys all life on the planet or whatever, but all that's going to do is feed your anxieties and intensify your addiction to Googling symptoms and testing times.

Take the reassurance he's given you at face value. Seriously. And if he gets any more posts here about this topic, it's likely he's going to close the thread and tell everyone to move on to the HIV Support forum (where I refuse to post, too. It's rife with paranoid and overly conservative advice, and the only reason I go there is to check out the occasional flamewars, which are fun to watch, and to see certain people get called on their BS).

So stop. 6 weeks is good for low-risk encounters. 3 months is good for high-risk ones. Period. Full stop. The rest, as the doctor would say, is quibbling and hair-splitting.
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Avatar_m_tn
I just wrote this on the other forum, these are my thoughts about testing:

That up to you. This is a question no one can answer. There are two schools of thought in my opinion.

1--The Leagal Part is:  All tests in this country must be certified by the FDA. All manufacturers work in concert with the FDA and also the CDC. The CDC is a massive organization who's views are taken seriously by world wide health organizations. It tries to cover all possible scenarios and therefore is very conservative in its recommendations. When HIV came on the scene, the health industry rushed to perfect a screening tool i.e. an antibody test. This type of test was not new but they did not have one for the HIV virus.  Anyway, at first they  [the tests] were not that sensitive thus the CDC stated it could take up to 6 months to detect antibodies. Your body was producing antibodies from the start but the tests were not sensitive enough to detect them. As the years rolled on the industry has made these tests much more sensitive and they now can detect the antibodies much sooner which leads to part two.

2—THE REAL WORLD:  As stated the tests of today are very sensitive, however the CDC and the manufacturers still want to be super conservative and although they have reduced the time for antibody detection in their literature, their official policy of detecting time really has not changed. Why should they? Why should they subject themselves to all the legal ramifications of blame and law suits. They have no competition so there is no incentive for them to change.
Now in the real world after ten years working with these new more sensitive tests Doctors and health care providers now know these new test are almost 100% reliable in a 6/8 week time frame. Some who have done studies on testing techniques even say MOST people will have produced enough antibodies to be detected within a 3/5 week time frame.
So now knowing this it is really up to the individual as to what he/she feels comfortable with. Some will accept the 6-week time frame, some will only accept the 3-month time frame and other will never accept any time frame and will always doubt the results.

For those who doubt the results it’s a sad thing and most should seek mental counseling.  I always am amazed at this because the same people will go and get numerous other tests in their life i.e. cancer, blood work [cbc] and the like and believe all the results.  Anyway hope this helps. Have a good day.


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Avatar_n_tn
Hello everyone-

I agree with monkeyflower- Dr. H is a 'freakin saint'. In my anxiety over this situation I've been googling all kinds of questions and coming up with references from this forum. Most everything that keeps me semi-sane while I wait for my test results has come from Dr. H's advice to others. I'm glad I asked him a question personally- granted I still worry and probably won't be satisfied until I get my results... here's to hoping they're negative! The main thing that made me unsure was the fact that I took a test at only 5 weeks and my regular bloodwork came back showing I did have some sort of virus. I thought maybe my body detected a virus but was not yet creating antibodies to it- detectable on an ELISA. Hence my worries; and my asking the good doctor. I appreciate his attention to my problem- and everyone else's responses :) Thanx!
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Avatar_m_tn
Don't worry about your 5 week test. I had one also and just took a 6.5 week test Neg. All other tests I take as well will be Neg.
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239123_tn?1267651214
Longone's analysis is very good.  In addition, as I have said many times, precise data simply are not available on seroconversion times.  Estimates of serconversion time are based on improving technology to detect antibody earlier, scattered reports based on when people say or think they were infected (which often is wrong), plus expert opinion.  The research necessary to get more precise data would be much more expensive than could be justified.  Twenty years from now, the data are not likely to be any more precise than now.  

All this cannot be re-explained for every new question on seroconversion time.  Therefore, our responses may seem more precise than the data support, and forum users who look for differences between responses will find plenty of them.  With 2 of us now involved in the forum, probably there will be even more difference than before.  Suck it up and don't read so much into it!

And to repeat another principle yet again:  Dr. Hook's and my assessments of the chance someone is infected are based not only on test performance.  They are based just as much (often more) on the likelihood of infection based on the exposure event and overall risk context, and those vary all over the map.

So the bottom line is that nothing has changed.  As a rough ballpark, I base my responses on the approximation that with modern HIV antibody tests, among newly infected persons roughly 85-90% will be positive by 4 weeks, 95% by 6 weeks, 98-99% by 8 weeks, and over 99% at 3 months.   Dr. Hook might use slightly different assumptions.  These are for antibody tests, not P24 antigen (a component of the DUO test) or PCR.  There are even fewer data on the performance of those tests.

Finally, I do not know the trade names for most of the many HIV test kits on the market, even in the US, let alone other countries.  Nobody will ever get anywhere by asking us whether antibody test A is different or better (or becomes more positive sooner) than test B.

HHH, MD
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