HIV - Prevention Expert Forum
Window period / Rapid Test
About This Forum:

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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Window period / Rapid Test

Dear doctors
I am Brazilian. Here in Brazil, as you know, we have a pretty good STD care system.
I went through 3 risky sexual encounters with a guy who was in his window period (it was exactly what happenedl). He had a negative test after meeting me for the first time but did not tell me the truth regarding window period. Well...

Risky encounters: **I performed oral sex on his penis twice. There was no ejaculation from him. Last time was on October 24th and the duration of the act was nos longer than  45 seconds each time.
                           ** I inserted my penis in his anus for about 10-15 seconds (I did not notice bleeding) - the reason I did was due to the fact he had a recent 4th gen ELISA with negative result and I trusted him about his window period. Pretty dumb.

Anyways, I took two rapid HIV 1/2 tests at the same time (that's what's done down here in public STD services) on December 17th (61 days OR 8 weeks and 5 days after anal sex and 54 days OR 7 weeks and 5 days after oral). Both came back NEGATIVE.
Regarding window period, they told me I am ok (regarding as well risk, etc). I never went through receptive anal and never got cum in my mouth.
I got so scared.
Do you think I am OK wiht these tests?
Thank you so much and congratulations for your wonderful work.
Related Discussions
239123_tn?1267651214
Welcome to the HIV forum.  Thanks for the thanks about the forum in advance of my reply.

I'm not sure about one aspect of your question.  Your comments about your partner's window period suggest he might have gone on to have a positive test after your sexual exposures with him.  Did he turn out to have HIV after all?  If so, your risk was substantial, especially from the unprotected anal sex event, less so from oral sex -- since HIV is most transmissible during the window period before the HIV antibody tests become positive.

However, even if he has a new HIV infection, your test results show you weren't infected.  With modern HIV antibody tests, which undoubtedly includes the tests in common use in Brazil (medically a very sophisticated country with respect to HIV, which you seem to know), almost all newly infected people have positive results within 8 weeks -- mostly by 4-5 weeks.  This is no different for the rapid tests compared with lab-based tests.  Some experts who believe it still can rarely take up to 3 months, but definitely this is very rare.  Therefore, you can rely on your test results.  However, if your partner indeed has a newly diagnosed HIV infection, you should have a final test about 3 months after the last exposure, just to be doubly safe.

Now comes the important part of my reply.  Congratulations on asking about your partner's HIV status, which is a crucial factor for safe sex among MSM.  And you believed your partner didn't have HIV.  Still, you had unprotected, non-monogamous anal sex.  What were you thinking?  Please learn from this experience and your anxieties about it, and get into the universal condom habit for anal sex.  Save unprotected anal for a time when you are in a genuinely mutually monogamous partnership with an uninfected person.

Best wishes and happy new year--  HHH, MD
9 Comments
Blank
Avatar_m_tn
Doctor Handsfield
Yes, he was on his window period when I first met him. His first test (negative) done after 25 days from his risky encounter with someone who was possibly HIV positive was the reason to set my mind at ease at that time. But he lied to me telling that such encounter had happened 3 months previous to the negative test (and it was indeed 25 days). Yes, he has seroconverted after all. When I found out he was positive I freaked out thinking the source of his infection could have been me so I took a PCR 12 days after the anal intercourse I wrote you about and it came back indetectable (also a 4th gen ELISA which came back negative). So I wasn't the source and I knew it because I hadn't put myself into anything risky before. So, I had that PCR after 12 days (plus 4th gen ELISA) and 2 rapid HIV 1/2 tests 61 days fater the anal insertive sex, all negative. I have had no ARS symptoms either. Thank you so much for taking your time to answer me. One more question: do rapid tests detect IgM antibodies as well? Regards!! Happy New Year!!
Blank
239123_tn?1267651214
Thanks for the clarification.

To my knowledge all available tests are for IgG antibody only.
Blank
Avatar_m_tn
Thank you!
So, at last, your medical opinion is that I have not been infected, right? The 3 months mark test would be for extra safety?
This is the last one.
Regards.
Blank
239123_tn?1267651214
That's what I meant.  The STD clinic's advice is correct:  you really don't even need the 3 month test, just an extra small margin or certainty.  It will be negative.
Blank
Avatar_m_tn
Doctor Handsfiled
Finally I had all the information on the guy I had a risky encounter with.
Here what he has told me after all:
On September 10th he performed oral sex on a man who ejaculated in his mouth (he told me he had a tooth problem at that time) --> on September 22nd he tested negative after taking a 4th gen ELISA --> on October 25th he got ill (sore throat, high fever, enlarged cervical lymphonodes, muscles pain, etc which lasted about 10 days --> on October 28th (while he was on this ARS period) he tested 4th gen ELISA INDETERMINATE and NEGATIVE WESTERN BLOT --> on November 21st he tested 4th gen ELISA POSITIVE and WESTERN BLOT POSITIVE.
Doctor, I am a biology researcher myself at a important university here in Brazil, so that's why I am so interested in such details.
My questions are:1) does all this scene (seroconversion) make sense to you? I mean, wouldn't be odd to have a indeterminate 4th generation ELISA and a negative Western Blot at 6 weeks and 6 days after infection? Shouldn't he have already seroconverted by then?  2) If receiving cum was his only risk, would that make any difference regarding seroconversion time, I mean, would it be different if he had received cum in his rectum? 3) Indeed, I am psychologically ill as you can see - that is due to my job, I am a researcher and this guy's story seems to be a bit different from what I have read and heard.
I am so sorry about bothering you. I will not upset you with my story anymore.
Best reagards! Your opinion means a lot to me.
Blank
239123_tn?1267651214
1) The sequence of blood test results sounds fine to me.  The fact is he obviously was infectged.  2) Seroconversion time doesn't seem to be related to the nature of the exposure or the dose of virus.  3) I can't comment on this.

The fact is that you weren't infected.  It seems a waste of emotional energy for you to be analyzing what is or is not typical about your partner's new HIV infection.

That will have to end this thread.
Blank
Avatar_m_tn
What does "that will have to end this thread" mean? Sorry, I am not a English native speaker...
Blank
239123_tn?1267651214
That you should not post any more comments and I won't have any more replies -- after this one.  Best wishes.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank