Would like some advice while waiting for test result

Dear doctor,

Thanks for taking the time to give some objective advice.
My risk was unprotected vaginal intercourse with a csw. This was 9 weeks ago.

My test history:
Week 4 - negative rapid test
Week 7 - negative 4th generation duo

I am now on week 9 and went to have a rapid test which also came out negative.
I also had blood drawn for another duo test. The results should be with me tomorrow or the day after.
I have tried to calm myself by repeating the fact that I've already had a negative duo more than 4 weeks after exposure however I seem to think its possible that this may have missed the P24 produced by the virus to which I may not have produced antibodies to at week 9.
Is this a possibility? And do you think further testing was necessary considering my results so far? It seems waiting for the result of another test has sent me into a spiral of what ifs.
What would be your advice and expectation of my test result?

Lastly I seem to think that I have swollen lymph nodes in my groin and armpit, I realise self diagnosis is not reliable but would like to know if pea sized lumps are normal and I shouldn't take notice?

I have been reading the forum for a quite a while now and finally decided to post a question as the information here seems more reliable than the advice given by the nhs which seems to be standardised.

Thank you in advance for your help

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

I stopped reading your question after you gave your test results as negative at 4 and 7 weeks, including a duo test for both HIV antibody and p24 antigen.  Test results done sufficiently long after exposure -- and 7 weeks is plenty for the duo test -- always overrule symptoms, exposure history, or anything else. No matter what sort of exposure you had, or what symptoms you describe in the remainder of your question, you can rely on the test results:  you didn't catch HIV.  See the thread linked below for more discussion why testing is usually valid before the commonly recommended 3 month interval:

http://www.medhelp.org/posts/show/1704700

Now having read the rest of your question:  Stop getting tested for HIV!  You are wasting money, not to mention your emotional energy, on reassurance that you shouldn't need.  Please make the most recent test your last one.  It will be negative.

Thanks for your kind comments about the forum.  If you indeed have been reading it carefully, you should also have seen the multiple discussions about how low risk your exposure was.  Almost nobody ever gets HIV from a one-time heterosexual, vaginal sex exposure -- both because the large majority of sex workers don't have HIV, and because even if they do, vaginal sex results in transmission under once for every 1,000 exposures.  

I hope this information has helped.  Best wishes--  HHH, MD

[8weeksgone]

Just to clarify, I only noticed these nodes a few days ago, and they haven't been there before then.

[8weeksgone]

Sorry to keep posting, information that may be relevant keeps coming to mind.
I thought I should mention I'm from the uk and all tests were done in nhs clinics.
I'm not sure if that makes a difference to the quality of the 4th generation test used?

[H. Hunter Handsfield, M.D.]

These comments don't change my opinion or advice.  The NHS GUM clinics use the same, highly accurate HIV tests as in any other country.

[8weeksgone]

Thank you very much for your reassurance doctor HHH I have not felt as I do after reading your answer in quite a while.
I had read much around the forum and it was helpful however I felt an answer specific to my situation woul help somewhat more.

I also read that experts such as yourself are more than certain an antibody only test is definitive after 8 weeks... Therefore my negative antibody rapid test at 9 weeks again proves I am in the clear?

That's my final question

I will post my results when I receive them.

[H. Hunter Handsfield, M.D.]

This question suggests you didn't read the other thread that I linked in my original reply.  Please do so.

There's really no need to post an other negative result.  Feel free to do so, but I won't have any comment about it.

[8weeksgone]

I did read the link you posted it's just that along with th lymphnodes I also have developed a sore throat a day after my 9 week test which has me very worried.

Do you think I have anything to worry about?

I would really appreciate it if you could reply to this post as my duo test result is still not back and I am now feeling quite anxious.

Thank you doctor

[8weeksgone]

I guess what I'm asking is, would it be possible for the p24 to not replicate to a detectable level at week 7 and be missed by the duo?
Only reaching a level where it may cause symptoms at week 9 causing antibody production?

I realise these are outlandish questions but would really be greatful for a reply

Thank you

[H. Hunter Handsfield, M.D.]

"I guess what I'm asking is, would it be possible for the p24 to not replicate to a detectable level at week 7 and be missed by the duo?  
Only reaching a level where it may cause symptoms at week 9 causing antibody production?"

No, that isn't possible.  

"I realise these are outlandish questions."

Correct.

Ignore any and all additional "what if" or "is it possible" scenarios that may come to mind, or at least don't ask about them on this forum.  There is absolutely nothing you can add that would possibly change my opinion and advice.  You came here for reassurance and I have tried to give it.  Accept it or not, I don't care, but this isn't a debate.   If if continues, the entire thread will be immediately deleted.

[8weeksgone]

Hello doc
Results came back neg today
Thank you for your support
I'll move on now
Just wanted to say both of you are doing a wonderful thing here
Once again thank you