negative HIV after 4 weeks

[ksanford99]

Hi, I've read some of your responses so I won't go on about symptoms, except that there are plenty there.  I'm a female and on August 15th I had unprotected vaginal and then brief anal with an exboyfriend (the vaginal was consentual but anal was forced/NOT consented by me...the only reason i mention this is that because of the roughness i think there is more chance of having tears in the anus, and he did ejaculate there as well).  Anyway, I was tested at 4 weeks and it came back negative, but given that I am having many symptoms commonly associated with HIV, what do you think the accuracy of the negative result is? I will be tested again next week (at 8 weeks) and am wondering if that result also comes back negative, do you think I can relax or should I retest at 12 weeks?  Thanks!

[H. Hunter Handsfield, M.D.]

Reacting only to the title you chose for this thread, before reading your question:  With modern HIV tests, a negative result 4 weeks after the last possible exposure almost certainly means you didn't catch it.  This depends a bit on the nature of the exposure, but if typical of most on this forum, you can be virtually certain you don't have HIV.

Now I have read the question.  Guess what?  As you already have read, your symptoms make no difference.  (Thank you for not listing them all!)  With today's standard antibody tests, at least 90% of newly infected persons are positive by 4 weeks.  The trauma of anal sex (and most anal sex is inherently more traumatic than vaginal sex) probably increases the risk of acquiring HIV--but of course the risk was zero if your partner wasn't infected.  If he is bisexual, an injection drug user, or an immigrant from an HIV-endemic country (e.g., sub-Saharan Africa), your risk is relatively high.  Without those things, the chance he has HIV is almost zero.

Finally, in response to your follow-up comment below, his defensiveness is unfortunate, but it doesn't necessarily mean he is infected.  Most likely he is embarrassed by the forcible nature of part of your sexual experience with him.  Or maybe your approach wasn't as diplomatic as it might have been.

Bottom line (no pun intended):  For peace of mind, get retested at 8 weeks.  You can be very sure of a negative result.  And of course follow-up with a health care provider if your symptoms (whatever is causing them) persist.

Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

See my previous reply.  The answers are readily available.  This is not a counseling site to answer every anxiety-driven follow-up question that enters your mind.  If you post any additional follow-up questions I will delete the entire thread.

[ksanford99]

if this thread is closed, and i know i said that would be my last Q, so i do apologize, but i really wouldlike your opinion.   as i said, my ex is ignoring my concern so i can't ask him to get tested.  i was told (and assuming this is true) that there was a girl my ex was "seeing" who does have herpes.  his friend said my ex told him that he knew she had herpes so he only let her perform oral sex on him, they never had vaginal sex.  how often is HSV2 infected in the mouth rather than the genitals, and if she did happen to have it orally, do you know how easy it is to pass on to a man from oral sex?  i am going for my blood tests after 12 weeks, i was going to go after 8 weeks, but my gyn. told me that herpes tests are not 100% valid until 12 weeks so she's having me wait to retest. in the meantime i'm just trying not to stress.   i have gotten so many different opinions on the timespans which provide accurate test results from my PCP, gyn, STD clinic, and here on this forum.  I don't mean this offensively, but who has the correct info?  

[H. Hunter Handsfield, M.D.]

No. Search the forum before you ask questions that have been asked and answered hundreds of time.

[scaredmark]

Does infection with any other disease inhibit the production of HIV antibodies? (such as hepatitis B?, etc.)

[H. Hunter Handsfield, M.D.]

It takes longer for HSV than HIV.  Negative results don't reach 90% reliaiblity for HSV until 3 months and sometimes it takes 6 months.  But if you didn't develop symptoms suggesting herpes, the chance is low.  (If positive, it would be just as likely that you had been infected well before the exposure you are concerned about.)

[ksanford99]

Thank you, I was concerned because my OBGYN basically scared the **** out of me by telling me that I can't be sure until 6 months after exposure...and with how sick i've been making myself, 6 mos is a VERY long time.  Promise this will be my last question, and I know it's not completely relevant to HIV, but my HSV test was also negative at 4 wks, can I have the same assurance as with my HIV results from my 8 week test if that one, too, comes back negative? Thanks again for your help.

[ksanford99]

PS...when I asked him to get tested he got offended, hung up on me and is now not returning my calls...this worries me that he knows something, why would he get so defensive?  and he's shown me that he's clearly okay w/ having unprotected anal sex, and given where he lives I'm worried that these make him more at-risk for HIV.  i know he'd never have sex with a man, but who knows what kinds of guys the girls he's slept with have been with...There are lots of 'freaks' in that city.