HIV - Prevention Expert Forum
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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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Dear Doctor- I posted this question yesterday in another forum and received the answer I was expecting.  Still, I want your thoughts.  My partner and I have been in a monogamous relationship for just over two years and nearly most of that time we have had unprotected sex.  He was just tested positive for HIV.  Subsequently, I had a test and was negative. Generally, he is the receiver, not always. My question is, 'Given our sex life has been pretty consistent for the past two years, what is the likelihood, perhaps the odds, of having gotten HIV during this window period.  I am aware of the three month period for conclusive results but I am going crazy with a vivid imagination and scenarios.  Thank you Doctor for your time.    Tony
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Welcome to the forum.  Thanks for your question.

The brief reply you had on the community forum was officially correct -- i.e. the HIV antibody test manufacturers and standard advice from public health agencies is that testing is not conclusive until 3 months.  However, that's outdated advice, for two reasons.  First, the modern antibody tests are almost always positive by 6 weeks; it rarely if ever takes 3 months.  Second, combination testing -- for both HIV antibody and the virus itself (by either antigen or nucleic acid amplification test, or NAAT) -- is 100% conclusive by 4 weeks after the last exposure.  Below is a thread that discusses the apparent discrepancy between standard advice for testing at 3 months and the current scientific realities:

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

I have the impression you're a bit surprised at your negative test.  I'm not.  Even after two years, many partners remain uninfected.  It depends largely on what your sexual practices usually are (anal, oral, mutual masturbation, etc), his HIV viral load, and other factors.  I'll be happy to comment further on this if you'd like to describe some of these details, beyond the fact that you're usually not the sexual "receiver".

My advice is that you see a doctor or clinic with substantial experience in HIV diagnosis, if you haven't done so already.  With the right tests, you can have a 95% reliable result as soon as 10-14 days after your last sexual contact with your partner and 100% conclusive testing at 4 weeks.  (Because of the offical advice, many experts would also recommend a final antibody test at 3 months -- but that would be icing on the cake, strictly for reassurance.)

Best wishes--  HHH, MD
7 Comments
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Firstly, THANK YOU for your answer.  You have lowered my stress.  Please forgive my second comment.  I saw another question answered before mine and thought I did something wrong.  I am very new to the online HIV scene and my mind is racing.  

The only other concern about a future positive result is that he ejaculated into me during anal intercourse maybe 10 days ago.  A very rare event for us, but it still happened.  Other than that, things haven't changed.

THANK YOU again for this great online service.
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The single most important factor in judging your risk from that last exposure is your partner's HIV viral load.  Do you know if that's been measured yet, and what the result was?

In any case, you're already at the window period for NAAT testing for the virus in your blood.  You should line yourself up with an HIV/AIDS doctor or clinic for professional advice, including prompt testing.

No worry about the extraneous comment.  I deleted it.
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Avatar_m_tn
I have a test scheduled in two weeks from now, which will be a solid four weeks from last exposure.  I have no symptoms to my knowledge, although I haven't any appetite due to worrying.  I am hoping against hope that despite this window period, that this second test will also be negative.  I love my partner, we are committed to each other, but I was a damn fool to let my guard down and go unprotected.  This is nerve-racking.  When I see the odds of contracting HIV are sometimes 1/1300, I don't even know how to interpret that.  Does it mean I can have unprotected sex that many times?  If that is the case, then I am hopeful in that I was so seldom the receiver.  Anyway, I thank you for your time. btw - my partner's doctor is on vacation so we haven't the results yet of his blood test. My partner appears healthy and has ever since we met over two years ago.   Tony
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I'm not sure where the 1 in 1,300 figure comes from.  A commonly cited risk for anal sex, from the anal to penile partner (if the anal partner has HIV) is 1 in 500.  That means the same thing as it would in gambling or anything else:  each episode carries 1 chance in 500 that transmission will occur.

I expect your 4 week test to be negative.
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Avatar_m_tn
Dear Doctor - I wish I could give you specifics as to what blood tests were taken, but last Thursday I had about 5-6 vials of blood taken, and MUCH to my relief, the tests came back yesterday and were negative for HIV.  The tests were taken 2 weeks and 3 days after my last exposure.  The doctor who specializes in infectious diseases felt the results would be negative.  I believe he said there is now a reasonable expectation there is a 99.9 percent chance I am HIV negative.  This is too good to be true, although I gleaned a similar message of hope from your previous message.  This waiting period has been truly hell but it is looking more and more hopeful. Other than nerves, I still haven't any symptoms, and it is now three weeks and counting after my last exposure.  Thank you for your online council and encouragement.  I am very grateful.   Tony
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"[The ID specialist] said there is now a reasonable expectation there is a 99.9 percent chance I am HIV negative."

I agree.  You should follow upon any additional testing recommended by the ID doc (probably he will recommend one or more additional tests) but you can definitely expect negative results.  From here on out, you can concentrate on remaining HIV negative as your new relationship goes forward.  The main thing will be for your partner to be on effective anti-HIV therapy with a low or undetectable HIV viral load.
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