Am 100% in the clear

[justintaylor]

Hi Doctors.  I have read many questions on the forum and had one from myself for your professional opinion. I had a condom breakage during virginal sex with a CSW in Melbourne, Australia. When I called the local Sexual health clinic they informed my about a six week wait to test for HIV. Having an extremely high level of stress I went to a local GP and had a test done at 25days which was negative and then at 6 weeks again which was negative. Both where duo tests. I found out after 3 months after the fact that the CSW I had seen had retired for some reason which sent my aniexty levels up worrying if she may have had an STD (HIV). I saw my doctor and requested another test at fourteen to fifteen weeks which also came back negative. I wanted to know that after tests at 25days, 6 weeks and 100 days am I in the clear to 100%. Even if this CSW was HIV positive is there a chance that all the testing that I have done could be positive in the future of 6 months to a year or two. I want to move on and need to know if I dont need to worry at all or not.  Thank you

[Edward W Hook, MD]

I am not aware ot he case you mention.  I spoke of my personal experience, Dr. Handsfield's experience, our reading of the medical literature and our discussions with other experts.  There may be such a report.   If so, such a report may or may not in fact be true, as many such reports are incorrect and poorly documented.  There are also, sadly about 60,000 cases of new HIV infection in the U.S. each year and millions more worldwide.  Thus I will not be absolute in my statments.,  You and our other clients ask questions about your specific situations and test results and receive them,  Just as I am sure that there is someone who has sometime, somewhere been hit by a meteorite, the scenario you suggest may have happened.  I am confident you do not have HIV but mabe you are the one in not millions but tens or hundreds of millions.  If you wish to let such incredibly rare events rule you life and your fears, so be it - I feel sorry for you.

I have nothing more to say.  EWH

[justintaylor]

You have stated that you havent had or heard of anyone that has turned HIV positive after six weeks. There is a documented case of a person that turned positive after one year. With the exception of anti HIV drugs or treatment for cancer can a person go undetected for so long. Purely that people such as myself or others on the forum get tested at the recommended period 6-8 weeks which turn out negative only to find out that a year later it's not the case, could be of concern. Your comment above about new testing could be the difference as the case I state may be old. This question is purely to clarify things and with a person such as yourself in the field I wanted your professional opinion.

[Edward W Hook, MD]

I'm sorry, I don't follow your question.  EWH

[justintaylor]

This isn't meant to be rude in anyway. I read a response you made on the forum that you haven't heard or had a patient that turned positive after 6 weeks but why is there documented evidence of one such case that turned positive after a year?  Do these people have special circustances that make it take so long. I wouldn't assume that its related to testing?

[Edward W Hook, MD]

Your questions are getting repetitive.  If there is virtually no risk, why would one be worried about contact with their regular sex partner?  I think the answer is pretty obvious.

As far as testing, you don't need it (one more time). Thus it really doesn't matter when you are tested, the results relative to the exposure you describe will be negative.  If you had been at risk, results of testing at 6-8 weeks will be reliable despite the fact that some places still recommend testing out as long as 12 weeks or even 6 months.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or n-on personalized sites such as this, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.

I think it is time for this thread to end.  No further questions please.  EWH  

[justintaylor]

Another question. What is the offical testing period. I have been told by the local sexual clinic that it's six weeks yet read on different web sites that three months, six months is the norm. I read that one person was documented as tested positive after one year for HIV and Hep. If the people folk in the know suggest a window period why is it different from different views. One would assume if you are told six weeks is when you will know either way that it or is it based on testing.

[justintaylor]

Would it be okay for me to start having unprotected sex with my partner and have you had or heard of a person that tested negative after 14 weeks turn positive. I may seem to be repeating myself but I am worried about being surprised in a couple of years with a positve result. I want to know from you as a specialist in the field if I can move on and not have a worry. Thanks again

[Edward W Hook, MD]

100%???   As a generalization for both you and other readers, you must realize that we VERY frequently get questions asking if different types of exposures or prevention measures are 100% effective.  The answer to that is that this is scientifically impossible.  For a variety of complex mathematical reasons far too complex to go into here, all one can do with well conducted scientific studies is estimate probabilities.  By definition, any estimate, cannot be 100% certain.  On the other hand, when Dr. Handsfield or I say that something is very close to no risk or of minimal risk, or use any other term to indicate a very small risk, that means "close to zero" in a world where zero cannot be attained.  I am not 100% sure you won't get hit by a meteorite while reading this either but just as I am confient that you do not have HIV and do not need testing, I see no need for you to run for cover.  EWH

[justintaylor]

Can I take this as 100% conclusive from your comments. As I mentioned before I am concerned about the future and finding later that I am HIV positive after the testing that I have had. Has anyone from your experience had a similar situation that has turned out positive and as a doctor would you say I can take my results as closed and final. The reason for clarity is that I want to start a family in a year or two and couldn't stand the thought of infecting anyone. Thanks

[Edward W Hook, MD]

You can be quite confident that you do not have HIV.  Your  6 weeks and 100 day negative Duo tests prove that.  Your chances of getting HIV, even if your partner are low.  With a single exposure to an infected partner the risk of infection is 1 infection per 1000 exposures.

Be comfortable that you do not have HIV and there is no need for you to seek further testing related to this exposure.  Take care.  EWH