S I X - W E E K S .....

I'm always surprised to see the doctors tell folks that 6 weeks is conclusive. I'd be more inclined to believe them if the CDC changed there guidelines as well, but they still say three months is conclusive. 6 weeks / 3 months / 6 months, the information needs and overhaul, if oral is not a risk the CDC should say so. I understand the doctors work from unique first hand experience & a great deal of knowledge. I wish MedHelp could have the doctors do a page(s) similar to the CDC's site, this would be helpful and clarify things for many folks who arrive in doubt and with questions about there risk / testing & exposure based guidelines. Just a thought...

[veryveryscaredguy]

surprised to see what doctors? who said that 6 weeks is conclusive the docs here say 90%

[troggs]

Go on the doctors forum V.S.G....read there posts.

[Teak]

Doesn't matter, 3 months is what it takes to get a conclusive negative result.

[DexDexter]

so teak u disagree with the doctors here?

[ziggy1706]

I agree with Chapeau.. I have been thining of the same thing myself for months now. EVERY aids/HIV website out thier, not including, this website, CDC, or webmed.com, all state to go at 6 months. Nt one mention of 3 months. The way i see it and think now, if more poeple were informed , within the 3 month window, not as many wold run the risk of infection...theyde hopefully, be getting sooner and updated tests done, to help prevent spread of hiv.
Im with Chapeau on this one.

[atombomb9]

Go on the doctors forum V.S.G....read there posts.

You said read the doctors forum but the Question is how do you get there? I am new this forum and I find it very difficult to use. Can you please give me advice on how read the doctors answers to peoples questions.

[troggs]

I really do think this is a matter not to be dismissed and brushed aside-these discrepancies are the cause of a great deal of confusion all around. When people arrive here at MedHelp and other respectable sites, reliable, decisive answers are a crucial instrument in helping folks assess what there own personal risk factor(s). The true time frame(s) needed to transpired before a conclusive result can be reached, ect.

[atombomb9]

I believe 6 weeks is wrong to say someone is not positive for a few reasons. 1) Most people who have unprotected sex dont know the exact date so if they had sex on Jan 19 and they knew it was a Saturday they can easily mistaken for the 12th. This loses then an additional week. I guarantee that most people dont remember the exact date and time they had unprotected sex. Then it can tak up to 9 weeks for the anti bodies to show up. I think people should test after (10 weeks of exposure) Then this should be enough time for the anti-bodies to kick in show if they are infected or not. I believe in a (10) rule then they should be re-tested in additional 10 weeks just for further verification, just for a breather to guarantee they dont have the virus. So its a 20 week process which is 5 month window but should be 94% accurate after 10 weeks which is (2 months 1.2)

[troggs]

The doctors forum can be reached under hiv forums, then it will be the very first page after that-there images and names will also be on display to the right of the page.

[Landers]

The average time it takes your body to produce enough antibodies to be detected is 22 days.  A six week negative test is very encouraging but a 13 week test is conclusive.

[Teak]

Yes I disagree with them. Neither have the authority to change the testing guidelines stated by both the manufacture or the FDA.

[bemyown234]

Well, both docs on the experts forum are what it says, experts, working in this field for more than two decades and have written several text books on the subject. They have their reasons for saying 6-8 weeks, CDC has its reasons for saying 3 months.

You can choose whom to believe.

[Teak]

CDC says what they say because that is what the tests that are marketed in the US states for a conclusive negative test result. I believe I would stick to what the manufacture of the tests suggest.

[Xhost]

And I would probably go by the Doctor's advice. They are the doctors, after all. Frankly, if they told you a 6 week test was the way to go, I wouldn't question it so much. That's just me, though, and I am comfortable with what the Doctors have to say.

Everyone has to make their own decisions, though, and judgments. So, do what you feel comfortable with.

[bemyown234]

Dr HHH has repeatedly said that his advice is tailored to the risk of the specific individual, whereas CDC guidelines are a catch-all guideline applying to everyone irrespective of risk or testing status.
See this link from a latest journal update :
http://www.****

No test at whatever time can be 100% accurate. Even at 3 months there might be a miniscule chance that you might miss something. For example if a test is 99.999% acccurate at 3 months, you might still miss 0.001% of cases. But would you bother to retest? No.

Which is why testing should be oriented by the background risk so that the overall odds work out.

[Teak]

Xhost has a point. If you go by their advise and for some reason you are positive and you cause someone else to contract HIV because you were told that you were negative, then you would have someone to file a lawsuit against those doctors for unauthorized changing of the tests guidelines.

[bemyown234]

Precisely, Teak

So I wonder why two eminent doctors should risk their career by giving wrong information unless they had overwhelming scientific reasons to justify their conclusions. Also please note that they cater to an international audience online and not necessarily US, hence discussion need not be limited to US cdc guidelines.

[Teak]

Could be because neither one actually treats patients.

[bemyown234]

No need to "treat" patients. They screen patients and that is all that matters with regard to diagnosis of HIV . You can bet between them they have screened thousands of patients in a few decades.

[bemyown234]

In any case, most guidelines on screening and wondow periods, including the CDC ones  are not made by actual treating clinicians but by researchers and epidemiologists.

Since you are so hung up on CDC guidelines, Teak, how do you justify that fact the CDC maintains a possible risk with oral sex whereas you consistently state categorically that it is no risk. Surely the same argument you put forward regarding window period should be applicable to this and we should all follow CDC recommendations?

[Teak]

I don't know who tested you, but here it doesn't take an MD to read and HIV test.

[Teak]

I knew you were going to start making statements you couldn't back yourself up with. I guess on the Oral SEX study you didn't see that USF and the CDC did that study. Did you happen to read that study? Didn't think so. Oh by the way. You need to read the guidelines about having more than one nick.

[bemyown234]

I am aware of the study, We are not discussing specific studies.We are discussing what information cdc gives on websites and people who call them

CDC website still maintrains oral sex as a risk. So who is making unsubstantiated statements?

See http://www.cdc.gov/hiv/resources/qa/qa19.htm

[bemyown234]

So my point is CDC maintains that oral sex is a risk , in spite of these studies. Why? and does it not go against your personal viewpoints regarding oral sex being no risk?

[Teak]

Your point it mote. The CDC along with the Univ. of S.F. do a study on oral sex and found it not to be a viable way of transmitting HIV. I think if you will check the Drs.Forums you will see that they too use the same information.

[bemyown234]

By the way the initial UCSF/CDC study done in 2000 actually supported the CDC view that oral sex can transmit HIV .
See http://www.planetout.com/news/article.html?2000/02/17/2

The more recent study was done mainly by UCSF with no direct CDC involvement., and showed zero transmission through oral sex Please see this final report/poster, there is no mention of CDC anywhere::
http://www.caps.ucsf.edu/pubs/presentations/pdf/shafer.pdf

Soomeone sure is getting their facts right.

[bemyown234]

In fact CDC had NO involvement

http://www.ucsf.edu/pressrel/2001/08/081401.html

"The study's co-authors are Caroline Shiboski, DDS, MPH, PhD, assistant clinical
professor in UCSF's School of Dentistry's stomatology department; James W.
Dilley, MD, executive director of UCSF's AIDS Health Project; Joyce Balls,
project coordinator at UCSF CAPS; Willi McFarland, MD, PhD, San Francisco DPH
HIV Seroepidemiology Unit and UCSF Center for AIDS Prevention Studies; Deborah
Greenspan, DSc, professor of clinical and oral medicine in UCSF's School of
Dentistry's stomatology department; Stephen Shiboski PhD, and Dennis Osmond,
PhD, both associate adjunct professors in UCSF's Department of Epidemiology and
Biostatistics.

The study is funded by the National Institute of Dental and Craniofacial
Research."

So its time for you to backup your statements . Please explain whats the CDC involvement in this study as you claimed? They didnt fudn it and they didnt co-ordinate it.. So what did they do?

And why is it so moot? In that case CDC is guilty of providing wrong information causing panic on their website.

The fact remains that CDC guidelines are broad catch-all guidleines which are conservative guidelines

[Teak]

Guess you're not getting your facts correct. Since you play on the Drs. Forum you tell them that the information they are giving out is incorrect.

[bemyown234]

I also agree that oral sex is no risk, The discussion was about CDC recommendations and their validity.

1. The CDC had no involvement in the study as you claimed . So you were wrong and yet  you accuse me of getting my facts wrong

2. CDC stll maintains on the info they maintain for the general public that oral sex is a risk. Link already posted. You disagree with this and maintains oral sex is no risk, Which is fine and yet you dont want others ( expert docs) to disagree  with the CDC on window period.

After posting all the facts direct from the horses mouth ( UCSF website) , obviously you have no reply. Please dont think everyone else is a fool and dont try to patronise people by saying " I am sure you havent read this ", or " you are making unsubstaniated comments"

[Teak]

I don't have to make up comments. I'm not the one going around using more than one nick on this forum. You know where you fall on this forum. ;)

[bemyown234]

I just saw your comment about me having more than one nick,didnt strike me initially  that you meant "nickname".  I have only one nickname and thats this one ever since I joined this site, If you want please ask the admininistrators to check  and verify IP numbers etc.Once again I am amazed at your patronisizing tone and making of baseless allegations.

[bemyown234]

I am going to mail the adminitrators of this site about your baseless allegations.  I am based in the UK and has been surfing from the same place and usually the same computer . Its a simple matter to check IP address and see if I have more than one nickname, I have posted more than 30 messages under the same nickname. I presume this is a diversion tactic when you dont have any further useful comments to make.

[bemyown234]

In fact Teak, I challenge you to report me to the administrators so that they can verify directly if I am using more than one "nick" as you say. I dont expect any apologies from you for making false allegations and clearly you have no intention of having a scientific discussion . I have nothing further to say to you in this matter and I have aleady reported this thread to admin so that they can check.

The facts are clear for everyone to see. Clearly some who behave as if they are experts are not really experts and are also rude and fond of accusing others baselessly.

[Med Help]

Ok, please end this before we need to delete the whole thread. It was a good healthy discussion, but starting to go off course.

MedHelp

[bemyown234]

Thanks to Med Help for the timeley intervention.

[Teak]

LOL

[longone]

I believe the Dr. 6/8 weeks is fine. I think oral is a very low risk but I would never say no risk. If one gets any infected substance in the mouth one must have some degree of risk.
I have had oral sex many times and have always tested Neg. Is it luck or no risk? Who knows.

[LIZZIE LOU]

if it were possible to just stick to the "facts" surrounding hiv instead of getting everyone's "opinion" about it...it would be better understood.

not all doctors are truly educated regarding hiv.  they may know "how" it is transmitted...but do they know the latest, up-to-date studies and research that is going on and has gone on?  i dont think so.  this is proven many times over right here on this site by ppl saying that they talked to this doctor or that doctor and were actually given incorrect information.

this 6-8 weeks vs. 3 months is getting sooooooooooo old.  what most of you here do not understand is that UNTIL the fda changes that window period...it has got to remain 3 months is conclusive.  does that mean that in 6-8 weeks you cant get a result that you can believe in????  this is the point and the argument...it DOES NOT MATTER that a 6-8 weeks test MAY give you an accurate result.  what matters is that the fda and the manufacturers of the test say 3 months and UNTIL that changes...no one should advise someone to not test past the 6-8 weeks period.

[mitm]

Good Discussion !!

[longone]

no one should advise someone to not test past the 6-8 weeks period.

Hmmmmmmm , so Dr.HHH and Dr. Hook should stop their postings? Both say 6/8 weeks is enough time for MOST. Its just about what all feel is conclusive for them. If I feel it is conclusive for me at 6 weeks that's all that matters. If conclusive means 100% then its never conclusive,right?  I agree it is nutty to keep on this subject but funny how most will go get a test for every illness under the sun and when the Dr. says your ok the test was Neg, most will walk out with a smile and never bat an eye doubting their Dr. They certainly don't run to the test Manufacturer and get their FDA approval papers for the test. Is all about the real world and the legal world.

[nervousnoodle]

when they say 6-8 weeks do they mean the regular elisa antibody test

[Teak]

You are right longone, neither one of them should make that comment when it is not supported by the manufactures of tests or the FDA.

[bemyown234]

This has been discussed ad inifinitum before, but the followinf response from Dr HHH might be illuminating:

http://www.medhelp.org/forums/HIV/messages/59.html

Allow me to quote Dr HHH from the above thread :"But to clarify (again) my stance on timing of HIV testing, suffers from too much nuance; it breaks a cardinal rule of health education, the KISS principle:  "Keep it simple, stupid".  So although I sigh with frustration at having to repeat my views so often, I understand the reasons for misunderstanding.



I AGREE WITH 3 MONTHS AS THE TIME FOR DEFINITIVE RESULTS OF THE STANDARD EIA (ELISA) ANTIBODY TESTS AND I ALWAYS HAVE.  However, the reliability of a given test result depends on the prior probability of infection, not only the time interval.  Almost all questions on this topic describe very low risk exposures (say 1 chance in a million, often even lower).  With a negative test that has 90% reliability, those odds drop to 1 in 10 million.  Any common sense analysis says that is low enough to be considered 100% reassurance against infection.  Testing at 6 weeks (and maybe 4 weeks, especially with Duo EIA/P24 testing)meets that 90% standard.



I always tell questioners that if this level of reassurance isn't enough, i.e. they remain nervous despite such low odds, they should also get tested at 3 months.



To whoever asked about diabetes, it does not affect the reliability of HIV testing.  And although the conditions cited by brian123 (JRA and others) might affect the test results, it's only theory, not proved fact; if they have that effect, it is rare.  And of course the conditions themselves are rare as well.

HHH, MD "

As you can see even  Dr HHH agrees with 3 months as being definitive and the 6 week testing widow applies only to low risk situations.

[plzhelpca]

I agree. 3 months is conclusive but it depends on the type of exposure and many factors.

[bemyown234]

No test or window in laboratory medicine is ever going to be 100 % accurate. If you are ok with an odds of 1 in 10  million, then testing at 6-8 weeks is fine. If you want to drop it further, then test at 3 months. I doubt if the odds are still zero at 3 months, in view of some rare chance of late seroconversion etc. So then  would  you want to test at 6 months?

[bemyown234]

And its not as if Dr Hook and Dr HHH are unconnected to the CDC. Both are connected to the CDC and sit on their committees

See http://wwwn.cdc.gov/cliac/cliac0900.aspx

http://www.cdc.gov/STD/treatment/2006/consultants.htm

[nervousnoodle]

you say that oral sex is of no risk. do you mean without a condom. or recieving oral sex. wahat if you are a female and give a blow job would you consider this no risk if semen enters your mouth

[Teak]

I would still say no risk.

[longone]

Dr. HHH
Says


Ah, I now see a minor language problem.  I think you originally meant to ask "Should I be tested" and "Should I wat 6 weeks."

Just get tested 6 weeks after the sex when the condom broke.  Or for absolute, 100% certainty, wait until 6 weeks after your last sex.


It's fine to get tested for peace of mind, and getting a first test at 3 weeks makes sense; by that time 75-80% of newly infected people have positive tests, so your negative result will be reassuring.  Having a negative test 6 weeks after the last exposure will nail it down for sure.

[regularjoey]

The problem is people confusing "conclusive" with "a guarantee".  There are not many guaranteed things out there and HIV test is not one of them.  Whether you like it or not, interpretation of an HIV test always comes down to odds calculation.  Naturally, it is more reassuring for someone with low risk to have a negative test at 6 weeks than for someone with substantial risk.