STD/HIV TESTING TOO EARLY?

[scaredstraight68]

I'm sure you've seen my pop through this forum lately.  

RECAP:  Condom broke / 5 second exposure with a girl of unknown status.  She ends up on her period. I freak out.

STD: With all the research I've been doing on HIV, I'm totally clueless on more common stds. At 3 weeks I had a case of epididymis.  Ran a test for Ghonorea and Chlimitia and both came back neg.  My doc said Ecoli or a UTI.  Anyway went on Doxycyline for 12 days and that got wrapped up.  I also tested for all other STDS at 3 weeks and all those came back ok.  But I'm starting to think all those were done too early?  I havnt had any thing show on my privates since the encounter some 7 weeks ago.  SHould I retest for all this stuff?  Would the Doxy clear up Syphlis if I had it?

HIV: Since I'm here I might as well ask the typical HIV testing questions.  Like everyone else on here my symptoms are through the roof but I'm trying to stay focused on the tests and not my body.  The only symptom I didnt seem to have was a fever.  At least none that I can recall.  I've developed alot of pimples on my forehead in the last week which Im hoping is due to stress a couple on my arms.  I would think that a rash (if it is a rash) wouldnt show up after 6 weeks. COuld it be from coming off the Doxy?  

Tested at 4 weeks and at 6 weeks via Bio-rad ab/ag + 0 at lab (California Standard).  Both neg.  When assessing the actual tests would 2 negs be better than one or does it matter?  Should I be scared to test again?  I was thinking of 10 weeks but my doc didn't think I needed the 6 week test.  I would like to believe the odds are at least in my favor now.  My risk contained blood which might have pushed me into the high risk catagory?  Of course I'm freaked out.  I tried to do the math on all this but I suck at math.

Thanks Doc

[H. Hunter Handsfield, M.D.]

This largely duplicates your own thread of several weeks ago.  Note that MedHelp limits users to 2 threads in a 6 month period.  Brief responses:

Tests for gonorrhea are accurate within 2-3 days of catching it, chlamydia within 4-5 days.  Syphilis takes 6 weeks, but the risk is too low from heterosexual sex (in the US) to worry about it.  Doxycycline cures syphilis.  You don't need further testing.

Your HIv test results, which you already described in the earlier thread, prove you didn't catch HIV.  Zero chance--that's nada, zilch, nichevo, nil, no way.

I won't have any further responses.

HHH, MD

[FiveCantonas]

Hi skerdsraght I have read quite a few of your comments and like you still have extreme anxiety on a daily basis. I also have a second test tomorrow, (seven weeks) I will let you know how I get on.

To be honest I think some of us need to try and come away from this forum, although it is a fantastic resource I have found you can spend hours looking for bad news, but every piece of good news you read does not make you feel any better.

I must have spent over twenty hours on this site in the last four weeks.

I am sure you have nothing to worry about !!

KEEP WELL...

[freddy999]

Thats the thing about reassurance...it fuels a need for more reassurance and we focus on finding exceptions to invalidate the assurances we have been given...Weird ????

[Rob73!]

Very much so. But, where does it end? Testing for the sake of testing isn't really an answer. It's hard for sure; I've been there  with the "window pains".

I think overall it's the nature of HIV and the stigma - it scares the hell out of people, rather than any real fear of actually being infected. I had tests @ 28 and 87 days (1 month and 3 months). Both were neg. Yet sometimes i'm still convinced i'm infected - though i know that isn't the case.

My advice and again, i'm speaking from personal exprience; if you have trouble, like i did about accepting that you're being neg, then seek councelling. It does make a real difference.

[FiveCantonas]

For me its the most bizarre experience of my life and would not wish it upon an enemy. The clinic I went to told me in three years they have never had a postive test after four weeks while using HIV DUO when the test was negative at four weeks, but they have had positives / Dr. H says the same in I believe a much longer time frame, but why do so many of us on this forum consider we may be the one to slip through the modern tests, then we get into a cycle of multiple testing, I admit to going down this route...

Realsied today I have never seen anyone who tested postive posting on here? I wonder if the threads are removed so as not to send the worried wells over the edge?

Good Luck to both of you in your particular cases...

[monkeyflower]

I've been here for around a year (maybe more, who knows). I have an online business and I'm a student, so I spend maybe 85-90% of my waking hours on the computer. I use this site for my breaks, which on some days is pretty often ;-) I've yet to see anyone post a positive result - and I've never seen such a thread deleted. What would be the point? In case you haven't noticed, this site is *educational*; it isn't about emotional reassurance and support :-)

The truth is, the people who post here are at *unbelievably* low risk; they tend to be overly anxious worried wells who have a better chance of winning the lottery AND getting hit by lightning than contracting HIV.

[skerdstraght68]

I do alot of things that would be considered "extreme" and nothing and I mean nothing scares me more than HIV testing. Maybe its just the not knowing.  I dont think Cancer patients do 1/10th the research that those who are HIV testing do.  HIV is the only disease where the more you read the less you know.  Its enough to drive anyone nuts. Good luck to everyone here.  

SIDENOTE: I did talk to a lady today from I believe Duke Medical lab who does the actual testing and she was very knowledgeable on current Elisa tests.  I asked her about testing periods with new antibodie tests.  She said the new tests were excellent at catching early positives and they were extremely accurate.  I asked if she had seen many - come back + and she said shes has seen very little and the ones she has seen were 2-4 week tests.  She claimed that just about everyone gets pos results by 4 weeks. 6 weeks is more like a safety net and Mass wasnt far off.  She claimed that the old tests were set up with a threshold of lets say catching 100 particles of antibody to become pos and the new ones need like 1.  It's highly sensity.  If you think that this makes me feel like I'm out of the woods you'de be crazy. lol.  When it comes to HIV, I'm just like all of you.

And thanks for the reply doc.

[H. Hunter Handsfield, M.D.]

monkeyflower is right.  Many months ago someone who initially posted a typical anxiety-driven question later said his test had come back positive.  There were strong reasons to believe he was not being truthful, and he stopped posting follow-up messages after he was challenged (by other users, not me).  Other than that, nobody on either the STD or HIV/safe sex forum has said s/he had tested positive for HIV.

HHH, MD

[FiveCantonas]

skerdstraght68 / excellent post and very useful information for all forum users. I too was told similar from a friend of a friend who works at lab corps who said they preform over 10,000 tests per year. They confirmed 99% of all positive tests were before six weeks and the ones after that where people who tested but could not give date of exposure.

Thanks for the follow up reply Doc on positive tests. The work you do on this forum warrants a knighthood, (maybe you do not have these in USA?) in the UK it would be issued by the QUEEN !

[monkeyflower]

"I do alot of things that would be considered "extreme" and nothing and I mean nothing scares me more than HIV testing. Maybe its just the not knowing. I dont think Cancer patients do 1/10th the research that those who are HIV testing do. HIV is the only disease where the more you read the less you know. Its enough to drive anyone nuts."

I'm sorry, I know this isn't the place for this discussion, but I just had to comment. I think this is such a fascinating phenomenon. I tend to think it's a combination of the stigma associated with all STDs (especially HIV), the scare tactics of our conservative govt, sex "education", and religion, the lack of accurate information, and our society's issues with sexuality in general. Let's face it, we're far from a sex-positive, healthy society. There's often lots and lots and LOTS of guilt, whether for being sexual at all, or for having other partners, etc. I also think this probably serves as a pretty handy container for all the anxieties associated with *real* issues in everyday living.

I wonder, too, whether age has anything to do with it - whether those who became sexually active before all the HIV/AIDS hype feel differently. Of course, people's perspectives change as they gain life experience anyway, so it might be hard to tell.

Oh - and re: cancer patients doing research, betcha folks finally diagnosed with HIV don't do this kind of exhaustive research either. Of course, they probably weren't in this anxious population to begin with...

[FiveCantonas]

Just wanted to give you an update to my scenario just returned from GUM clinic after 7 week test - negative HIV 1+2 and negative P24 test. I am told that I can consider myself 99% + in the clear, in fact when asked if it was OK to have unprotected sex with my wife Dr. said I see no reason why not - he said "even with one encounter of unprotected sex with possible infected sex worker, (originating from Cameroon) I had now tested more than enough and rather than worry about the less than 1%, (IF MY PARTNER WAS INFECTED) I need to move on with my life". As a closing comment, (which I found amusing) "Please no calls if you sneeze / cough / get the runs after a curry / sweat after a night on the tiles / find a new spot on your penis that has been there since you were born / etc"

Not sure if anyone else has felt the same anxiety I have over the last few weeks, (trust me at times suicidal) but it has all but gone away - I just hope the feeling lasts?

Testing:

10 days all STD negative
30 days negative for HIV 1 + HIV 2 + P24 Antigen
49 days negative for HIV 1 + HIV 2 + P24 Antigen

Good Karma to all the worried wells out there !!

P.S. Will I re-test @ 12 weeks, (who knows but if I do I will be sure to let you all know - for now I will live happilly with my less than 1% chance of infection)

[skerdstraght68]

I thought I'd post these findings so the ww dont have to go searching.  Maybe save you guys a few hours of agony. lol..

http://www.medhelp.org/forums/HIV/messages/258.html

http://experts.about.com/q/Immunology-including-AIDS-973/ELiSA-6-Weeks.htm

http://www.health24.com/medical/Condition_centres/777-792-814-1753,33966.asp

http://www.aac.org/site/PageServer?pagename=basics_home

http://forums.poz.com/index.php?topic=2523.0

http://www.aegis.com/askdoc/ASKD040318.html

http://www.hopkins-aids.edu/publications/book/03MMHIV1to3.pdf  (page 7)

http://www.unaids.org/en/MediaCentre/References/default.asp#begin (q:32)

http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Testing/Q142661.html

http://depts.washington.edu/hivaids/initial/case1/discussion.html (figure 7)

http://experts.about.com/q/Immunology-including-AIDS-973/u.htm

[FiveCantonas]

So from looking at all this your anxiety levels must be at an all time low by now? There is a lot of experts here giving the same opinions and all seem to be well qualified.

I have heard now from several sources they have not seen a patient testing negative at four weeks, then testing postive at a later stage.

For me after all the reading that I have done, I think testing can be summed up in a few sentances and even this may be conservative...

If you have been to a clinic that uses modern day testing and your risk was a single unprotected exposure of any kind whether that be anal / vaginal / oral then the chances that you would not show up postive for P24 or HIV1 or HIV2 by six weeks are far less than 1% unless other known medical factors come in to play. If you have been tested more than once in this time frame your risk can be decreased even further. The 12 week test should be used as a closure for people who cannot accept thier previous negative results.

Wonder if the Dr. agrees?

[skerdstraght68]

Everything you ever wanted to know about HIV tests..

http://liam.gnn.tv/print/1775/HIV_Antibody_Assays_Overview

[skerdstraght68]

This should make everyone feel good.

http://peds.wustl.edu/labmed/retrovirus/

[FiveCantonas]

Hi skerd hope you are well today, not sure if we will get an answer but the doc states in several threads he has never seen someone post positve after four weeks, who previouslt tested negative. I wonder is he has ever seen someone test positive within four weeks, I could not find the answer in any of the forums? Just wondering as it could be that its a simple case of everyone who has been to his clinic is negative.

In terms of timeline I am pretty much in the same boat as you, two tests one after four weeks / one after six weeks.

Doctor would you be good enough to answer?

[H. Hunter Handsfield, M.D.]

Good grief.  Of course my STD clinic sees people with positive HIV tests, hundreds over the years.  No more anxiety-driven questions that defy common sense, please.

HHH, MD

[monkeyflower]

"a simple case of everyone who has been to his clinic is negative."

I *seriously* doubt that scenario, since he directed the STD clinic at the King County Health Department in Seattle for like 30 years. I have a sneaking suspicion that he's seen more than a few HIV positive folks pass through his door :-)

I think the posters here and elsewhere may be giving you a false impression of reality. This board and others like it are self-selecting. You almost never find people who are at genuine risk posting on these kinds of boards; I have a feeling most just go to the doctor, get tested without undue angst, and move on. Online, though, you find anxious people who are desperate for some reassurance; perhaps they feel guilty because they're otherwise monogamous, are religious, conflicted about their sexuality, whatever. They're frightened and don't feel they can talk to others in their life, so they come online, where they meet lots of others who are in exactly the same situation. So just because you don't find a particular (realistic?) scenario in the forum/archives means nothing. What you read here isn't necessarily reflective of reality... but it is a fascinating phenomenon.

[Rob73!]

Well called MonkeyFlower! A very good friend of mine, who is in the highest of high risk categories, who gets tested every 3 months (always negative). Well, he just accepts that thats the way it has to be. I can say for certain, that he doesn't go down Hell Avenue like the rest of us. I guess it's because unlike most of the Worried Wells here (like myself, though I'm finally starting to move on), he can see HIV froma different prospective.

BUt you're right it is easier for the rest of us to talk online. Maybe it's because we call hide behind nicknames and that there will be no comeback, whereas, talking in the "real" world can. I've wanted to tell y two closet friends about whay i've been so withdrawn over the past few months and i love them to bits, i really do, but you end up thinking what if we fall out. It's easy then for that secret to become common knowledge. Online you can talk safe in the knowledge that your talking with others int he very same situation as yourself.

[still_worried]

ROB73 talking to your friends really helps, though as some one mentioned in the thread before we look for reassurances and then find illogical ways believe we are infected.

I have been going reading the forums this site for a couple of weeks and I have been having some of the symptoms like swollen lymph nodes under the jaw...which I realise could be becuase of frequent episodes respiratory infection since my childhood.But somehow I have convinced myslef that the tests that I have had are missing the infection.
Elsia at 9 weeks negative
Elsia at 11 weeks negative
Western blot at 10 weeks negative(No band formation)
Elsia at 12 weeks negative.

I have had a single episode of unprotected sex with a chinese sex worker.
Doc, I do not have a question for you as I have met atleast 3 specialist all of them saying the same thing that i do not have HIV.

I am under treatment for clinical depression and am currently on a sabatical from work..

I am not sure if all that I said above would make any sense, probably just want to share my experince with the others...

I might go for testing again at 4 months and 6 months..

[Rob73!]

Why would you need to, or indeed want *more* testing done? 12 weeks is pretty much a bang on result. Can't really see what testing out to 4 and 6 months will do for you.

Personally, I had my tests done @ 28 and 87 days - 1 month and 3 months. What more can i do? Further testing is always available to me, but what will it prove? I just can't put myself through all that again and frankly what would it achieve?

I really hope you can get through this.

[skerdstraght68]

I think the problem lies in the incosistancy on HIV testing.  Alot of the information is the same as it was 10 years ago including alot of what the CDC says.  I've called the Mass hotline as Im sure alot of you have and when asking about further testing after 6 weeks the will literally tell you to stop testing, it's difinitive.  Then when you call the CDC they have someone fumbling through a CDC answer guide telling you that antibodies need 3 months to build. Then Dr. Bob uses the word "encouraging" at 6 weeks which sends WW through the roof. If California said smoking doesn't cause cancer the CDC would condem them for putting the people at risk.  I havn't heard the CDC say anything about MAss testing guidlines.  Also, it's not like Boston is Bakersfield.  It's a huge city and I'm sure that a huge amount of testers are using the 6 week mark as their guideline and if the state was wrong we would here more about it.  Especially now a few years after the guidline was instated.  I also doubt the doc would be so strong on his 6 week statement if he had seen or heard different from collegues.  

[Rob73!]

Skerd, you're dead right about the various inconsistencies regarding the window period. I actually spoke to the UK's National AIDS helpline (twice) in about 20 minutes. And you just could not beleive how different the answers were on when to test, and when a test is considered conclusive!

The first chap i spoke to said that you should test out to between 9 months and 12 months for any test to be considered conclusive, when i pointed out to him that his advice went against pretty much all current evidence, he started backtracking to the 6 month point!!! Anyways, i phoned back about 10 minutes later and spoke to another chap who was more realsitic (if a little out of date) and went with the three month mark.

Obviously it's a volunteer service and they do do a superb job, but it does make you wonder.........

[skerdstraght68]

I talked to another very informed lady at a boston medical lab that does HIV testing.  She said shes been doing the HIV tests for 25 years.  Said that Mass use to have a 6 month window when it all started.  Then then around 1995 they went to the 3 month mark.  Then a few years ago with the third gen testing they went to 6 weeks.  At first she was to was skeptical and had a lenthy conversation with the top HIV expert:   "Arthur (Who ever that is), don't beat around the bush, is a 6 week test accuarate for my clients", and he told her bluntly, "If they test neg at 6 weeks, they are neg period."  I asked the all important question before getting off the phone: have you seen a 6 week - turn into 12 week pos.  Her answer:  After six weeks we dont retest them...

[appan]

Dear Doctor,
          
           What  is your opinion regarding a negative test with HIV DUO at week 1,2,3,6,9and 11 after a low risk exposure. what are the chances of hiv transmission in oral kissing (not deep kissing )for 3 seconds. A special attention on the tests. Do you suggest me to go in for a 13 week test.Waiting for your early reply.

           Thanking you
Yours truly

appan

[skerdstraght68]

Here the doc combines the science (not guideline) of the tests with the risk of the act.  I give the doc credit for not simply stating, "Here we follow the CDC guidline" which is common for most sites that want to cover their a@@ and not use their personal experience as proof.  Here for example, someone who engages in ongoing anal sex with men might be at a higher risk and the doc will say testing out to 12 weeks might be waranted.  With heterosexual cases in industrial countries he tends to back the 6 week testing as reliable tests.  The guidline set fourth by the CDC is a catch all which covers all tests, all immune systems and all vague exposure guesses.  As with anything in the medical field NOTHING is 100%. Not even the CDC's guidline but for all practable purposes it is medically rliable.  Even the docs 6 week guideline for that matter is reliable.  THink of it like the bell curve.  When you get to the top you struggling over 1% to .5%  or like the doc has pointed out before 1/1,000,000 or 1/10,000,000.  It's splitting hairs.

[scared...]

I really can understand how u are feeling,as i have been at the same situation.
I tested negative at six weeks with the ag/ab test..they told me that i am propably o.k but i have to go again at 3 months.
The test also had a value of 0.45 s/co negative.What does it mean?É cant understand what they try to measure with this value.
Any ideas?

[scared...]

I also read that the window period is not the same from person to person and thats why they give the 3 months mark..

[skerdstraght68]

the cdc calls the average 21 days..  6 weeks = 42 double that..

[skerdstraght68]

the cdc calls the average 21 days..  6 weeks = 42 double that..

[imprettystupid]

Hey, does anyone know if the UK National Health Service uses as up to date antibody testing as the US?

I rang up a unofficial helpline - the guy was certain they did. I have so far been unable to ask the NHS about it directly.

Any help?

[skerdstraght68]

you dont have HIV

[skerdstraght68]

Do you really think "your doc" who is probably a general practicioner is more qualified in STDs than Dr. Handsfield, Senior Health Research Leader at the Battelle Center for Public Health Research and Evaluation, Seattle, Washington, and Clinical Professor of Medicine at the Center of AIDS and STD, University of Washington.

[imprettystupid]

Just thought I'd let you guys know about something I've been thinking of lately:

Is the reccomended time of the window period based on a scientific understanding of the body's production of antibodies aswell as the observation of clinical records which state the average time inwhich people become positive?

The reason I ask, it because of this:

Say Guy X has a risky HIV exposure - he gets a test at 12 weeks and it is negative. According to most health services, he is in the clear.

Let's say guy X is an idiot and gets himself in another risky HIV exposure, say, 2 weeks after getting the previous results. Again, he waits around three months for an HIV test and it comes out positive. Guy X assumes it must have been down to his secound exposure, but what gets me is, what if it was infact his first and he seroconverted later than expected?

I don't want to worry anyone, but could such a scenerio be seen as a possibility? If so, the statement, "I have never seen anyone serconvert after 6 weeks", isn't very reliable. Of course, I'm no doctor, and I'm sure health-care officials have considered this possibility. Any help? I have posted the same scenerio to Doctor Bob on thebody.com and will hopefully get a reply.

By the way, I am not hinting that I am infact "guy X", my exposure was actually low risk (receptive fellatio on unknown status gay guy (no ejaculation) - an experimentation thing) I got a negative result at 9 weeks and took another test 12 weeks after (currently waiting for the results), but I am very confident in another negative result.

[imprettystupid]

errr.... I'm starting to doubt my own "theory". Argghh ... It's so confusing. I guess I'm living up the name, huh?