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window period and hiv anxiety
Hi guys,
I am a 38 years old married Austrian man. In 2006 I have had approximately 15 encounter with some escort girls mostly in the East European countries. We have always made protected vaginal intercourse but sometimes we had unprotected oral in both directions. I never had the suspect that someone of those girls could be HIV+. Only one episode worried me a little: during the month of September 2006 I have practiced cunnilingus on a girl and when I was finished, I noticed some menstruations blood; I have not swallowed neither vaginal secretions nor blood moreover I have good oral health, not bleeding gums and sore. The girl has confirmed to me of being HIV -. In any case end of November 2006 I have had the last encounter(without oral) and than I decided to quit with this behavior. On January 24th I got tested and the result was negative but I feel anxiety.In the meantime I have also discovered that my wife is pregnant of our first son. I would like to answer some questions:
how do you judge my risk level?
Is the test result definitive or has to be repeated?
Could the anxiety depend on sense of guilty or on my next fatherhood?
Thanks for your answers.
I am a 38 years old married Austrian man. In 2006 I have had approximately 15 encounter with some escort girls mostly in the East European countries. We have always made protected vaginal intercourse but sometimes we had unprotected oral in both directions. I never had the suspect that someone of those girls could be HIV+. Only one episode worried me a little: during the month of September 2006 I have practiced cunnilingus on a girl and when I was finished, I noticed some menstruations blood; I have not swallowed neither vaginal secretions nor blood moreover I have good oral health, not bleeding gums and sore. The girl has confirmed to me of being HIV -. In any case end of November 2006 I have had the last encounter(without oral) and than I decided to quit with this behavior. On January 24th I got tested and the result was negative but I feel anxiety.In the meantime I have also discovered that my wife is pregnant of our first son. I would like to answer some questions:
how do you judge my risk level?
Is the test result definitive or has to be repeated?
Could the anxiety depend on sense of guilty or on my next fatherhood?
Thanks for your answers.
To put your mind at ease. please follow this thread with comments from Dr HHH on the HIV prevention forum...
http://www.medhelp.org/forums/HIV/messages/748.html
The risk of HIV transmission via unprotected oral sex is extremely low.
Apart from that, you had a negative test at 7-8 weeks after your last potential exposure which basically trumps anything else. 95%+ of HIV seroconversions have taken place at this point, so the likelihood is that you are HIV negative. There are also other threads to follow if that helps. Brian 123 put a link in that points you to them a few posts below yours...
http://www.medhelp.org/forums/HIV/messages/748.html
The risk of HIV transmission via unprotected oral sex is extremely low.
Apart from that, you had a negative test at 7-8 weeks after your last potential exposure which basically trumps anything else. 95%+ of HIV seroconversions have taken place at this point, so the likelihood is that you are HIV negative. There are also other threads to follow if that helps. Brian 123 put a link in that points you to them a few posts below yours...
Thank you WorriedT.
I have read on W.H.O. website that the window period for HIV is consider now within 14-21 days from the exposure.
There are so many different opinions around this item and is realy difficult to convince myself.
I have read on W.H.O. website that the window period for HIV is consider now within 14-21 days from the exposure.
There are so many different opinions around this item and is realy difficult to convince myself.
There are 4 types of "commonly offered" tests and this is my understanding of them. Please correct me anyone, if I'm wrong.
Standard Ab Tests (ELISAs) detecting the immune response to the virus. 80% detection rate at 4 weeks, rising to 95%+ at 8 weeks. Used as the standard rapid test with results within 20 mins - conservative recommendations suggest 3 months at which the test is 99%+ efficient at detection.
p24 antigen tests detect the p24 protein that is part of the HIV coat. Effective early in infection (3-5 weeks post-exposure) as the virus replicates unchecked by the immune system during this period, but once the immune system starts combatting the virus, p24 detection can drop below detection levels. Detects at 75% efficiency at 4 weeks. it is used in conjunction with the Ab tests described above at 4 weeks as the 80% efficiency of those tests plus the 75% efficiency of the p24 test combines to give a 95% detection efficiency. The combined test is often known as the HIV DUO test.
Proviral DNA tests. Highly sensitive as they detect HIV that has incorporated into host cells and can detect 50 copies or less. Some websites suggest it is sensitive at 10 days, and is 99% sensitive at 4 weeks but is prone to false positive results of around 1%.
RNA PCR tests, that detect copies of actual HIV RNA in any sample (ie. NOT incorporated into host cell DNA). Often used to estimate viral load during treatments of HIV patients such as HAART. Also very sensitive.
The DNA tests are usually backed up with other lab tests to confirm any potential positive result (ie. because of the high false positive rate, it needs to be confirmed and therefore is not recommended to be used as a stand alone diagnostic tool, nor is it recommended for testing of low risk exposures because it is expensive and the chances of a false positive are often much greater than the chances of acquiring HIV)
That's my understanding, but other posters will have their own opinions, especially about the DNA vs RNA test! There's lots of recent threads about that....
Standard Ab Tests (ELISAs) detecting the immune response to the virus. 80% detection rate at 4 weeks, rising to 95%+ at 8 weeks. Used as the standard rapid test with results within 20 mins - conservative recommendations suggest 3 months at which the test is 99%+ efficient at detection.
p24 antigen tests detect the p24 protein that is part of the HIV coat. Effective early in infection (3-5 weeks post-exposure) as the virus replicates unchecked by the immune system during this period, but once the immune system starts combatting the virus, p24 detection can drop below detection levels. Detects at 75% efficiency at 4 weeks. it is used in conjunction with the Ab tests described above at 4 weeks as the 80% efficiency of those tests plus the 75% efficiency of the p24 test combines to give a 95% detection efficiency. The combined test is often known as the HIV DUO test.
Proviral DNA tests. Highly sensitive as they detect HIV that has incorporated into host cells and can detect 50 copies or less. Some websites suggest it is sensitive at 10 days, and is 99% sensitive at 4 weeks but is prone to false positive results of around 1%.
RNA PCR tests, that detect copies of actual HIV RNA in any sample (ie. NOT incorporated into host cell DNA). Often used to estimate viral load during treatments of HIV patients such as HAART. Also very sensitive.
The DNA tests are usually backed up with other lab tests to confirm any potential positive result (ie. because of the high false positive rate, it needs to be confirmed and therefore is not recommended to be used as a stand alone diagnostic tool, nor is it recommended for testing of low risk exposures because it is expensive and the chances of a false positive are often much greater than the chances of acquiring HIV)
That's my understanding, but other posters will have their own opinions, especially about the DNA vs RNA test! There's lots of recent threads about that....
Griass Di, paranoid68,
You do not have HIV, as confirmed by your negative antibody test in Jan07. You do not need additional testing.
The risks of HIV transmission from insertive oral sex (e.g., receiving a blow job) and receptive oral sex (e.g., giving cunnilingus) are extremely low, on the order of 1/20,000 with a KNOWN HIV+ partner. While the presence of menstrual blood can increase the risk of transmission for cunnilingus, your JAN07 test confirmed that you did not contract HIV from the SEP06 incident.
While some agencies recommend follow-up testing at 3 months (12-13 weeks) after the last possible exposure, this is extremely conservative. Most people can rely on a 6-week antibody test as definitive. This is true in your case based on the extremely low risk you had from the NOV06 encounter. Your odds of having HIV from the NOV06 encounter are roughly .0001 (chance of HIV from ins/rec oral) * .05 (chance your Jan07 test was false-negative), or 1/200,000 IF WE ASSUME YOUR PARTNER WAS HIV+, which she most likely was not. If we assume a 5% (high) rate of infection in the general population, your risk becomes 1 in 4 million.
You are HIV-. Congratulations on the pending birth of your first child, and on your decision to forego escorts for the benefit of your wife, child, and yourself. Gluck Auf!
You do not have HIV, as confirmed by your negative antibody test in Jan07. You do not need additional testing.
The risks of HIV transmission from insertive oral sex (e.g., receiving a blow job) and receptive oral sex (e.g., giving cunnilingus) are extremely low, on the order of 1/20,000 with a KNOWN HIV+ partner. While the presence of menstrual blood can increase the risk of transmission for cunnilingus, your JAN07 test confirmed that you did not contract HIV from the SEP06 incident.
While some agencies recommend follow-up testing at 3 months (12-13 weeks) after the last possible exposure, this is extremely conservative. Most people can rely on a 6-week antibody test as definitive. This is true in your case based on the extremely low risk you had from the NOV06 encounter. Your odds of having HIV from the NOV06 encounter are roughly .0001 (chance of HIV from ins/rec oral) * .05 (chance your Jan07 test was false-negative), or 1/200,000 IF WE ASSUME YOUR PARTNER WAS HIV+, which she most likely was not. If we assume a 5% (high) rate of infection in the general population, your risk becomes 1 in 4 million.
You are HIV-. Congratulations on the pending birth of your first child, and on your decision to forego escorts for the benefit of your wife, child, and yourself. Gluck Auf!
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