3 week PCR HIV-1 DNA test and 7 week antibody

[Judo87]

Hello Dr. Jose,

Seven weeks ago, I was the insertive partner during anal sex.  Everything was going smoothly, but then the condom broke and I quickly removed myself (1-2 seconds unprotected) and washed my genital area with warm water and soap.  After the incident, I asked my partner when was the last time he was tested for all STIs, including HIV, and he stated that he tested negative for all of the common STIs, including HIV antibodies, a week before our encounter.  I wanted to really believe him, but I suffer from anxiety...I even thought about getting PEP after the incident, but I did not.

After stressing out one week after the incident, I started feeling really nauseous, which scared me!  So, I got tested for Gonorrhea and Chlamydia, and the results were negative, but the nauseous feeling continued.

3 weeks after the broken condom, I had the following test done:

(1) 23 day HIV-1 DNA PCR Test (Negative)
(2) Elisa HIV 1/O/2 Antibody Test (Negative)
(3) OraQuick Rapid HIV 1/2 Blood and Oral Fluid Tests (Negative)
(4) Clearview Rapid HIV 1/2 Advance Blood Test (Negative)
(5) Gonorrhea, Chlamydia, RPR (Syphilis), Hep C (All Negative)

I thought that with all these negative results, I would stop stressing, but I did not and the nauseous feeling continued and I have continued to test for HIV:

*Week 4: OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 5: OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 6: Two OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)
*Week 7: Two OraQuick Rapid HIV 1/2 Oral Fluid Test (negative)

Testing wise, should I feel confident in my HIV test results thus far, especially since I had a 3 week negative HIV-DNA PCR and an antibody test at 7 weeks?  Dr. Hook on medhelp said that I am HIV negative from the incident 7 weeks ago.

Any advisement, suggestions, and/or feedback will be greatly appreciated.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our forum.
The reality is that the initial risk of HIV infection to you is relatively low anyway, even if the other person were to be positive.  If we add to that, that you have had a negative PCR DNA at 23 days and a negative antibody test at 7 weeks, we can conclude that you are HIV negative, even though current guidelines would not consider these tests conclusive, as guidelines tend to always be very cautious and conservative.  The majority of people would sero-convert by 7 weeks.  In your particular circumstances, I am happy with your negative results.  Therefore I do not believe that you need to worry about it.
Best wishes,
Dr José

[Judo87]

Hello Dr. Garcia,

I just wanted to let you know that I tested for HIV 1/2 antibodies during the 10th week and just now (12th week)...the results were/are NEGATIVE!  Thank you so much for the support and advice, and I continued to test just for peace of mind.

Thanks again!

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

I think so.  A negative antibody test after 8 weeks can be considered conclusive in practical terms as over 99% of people would have sero-converted already by then.
Best wishes,
Dr José

[Judo87]

Thank you for the extra reassurance, Dr. Jose.  I wanted to take the 4th generation Eilsa (antibody and p24) test at the 7th week mark, but it is extremely difficult to utilize such a test in the United States.  Alere Determine HIV Rapid Combo test has not been approved by the US FDA.  The US FDA has approved a laboratory 4th generation (ARCHITECT HIV Ag/Ab Combo) test, but when you ask some doctors here in the US about this test, they look at you crazy and act like they don’t know what the blazes you are talking about; this reaction is very irritating and saddening.

On another note, I just got my NEGATIVE 8th week HIV antibody results via OraQuick’s Rapid HIV 1/2 Oral Fluid test.  Can I finally move on?