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HIV PCR Test 13 Days Post exposure

A month ago I made the biggest mistake of my life while in a drunken stuper, I had unprotected oral then vaginal sex with a prostitute while in New Orleans picked up on bourbon street. The vaginal sex was probably no longer than 3-5 minutes. I had a PCR test done at 13 days post potential exposure which was negative. Along with the PCR test I had all other STD tests done along with and ELISA antibody all were negative. I have no idea what the girls std status was so that is a shot in the dark and it is a coin flip if she is a drug injector, she was fairly younger I would say no older than 23 yrs old. This is the only time I have ever done anything like this and had a fairly safe sex life & have never had an STD. About 10 days after the event I developed a sore throat and mild headaches along with random muscle cramps and abnormal fatigue(just feeling kind of sick and lack of energy). No fever, night sweats, vomiting or flu like symptoms. I had another test yesterday which would have been at the 31 day mark. I want to also mention that I got a flu shot 2 day before the sample was drawn on the most recent test and have read that they have been known to produce false positives.
My question to you are:

1. About how confident can I be about the negative PCR test at 13days ? Precentage ?
2. Do you know of any false negatives within this time frame ?
3. Would you consider my risk high, moderate or low (im sure not low)
4. How confident can I be with the 31 day results, if doing another PCR test, will the be fairly conclusivly negative ?
5. What would you say my chances of having contracting HIV with all the factors considered, female to male, negative 13 day PCR and the time frame we had sex?
6. Are my symptoms more anxiety related or possible HIV symptoms.
7. Will my flu shot alter these next roound of results ?

Thank you for your time Doc!

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239123 tn?1267647614
MEDICAL PROFESSIONAL
"Therefore, after these results you would consider them conclusive that I am Negative ?"

Yes. Lots of hand-wringing goes on about 3 months for definitive testing, including on MedHelp's community HIV forum.  That debate is only valid when speaking of antibody tests (even there, 6-8 weeks probably is sufficienct).  But the COMBINATION of negative antibody at 4 weeks plus a negative direct viral test (PCR or p24 antigen) any time after ~10-15 days is equally definitive proof.
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Avatar universal
Got my results back this morning, I am clear. I wasted my money on an additional PCR test at the 31 day mark (mainly for peace of mind) along with the antibody, both Negative.
Therefore, after these results you would consider them conclusive that I am Negative ?

Thanks again the help and peace of mind Do.  I have definatly learned my leason here, cant beleive I got myself in this situation to begin with. Oh well you live and learn. Been living in horor for the last month, feel like a new man.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.

Reacting first to the title:  A negative HIV PCR test 13 days after the last possible exposure is highly reliable (probably around 99% or better), but proof will require additional testing, such as an antibody test at the 4 week mark.  The combination of negative PCR at 13 days plus antibody at 4 weeks will be 100% reliable.

Now I have read the question itself.  I would guess this was a pretty high risk exposure; street-working (or bar-working) female commercial sex workers in New Orleans probably have substantial rates of HIV.  The risk might be especially high if she is African American.*  Still, even the highest likelihood is under a 10% chance she had HIV, and most likely under 1%.  So given the occurrence of unprotected vaginal sex, having an early HIV test by PCR was not a bad move. To your specific questions:

1-3) See above. It is exceedingly unlikely you caught HIV. You put yourself at moderate risk.

4,5) You don't say exactly what test you did at 31 days.  If it was an antibody test, the combination of results will be 100% proof you were not infected.  If it was another PCR test, you wasted your money.  Given all the information, including your negative PCR at 13 days, the chance you caught HIV is no higher than 1 in a million, but you need an antibody test to nail it down for sure.

6) Your symptoms are not typical for HIV, and the negative test results prove HIV isn't the cause.  (You can't have acute HIV with symptoms and still have negative PCR.)  Whenever someone suggests his or her own symptoms have an emotional origin, usually s/he is correct.

7) No medicines, including flu vaccine, have any effect on HIV test resliability.

At this point, you shouldn't be at all worried.  Have a final antibody test to prove it for sure.  But you can definitely expect a negative result.

Best wishes--  HHH, MD

* For interested readers, the higher risk of HIV in African Americans is not a racist position, just a statement of fact; see the threads below:

http://www.medhelp.org/posts/show/717093
http://www.medhelp.org/posts/show/1261996.
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