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Avatar universal

Partner Positive - I'm Negative at 7 weeks post exposure

My partner ill off-and-on since 10/08 (pneumonia, fever, aches, chills/sweats). Week of 4/16 high fever, chills, sweats, purpleish splotchy rash on head & trunk (initially thought allergic reaction to ibuprofen script).  Late April had ELISA = non-reactive, 2nd = reactive. WB indeterminate.  Tested again early May ~ ELISA repatedly reactive, Western Blot positive negative.  What is "positive negative"?  He donated blood routinely ~ last time being 1/29 (plasma & blood).  No communication from Red Cross so assuming no HIV at that time.  Dr. thinks he was infected between February & April.  Two intimate, unprotected encounters (oral & vaginal) once on Feb. 14 and Mar. 21.  I was negative on rapid test on May 12.  Is 7 week test reassuring for me?

He insists no risky behaviors.  He traveled between PA & OH three times (1x Feb 13, Mar 20, Apr 18 ~ looked awful on that visit - thankfully we did not have sex since he felt so terrible) ~ dr. said possible he picked something up at a rest stop.  No recall of being poked, stuck or anything.

If he is being honest, I do trust him, but can't find anything to support it he could get this from any of the activities he claims are the only ones since then.  He did fess up that he went to a strip club on his birthday (April 7).  Stripper did touch him ~ although he did not touch her (or anyone).  No risk there (except he knows how I feel about strip clubs...it could be high risk for the relationship).

Any chance the test results incorrect? Is he being dishonest to himself, me and his dr.?  When do you think he was infected based on symptoms/test results.  I'm praying for April which would leave me in the clear ~ but I'm scared to death (for both of us).

I don't think I can face his illness until I know about my own results.  Selfish, but true.

Thank you.   Teak, Nursegirl6572 & LizzieLou gave me some insight, but was hoping to hear more from the doctors.
3 Responses
300980 tn?1194933000
MEDICAL PROFESSIONAL
I've read your interactions with Teak, Nursegirl and LizzieLou on the HIV forum and agree in large part with what they have said.  I have several comments,

1.  His infection.  The way you recount the test results is a bit confusing to me, as it is to you and others.  I don't know what was meant with "positive negative".  On the other hand, both the doctor’s statement and the progression of his test results from negative to positive and the WB from negative to indeterminate and possibly positive sounds pretty convincing, as does his illness in mid-April for being the ARS.  While we typically discount symptoms on this site, in this scenario their value is not that they support the diagnosis but that it may help to time his seroconversion and presumed HIV acquisition.  This is turn is important because it also implies that he may well have acquired HIV in the interval since your last sex with him.

2.  The test certainly does need to be repeated.  I presume his doctor will do this week.  The testing should include a quantitative HIV "viral load" which will help to validate the earlier results

3.  It is unlikely that you are infected.  Even if he was infected when you last had sex, most exposures to infected partners do not lead to infection.  The quoted risk for HIV from unprotected genital sex is 1 infection per 1,000 exposure and the quoted figure, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.

     Your situation is a bit more complex if he was recently infected because HIV is more infectious at the very beginning of the infection than at other times but even in this instance, your risk the last time you had sex was probably on the order of 1 infection per 100 exposures.  Thus the odds are very much in your favor.

4.  Your test results are very reassuring as well.  At 6 weeks at least 95% of tests that are going to be positive and by 7 weeks that figure is closer to 98%.  Is that perfect?- no, but the odds of you having HIV are now very, very low - i.e.  there is an about 2% (very low) chance that the test missed an event that was no more likely to occur than 1 in 100 times.  To be 100% sure I would suggest you repeat the test in a few weeks (hard to say when, the most conservative time would be at 12 weeks but I think you could be confident as soon as 8-9 weeks after last exposure).  The reason I say this is that the newer HIV tests are more sensitive than the ones used just a few years ago.  Dr. Handsfield and I have been informally polling our expert colleagues and can find no one who has seen a recent seroconversion that was not detectable by 8 weeks following exposure.

Bottom line - you can be confident that you did not get HIV infected but we would recommend confirming this through repeat testing in a few weeks.

I hope this is helpful to you in this difficult time.   EWH

p.s.  I understand that if he has HIV he has not been truthful to you about his risks.  If he has HIV, please try to give him the space to correct his mis-statements.  He. like you, is in a very needy place right now but I expect that your outcome will be easier to deal with than his. Once you are confident that you have not been infected, he will need a friend, particularly if he has been living with secrets.  You sound as though you have that in you.  Take care.  EWH
Avatar universal
Thank you very much for your informative comments.  It is a very difficult time and we are both trying to stay strong.  I am making a concerted effort not to keep hounding him about his activity ~ in a way I feel somewhat guilty.  He got transferred to PA in 2/08.  We got engaged before he left; however, we made the choice I would stay in OH until he was sure the job there was going to be what he wanted to continue to do...I keep thinking if I had just gone ahead and gone ~ he would not have needed to find companionship elsewhere.  We have been together for 3-1/2 years (met him while going through my divorce in 2005).

I just can't believe this is happening...it's is very scary how life can change in a moment.  I will always be there for him.   Obviously there will be a lot of life decisions to be made.  My family is in OH, fortunately he has family close to him in PA.  From what I read (and I've been reading non-stop since Monday) he could live 20+ years with this.

I think he treated himself to more than a stripper on his birthday...I really think he's been faithful ~ so, if this is all he did, unfortunately the odds were not in his favor and he got infected on his first risky behavior.  But, this is something that he will need to reveal in his own time.

Okay...maybe I need a therapist!  I will share my final results (and maybe even his if it ends up chaning) if you don't mind.  Thanks for the reassurance that I am most likely ok.  I will be testing at 12 weeks if I can wait that long...I'm at 8 weeks today.

Thank you again and take care.  You and your partner are very kind to offer this service to the public.

300980 tn?1194933000
MEDICAL PROFESSIONAL
A few more comments.  Guilt is not appropriate.  The reactions you are going through are a huge emotional burden.

In addition, I  would recommend considering seeking the assistance of a counselor to assist you in working through this for yourself.  A little later, as things sort out, couples counseling (with a different counselor for ethical reasons) may also be helpful but that it downstream.

Finally, you are correct, with good care, he should live a normal life.  Advances in HIV therapy have transformed this illness which was previously uniformly fatal into a chronic infection in which persons who take their medications (and this is critical) live long, normal lives.  At this time, at least in some ways, HIV is more like diabetes or hypertension than anything else.  With medication and good care, people do well.  Without good care, they do poorly.  He should see someone for care who specializes in HIV care.  There are many in the larger cities of PA.

Take care.  EWH
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