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Avatar universal

Question about testing reliability

Good Day Doc,

I had a protected sexual encounter (oral and vaginal) with a CSW in Las Vegas 6.5 months ago. Since then I was tested for everything with sufficient time and everything came up negative. What worries me is HIV. Because in the middle of the sexual encounter I looked at my penis and it looked like there were some fluids in the reservoir of the condom. I hadnt had an orgasm yet so I worried that it was the CSW's vaginal fluids trapped inside since I didnt have a full erection. However, with regards to HIV, I have had the below tests done.

3 weeks - DNA my PCR/Antibody blood test - Negative
6 weeks - Antibody blood test - Negative
10 weeks - Antibody blood test - Negative
18 weeks - Antibody blood test - Negative

1) Since I have had some symptoms along the way should I retest now since I am over six months?

2) My test at 4.5 months was a relief but I just want to be sure that it was within the window period. I have heard some doctors say 6 months is conclusive. Should I consider my 4.5 test to be conclusive?

3) If I had symptoms that were true ARS symptoms would my test have been positive already?

I seriously, want to put this behind me and concentrate on my future but I keep worrying that the stand alone antibody test hasn't detected the virus if I do have it. I only worry about this because I have heard of others saying that some people dont turn positive until 6 to 12 months.

Please advise Doctor!
4 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

The HIV antibody tests and the combo tests for both antibody and p24 antigen are among the most reliable diagnostic tests ever developed.  As long as testing is done sufficiently long after the last possible exposure, the results are far more reliable than all other predictors of HIV infection -- that is the test results always overrule exposure history and symptoms.  With the modern tests in routine use worldwide for the past 10 years or so, it is an urban myth that positive results can take more than 3 months, and for the most part 6 weeks is adequate.  And the combination of engative PCR at 3 weeks plus negative antibody any time after 4 weeks is 100% reliable.  Your tests beyond the 6 week one were excessive.

Since your sexual exposure was condom protected, it wasn't high risk.  And anyway, even without a condom, if a woman has HIV the risk of female to male transmission averages once for every 2,000 exposures.  The small potential contact you had with vaginal secretions is trivial and carries little or no transmission risk.  And statistically, it is unlikely your partner had HIV anyway. The large majority of CSWs in the US and other industrialized countries do not have HIV.

You don't say what symptoms you have had, but it really doesn't matter.  And it also doesn't matter whether or not your partner had HIV, nor whether the condom might have not fully prevented all contact with vaginal fluids.  For the reasons just noted, your test results prove with 100% reliability that you didn't catch HIV.

Those comments answer all three of your questions, but to be explicit so there is no confusion:

1,2) You should not be tested again; your current results are 100% reliable.

3) p24 antigen and/or DNA testing are always positive by the time ARS symptoms begin, and measurable antibody is always present within 10 days of onset of symptoms.

I hope this helps.  For sure you don't have HIV.

Take care--  HHH, MD
Avatar universal
Dr. Handsfield,

So no matter what my symptoms were, I shouldn't worry about it? I never hand any flu like symptoms, no fever, no swollen glans, etc..

The symptoms that I have endured have been; nausea (i have Acid Reflex so not sure if that the cause), post nasal drip, and I have had back paid in the lower back region since about 2 weeks after the encounter. The pain seems to come and go and its never sever but it is bothersome and at times it does hurt a bit. I was doing kettle bell workouts and such around the time when my back started hurting so it could be that. I dont think HIV would cause back pain for that long right?

The thing that is the most alarming is that I have noticed some dry spots on my body. Not many maybe just a few but I never noticed it before. I noticed one on my wifes thigh yesterday and it freaked me out. Its circular and it looks dry. I have heard that HIV causes that. I know you dont recommend me taking any more tests but I want to start trying to have a baby with my wife and i think its important for her to get checked. Do you agree?

At the moment I think I have a common cold but I cant seem to shake off this cough. Its been a week...This is normal right?
Avatar universal
Dr. Handsfield,

Another symptom that I forgot to mention is that sometimes I get like pin prick feeling throughout my body. I can feel it in my wrists, leg etc..It comes for like a day or two then it disappears. Also, sometimes I get itchy in my neck and i noticed recently what looks like chicken skin...Is any of this related?

Also, should i not be worried about delayed seroconversion? Ive heard you say its a myth but thought id ask. Thanks in advance to your reply!
239123 tn?1267647614
MEDICAL PROFESSIONAL
You are re-asking the same questions as before, using slightly different wording.  I haven't changed my mind, your symptoms do not suggest HIV, and your test rssults prove that isn't the cause. If they continue to concern you, see a doctor or clinic.  You can be 100% certain they are not due to any infection from your Las Vegas sexual experience.  If they are related to that event, it is because they are the physical manifestations of anxiety or regret about it.
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