Son still concerned after 14 week NEGAITVE?

[worriedfather99]

Dr. HHH:

You gave my son advice several weeks ago regarding testing after an exposure with an African prostitute in Germany, (brief unprotected vaginal sex).

He has tested at 4/8/10/12 and 14 weeks after the event all NEGATIVE for HIV1/HIV2/P24 using modern testing.

I also believe he tested negative for any other infections/STD's he could have picked up.

After admitting the incident to me and my wife we are trying to help him get through this difficult time, but are not exactly up to date on HIV.

At weeks 13 my son got a non itchy rash while on holiday on his back arms and legs, it took about three weeks to dissapear, he has convinced himself this is HIV related, but he tested NEGATIVE a week after developing this rash on returning to England.

I have got my son to seek professional help with this obsession which I am hoping will help, but I am wondering if you can answer some questions for me and my wife?

1. Does this rash have any significance to HIV?
2. Is a 14 week NEGATIVE conclusive?
3. Have you heard of a 14 week NEGATIVE changing?
4. Would the test at 14 weeks have been positve if the rash was HIV related?
5. My son wants me to take him for another test, do you think this would help to 100% rule out HIV?

Thanks in advance for this excellent service you provide.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks about the forum.

As I undoubtedly told your son, the chance of HIV, even if his commercial partner had HIV, averaged 1 chance in 2000.  Assume a 10% chance she had HIV.  Assume that there is 1 chance in 10,000 that a 14 week test is wrong (it's probably closer to 1 in a million).  The odds he has HIV, given that entire sequence, is 0.1 x 0.0005 x 0.0001 = 0.000000005.  That's 5 in a billion, or 1 in 200 million.  That is, truly zero.

Symptoms mean nothing in comparison with a negative test result.  With current standard HIV tests, nobody ever has HIV if negative more than 3 months infection.  I have never heard of an exception.  His rash cannot be related to HIV, period.

Your son does not need more testing, and clearly his irrational anxiety is such that he will never be satisfied, no matter how many HIV tests he has.  Your description of the situation clearly is of someone who is mentally unable to let it go despite all rational assessment.  Instead of another test, almost certainly he would benefit from mental health counseling to address the underlying emotional issues.

Good luck--  HHH, MD

[Fishingbillr]

A related discussion,   Educate Yourself About HIV was started.

[worriedfather99]

I find your comments totally unwarranted!

Yes: my son told me about this web-site
Yes: my son posted a thread several weeks ago
Yes: I have asked questions that seem obvious to some
Yes: it was my son who pushed me to ask these questions
Yes: my sons situation has changed since his last post
No: I am not a HIV expert, hence the reason for my post!

I will not post to this forum again, but thank the Dr. for answering the questions I needed to help understand the possiblity of my son having HIV at 14 weeks NEGATIVE.

My son is seeking professional help for this obsession and I will support him through it, what I do know now is that I do not need to allow him to continue testing for HIV!

Ronald :(

[JDHAWK]

You will not change my mine, however the good news is that you are HIV negative.  Make sure you have safe sex in the future.  I hope you would re-think your statement about the forum.  The Doctor is a good one!

Take care.

[worriedfather99]

I think this forum is an excellent service, that is for sure, just do not appreciated being called a liar.

Anyway no harm done...

Ronald :)

[worriedfather99]

I have been discussing your comments with my son, his major hang up seems to be that he read on this forum that during primary infection that tests will not show NEGATIVE for up to three weeks after symptoms begin.

So he believes the only way to put this behind him is to test three weeks after he obtained this rash, which is next week.

To be clear his rash developed at 13 weeks after exposure and he tested NEGATIVE at 14 weeks with 4th generation test, (HIV1/HIV2/P24).

Reason I ask is that local GUM clinic in UK refuse to test my son again and I would have to pay for a private test, I want to help my son, but do not want to make the situation any worse, waste any of my hard earned money.

Is there any scientific fact behind what he has read / misunderstood?

Thanks in advance, Ronald.

[Brian123]

Ron,

Symptoms of (ARS) Acute Retroviral Syndrome is active only within the first few weeks of being infected with HIV.  The 14 week test indeed proves he doesn't have HIV.

"My" suggestion:  Have him see a dermatologist and a good counselor.

Search the archives for "time to positive", etc.
MD HHH has explained mathematically numerous times on this forum the likelihood of being HIV negative and positive.  Somewhere in the archives you will find it in one of MD HHH's replies to previous forum readers.

The rash would and is not due to HIV infection.

Brian

[H. Hunter Handsfield, M.D.]

Your son misunderstood something on this forum.  The clock for the time to a positive test starts the day the infection might have been acquired.  It is totally unrleated to when symptoms start or end.  3+ months is more than enough.  The GUM clinic (or any NHS provider where care is mostly through public funds) is entirely correct to refuse further testing.  

HHH, MD

[worriedfather99]

I have been discussing your replies with my son, his major hang up seems to be that he has read on this forum that during primary infection, i.e. his rash occurring testing will not show up positive for a few weeks after the symptoms start.

This is his argument for another test as his last test was only one week after this rash appeared, is there any scientific proof regarding this statement?

To be clear, rash appeared at 13 weeks after exposure - tested NEGATIVE at 14 weeks with 4th generation combination test, (HIV1/HIV2/P24).

Thanks Ronald.

[Alex73]

Atleast your son has care and support from his father. Good on you mate. No doubt he will get through this.

[H. Hunter Handsfield, M.D.]

YES!!!  How many ways can I say it??  You're as bad as your son.  Do you share an anxiety gene?

This is my last response.

HHH, MD

[JDHAWK]

I think the son and father are the same person!  Just my feeling...

[H. Hunter Handsfield, M.D.]

Sounds like a good bet.  I should have thought of it.

HHH, MD

[worriedfather99]

So what you are saying is that my son is conclusively HIV NEGATIVE with this test result?

[shygirl1981]

your son is completely healthy. this fear has consumed him and he is not being rational. a negative result at 14 weeks is all he needs. he doesnt need anymore testing!! NONE! if it were me at 14 weeks, I would have cracked a bottle and celebrated! no worries. the doctor just said 3+ months is more than enough, there isn't anything else he can say. your son needs to believe this is conclusive, and it's time to move on.

[worriedfather99]

Many Thanks for your swift response, (espeically on a Saturday) I will do my best to stop his testing cycle and give him the emotional support he needs.

I have been told similar from a nurse at a GUM clinic, but wanted to get a second opinion from a HIV specialist.

Just hope he can let it go soon...have a good weekend !

[RedDevil99]

Hallo mate. I understand your sons obsession however I also understand the both of us are probably a wee bit mental at this point. I can logically say. My fear has become something unhealthy. If I were you I would listen to what the doctor said. I know I will listen when he replys to my post. It seems all us worrisome people have to hear that we will be okay from multiple doc before we can let go. I hope I never ever have to feel this way again. And, if it takes a trip to the mental clinic to sort myself out thats just what I'll do. Cheers and G-d bless.