Testing throughout window period

[theworriedwell]

Hi Drs

I am writing from the UK and would really appreciate your advise on my potential exposure.

I met a lady of unknown status on a night out (white/40 years old), ended up at a house party and one thing led to another. I was extremely intoxicated at the time and thus struggling to identify what exactly happened. I know for sure that she performed unprotected oral sex and penetrative sex may have occurred, i'm very unsure. What worries me is that the lady confessed to having many partners in the past and unaware of her status. She did say that she had always used protection & had just been given the all clear for cancer. My hope is that if we had had sex, protection was used.

Anyway around the 7 week mark I came down with a sore throat which cleared up after a week. I also developed a follicular type rash on my upper arms around the 2nd week mark which has remained there now at 12 weeks. My Dr is sure I've always had it and made it worse because i'm constantly examining myself for signs and symptoms. It's essentially a patch of skin coloured bumps on both upper arms. I also had 2 night sweats around the 2 week mark but this was at the height of my anxiety. I have had the following tests:

1 week - Ab/Ag Duo (neg)
4 weeks - Ab/Ag Duo (neg)
6.5 weeks - Ab/Ag Duo (neg)
9.5 weeks - Ab/Ag Duo Rapid (neg)
12 weeks - Ab/Ag Duo Rapid (neg)

My last test fell slightly short of the 12 week mark by 4 days. Do you feel this is of concern? I basically counted my days wrong. I would really like to put this behind me and although confident with my test results, my anxiety over symptoms is getting the better of me.

Thank you & I hope I find you well.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Your questions are among the most common asked on this forum, so my replies are brief.  Below are some other threads that provide more detail.

The bottom line is that you for sure did not catch HIV and should stop testing.  HIV test results always overrule symptoms and exposure history in judging the possibility someone is infected, and your results prove you do not have it.  In any case, you describe a low risk exposure and your symptoms are not suggestive of a new HIV infection anyway.

You misunderstand the essential elements of HIV test timing following exposure.  The common advice for 3 month testing applies only to the stand-alone antibody tests.  Even that is too conservative; such tests almost always are positive by 6-8 weeks.  However, you had the duo test -- which is 100% reliable by 4 qweeks.  Your last 3 tests were superfluous; you could have been certain 2 months ago that you didn't catch HIV.

If your symptoms continue and/or you remain concerned, see your GP or other health care provider about them.  But stop worrying about HIV.  For sure you don't have it.

Here are some other threads about timing of the various kinds of HIV tests.

http://www.medhelp.org/posts/HIV-Prevention/Confused-over-testing/show/719310
http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755
http://www.medhelp.org/posts/HIV-Prevention/Need-your-help/show/1345664

Regards--  HHH, MD

[theworriedwell]

Thank you Dr.

[H. Hunter Handsfield, M.D.]

Yes, you correctly understand.

[theworriedwell]

Could you please clarify this for me doctor? I will have no further questions.

[theworriedwell]

I meant if it was a low risk exposure (such as myself) then a duo at 4 weeks can be considered conclusive? I assume the same rule applies to a high risk exposure? I am in agreeance with your advice but would like some clarification on this question.

[H. Hunter Handsfield, M.D.]

This information does not change my opinion or advice.  I don't know what "the 100% duo figure is based around circumstances" means.  Your test results prove you didn't catch HIV during the exposure you are concerned about.  There is no point in further discussion of it.

[theworriedwell]

Thank you for your answer Doctor. I know I may sound like your typical worried person, it's just such a thing has never happened to me before. My main concern is that this lady admitted to having multiple partners without ever having taken a HIV test. On top of this my symptoms seem to have come out of nowhere. Regardless of the information I have provided would you consider any situation with the test results I have received to have conclusively ruled out infection? I sometimes feel as though the 100% duo figure is based around circumstances.

Thanks again.