Worried about HIV! Dr HHH/Dr HOOK

[Mns123]

Hello Doctors,

I am a male 20 years old and had protected sex with a sex worker on the 23rd of December 2012, that was the first time for me to have sex, then I became extremely worried about contracting HIV, so I did many tests ( PCR RNA at 16 days, DUO test at 6 weeks, DUO test at exactly 68 days, INSTI Rapid test in 83 days and the last test was INSTI Rapid test at exactly 94 days) and all the results were negative. And today I noticed there are like small red dots on my both arms from the behind. ( I think I saw them before the exposure as well but HIV made me crazy )

my questions are:

- Do I need to have more tests or these tests are conclusive? Because I'm still worried and cannot focus on my studies!
- Does INSTI Rapid test detect all subtypes groups of HIV-1 and HIV-2?
- Is there any more accurate test than INSTI you recommend me to have?
- Should I be concerned about the red small dots on my arms or are they a symptom for HIV?

I would be really appreciate it if you could answer my questions because I really cannot forget it and feel guilty! and could you tell me how can I just forget it. :(

Regards,
Mns

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

You already had accurate responses on the community forum.  Congratulations for using a condom for your first sexual exposure.  As a result of that wise decision, you are not at risk for HIV (and minimally so for other STDs) from that event.  But even if you had had a high risk exposure, and even if your skin symptoms were typical for HIV (they are not), it wouldn't matter at this point:  HIV test results, done sufficiently long after the last exposure, overrule all other considerations. In other words, no matter how how the risk and no matter how typical or atypical the symptoms, your test results prove you did not catch HIV.

--  You do not need any more tests.

--  HIV-2 is virtually absent from the UK, and in any case the tests you had would have detected that virus if you had it.

--  There are no tests that are more accurate than the ones you have had.

--  Such symptoms do not suggest HIV.  If they continue or you otherwise remain concerned, see your GP -- or you could visit your local NHS GUM clinic for expert advice.

Regards--  HHH, MD

[H. Hunter Handsfield, M.D.]

Like many (most?) anxious people with an internet connection, you are being drawn to the information that maximizes your anxiety and missing the reassuring bits.  Trust me on this:  there is no realistic chance you caught HIV (most people would not have felt a need for testing after an exposure like yours, and they are the ones with the right perspective, not you).  And if you had been infected, your test would have been positive.

My advice is that you re-read my replies above and concentrate on them; put a moratorium on online searching about HIV, its risks, prevention, and testing; stop analyzing and re-thinking the situation; trust the reasoned, science-based reassurance you have had; suck it up; and put this behind [you] and move on with [your] life".

That's the end of this thread.  

[Mns123]

Hello, DR HOOK & DR HHH,

Sorry for replying again, I just want to tell you that I did another INSTI test today ( exactly 17 weeks from the exposure ) and it was negative, and then I read in a website called www.aidsmap.com, according to this site that "Results for whole (fingerprick) blood tend to be slightly less favourable" , so what do you think about it? because I was trying to find a clinic in london provides ELISA Test but I could not find, so I went for INSTI. Should I believe the result of this test? and could that test detects the virus with a small amount of blood from my finger? because this is what makes me worried and not sure about my results.

this is the website page that I got the information from:
( http://www.aidsmap.com/Accuracy/page/1323395/ )

And Im really sorry for replying again but I'm really worried and I want to put this behind me and move on with my life and I could do my studies without worries.

Regards,

[Mns123]

Thank you very much Dr Handsfield, you helped me a lot, I appreciate your effort in this forum.

Regards,

[H. Hunter Handsfield, M.D.]

Take my comments and advice at face value.  There is no hidden meeting -- I was just being courteous in giving more than one option.  There is absolutely no chance a future HIV test will become positive.  As to "why experts are sure results are conclusive after 3 months", all I can say is that there are 30 years of repeated scientific studies.  In fact, it usually is 4-8 weeks for definitive results, not 3 months.  See the thread linked below.

http://www.medhelp.org/posts/show/1704700

[Mns123]

Thank you very much for your answer, you made me worried when you said visit a NHS GUM clinic, why you did not say go to any GP? do you think it could be an HIV symptom?

and last question if you don't mind, is there a chance that my result turn positive later on? why experts are very sure that the conclusive result is after 3 months?

Sorry about my English because I'm not a native speaker.

Thank you very much, I hope you answer my questions.