4th Generation HIV test conclusive at 30 days?

[FranktheWorrier]

Hello all,

    So after reading this msg board religiously for 7 weeks, I am now posting hoping for peace of mind and clarity.  Here's my story.  About 7 weeks ago I met a lady and had a one night stand.  I am a 36 year old white, heterosexual, circumcised male living in the United States.She was a white heterosexual female that was 46.  Before we slept together, we discussed STDs, and she told me she had none. She also said she always uses condoms when she sleeps with men.  I received unprotected oral from her and also performed unprotected oral sex on her.  I used a condom for sex, but at some point it came off and I'm assuming I was briefly inside of her unprotected, maybe a minute tops.  She reassured me that she had no STDs, but my mind wandered into all the what ifs...maybe she lied to me, maybe she was in the acute HIV stage, maybe she was HIV positive and didn't know.   Since then I never had any real ARS symptoms, I took my temperature everyday for five weeks and never had a fever. I did have some red  lumps in my armpit, but I'm pretty sure they we're ingrown hairs (I get bad body acne when I'm super stressed).

I am a self-admitted STD hypochondriac, so I've been freaked out by this incident and have barely slept more than 3 hours a night for the past 7 weeks.  11 days after the incident, I tested negative for chlamydia and gonrrea via a urine test and negative for HIV with a 3rd generation HIV test (I know this really had no value aside to show that I did not have HIV prior to sleeping with her).  It's been many years since I've been through an ordeal like this, so I assumed I had 3-6months of worrying and sleepless nights ahead of me.  However, reading this forum I came across great information from Dr Handsfield and Dr. Hook about the advances in HIV testing.

Links:  http://www.medhelp.org/posts/HIV---Prevention/Testing-Confusion/show/2174457
            http://www.medhelp.org/posts/HIV---Prevention/4th-gen-hiv-testing-accuracy/show/2057325

So based upon this, I went and got a 4th Generation HIV Test (DUO Test) at Labcorp 30 days post exposure.  The results came back negative!  I was ecstatic for a day or two, then I went down the Google Worry Well and started panicking again.  I did find that in the UK, 4 weeks on a DUO is considered conclusive unless there was a high risk event:  https://www.gov.uk/government/publications/time-period-for-hiv-testing-position-statement  And I also found this from Dr Handsfield:  https://www.healthtap.com/user_questions/6759022

So, all this being said, can I move on?  Would my exposure be considered a "low risk event" where I fit into the UK guidelines?  Should I get another test at 8 weeks to confirm?I read the CDC guidelines and couldn't make heads or tails if a 4 week DUO test is conclusive or not.  My Dr told me that HIV transmission from female to male is rare...but being a worrier, I just keep assuming that I'm the exception. I have been dealing with this alone as I just can't talk to any of my friends or family about this due to their judgment on me having a one night stand.  Any help, insights or recommendations would be appreciated.

[paranoidstd]

move on a duo test is conclusive 28 days beyond.

[FranktheWorrier]

Thank you for your words of affirmation...I just think I needed to hear it from someone else.  It's been 9 years since my last HIV scare, and back then the debate was still on, somewhat, over 3 months vs 6 months.  There were still many websites back then saying only 6 months was definitive. I guess thst is what made it hard for me to have faith in the 1 month definitive DUO test, but the science is there.  Thank you for all the hard work you do on the forum with all of us going through this.  I found this additional statement from Dr Handsfield that really explains the science of the 4th generation test.  This, with your comments, made me believe my results.  Here is how he explained it;  

"This has been explained before -- but this time I'm going to bookmark this thread so I can refer questions to it and won't have to keep repeating myself!

Many people misunderstand the duo (4th generation) HIV test. It might seem that after the period in which p24 antigen can no longer be detected in the blood (around 4-6 weeks), the test behaves just like a stand-alone antibody test. This would seem to leave open a possibility that after p24 antigen disappears, there could be brief time before antibody shows up, and therefore a possible false negative test result.

But it doesn’t work that way. The tests for HIV antibody and p24 antigen that are incorporated into the duo test are not independent of one another. It is the HIV antibody that clears p24 out of the blood. If p24 antigen is no longer detectable, then antibody MUST be present -- that's the very reason that p24 is gone. Therefore, in every person with an HIV infection of 4 or more weeks induration, either antibody or p24 is always detectable in the blood. (Both may be present for a couple of weeks in the 2-6 week time frame.)"

Here's the link:  http://www.medhelp.org/posts/HIV---Prevention/Are-my-test-conclusive/show/2064508

Again thank you and to everyone reading this forum pls consider the above from a respected HIV expert when going through your testing.  Here's to health and happiness to everyone reading this board!