Need reassurance

[needadvise553]

Hi Dr. Hansfield or Hr. Hook,
I am a female in the US and I have had three relationships in the past three years and had unprotected sex during each of those relationships.  I know stupid.  I took their verbal word they were negative.  Now looking back I realize each person I had sex with had at least 5-10 past partners; the last person I was with had 20 past partners (supposedly w/ condoms for the majority of them).  I have tested negative for stds consistently after each relationship, however, I realize now that std panels are not 100% accurate.  

I tested negative for hiv 1/2 per EIA 4 months after my last partner.  However, considering the genetic diversity of the hiv virus (hiv 1 subtypes a-k), circulating recombinant froms (like a/b), atypical/abberant host response, the limited sensitivity and specificity of the available hiv test today (eia, pcr, ect), cases of hiv o in the united states, latent host reponse, hiv n and p (ok I know these are mainly in africa) makes me question my test results.  Can I consider myself negative for all strains of hiv? Should I get tested for hiv o? Should I retest in 6 months? In addition, one of the guys I had a relationship with was in the military and was stationed in Somalia before we met.

My main concern is unknowingly passing on a rare strain of hiv that cannot be detected with todays technology for the above reasons.  As I write this question, I realize how paranoid I sound. I need an expert to address my above concerns and give me some perspective so I can move on with my life. Thanks.

p.s by the way Dr. Hook and Dr. Handsfield. I think you both are providing such an excellent source of information on stds for the public.  Your excellent work is truly appreciated.

[iscrewedupbig]

Dr. Hansfield, to all here.  I am asking you, how confident are you that the current US antibody testing would not miss any rare strains (crf's,etc) like she was asking?   I have tested out negative to 8 months and am in a similar situation.  I don't know if I can ask that here, but if you would respond with a quick answer we would all appreciate it.  Thank you and have a great Holiday Weekend.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  Thanks for your kind words about our services.  However, the response to your question will be very brief.

You are badly overreacting over nothing.  You obviously have been reading a lot and learning a lot about the biology of HIV.  But the concerns you express are theoretical only.  The HIV tests in current use do not miss any unusual HIV strains.  A negative antibody test 4 months after the last possible exposure is 100% proof you do not have HIV.  The nature of your sexual exposures is really not relevant at this point.  The test results show you were not infected.

My guess is you have been told this by one or more of your health care providers.  If so, and if you continue to have difficulty accepting it, you might need to consider counseling.  It is not normal to be so resistant to such strong evidence and reassurance.  Perhaps there is a connection with guilt over your past sexual lifestyle, I don't know.  But please think about it.  I suggest it out of compassion, not criticism.

Best wishes--  HHH, MD