HIV TEST

[ssingh401]

Dear Doctor:

I have been thinking of asking this for a while. I am 48 year old heterosexual male.I had exposure with a couple of female sex workers about 4 months ago.This was something that I never wanted to do. But happened. It was vaginal sex. No oral or anal.After the exposure i got worried and had the following tests done:

1. All STD tests including 3rd generation HIV1/2 at 28(4weeks) days. They were all negative
2. Another syphillis and 3rd generation HIV1/2 at 56 days(8 weeks). They were negative
3. Rapid INSTI fingure prick test at 87 days(12 weeks and 3 days). It was non-reactive

My questions:
1. Have I done enough testing for conclusive results.
2. Is there another syphillis test needed after 8 weeks.
3. Is INSTI rapid test as reliable as regular anti-body test.
4. My doctor says that conclusive is after 6 months. Is that true? CDC says 12 weeks is conclusive.
    I am a little confused. Do I need another one at 6 months.

Please reply. Thank you.

[Edward W Hook, MD]

I would not worry about your white tongue as being indicative of HIV.  My advice, as I said before, is for you to believe your test result. You did not get HIV from this exposure.EWH

[ssingh401]

Thank you for your response. I just had one question. I have read some articles that indicate that seroconversion can take upto 6 months in some rare cases. Could I be one of those rare cases. Recenlty i noticed that my tongue is quite sensitive and looks whitish. Could it be sign of hiv infection or should I just forget it and believe my result of INSTI test at 87days and not worry baout test at 6 months.

I appreciate your reply. Thank you.

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to provide the information you seek. Before I do, a little perspective.  Most commercial sex workers, despite having a somewhat higher rate of STDs than the general population, do not have STDs. Further, exposure to a partner with an STD, any STD, usually does not lead to infection. Thus the odds are in your favor.  You've now been tested. The tests prove that you did not get an STD from the exposure you reported.  Now let's deal with your specific questions:

1. Have I done enough testing for conclusive results.
Yes, you can be confident that you did not get HIV from your exposure.  

2. Is there another syphilis test needed after 8 weeks.
No, typically syphilis tests become positive within 3 weeks of exposure. while public health recommendations "worry" about people out to 3 months, this is overly conservative.  Be confident that you did not get syphilis.

3. Is INSTI rapid test as reliable as regular anti-body test.
Yes, it had to pass the same criteria as other HIV tests for the FDA to approve it. it works just as well.

4. My doctor says that conclusive is after 6 months. Is that true? CDC says 12 weeks is conclusive.
Your doctor is being overly conservative. Actually, tests are conclusive for most people at 8 weeks.  A 12 week test is certainly definitive.  no need for 6 month testing.

It is now time for you to put this event behind you and move forward. I hope my comments and reassurance will help you to do so. EWH