Question on Best Test and Right Timing

[NervousMaggy]

Hello:  About 9 weeks ago I had unprotected sex with a man from work who I knew casually.  Based on everything I know about him and what I have read on this site, I do realize that, as Dr. Handsfield might say, substantially better of being killed in a car within one year crash then having acquired HIV.  Having said that though, I do want to test for my peace of mind.  I'd like to get the following advice - some of it may be outside your area of expertise, but asking just the same:

1)  My most important question is, of all of the different tests I am reading about here, which is the most accurate?  My biggest concern is eliminating any risk of a "false positive".  If this means I have to wait longer then 9 weeks, or do a full blood test rather then one of these "Rapid" tests I am reading about, that is well worth it to me.  

2)  Do these "Rapid" tests carry a higher risk of a false positive result?  If I wait past a certain time post-exposure, does the risk of false positive for the rapids go away?  I would prefer to do one of these oral-swab or finger ***** tests, as that will allow me to find out the results immediately as I understand it, but if these carry a higher risk of false positive then I will do a full blood test.

3)  Are there any tests that are more accurate for a woman then for a man?

4)  Finally, in your experience with state or county health departments, is there a way to ensure privacy (or annonymity) in getting one of these tests, so that my insurance does not ever find out about it?

Thanks, Maggy

[Edward W Hook, MD]

My guess is that the health department will not even offer the PCR or antigen tests.  If your ask for the "regular" HIV blood test that should cover things.

No, this is not a stupid question.  Emotions and anxieties can produce symptoms and do so regularly BUT they do not influence the outcome of the HIV blood tests. Your friends CFS was symptoms, not a test result.

Take care.  EWH

[NervousMaggy]

Thank you very much, this is very helpful.  It sounds like I should just avoid the PCR or Antigen tests then.  If I ask the folks at my county clinic to avoid these, will they know what I am talking about if i say "please avoid PCR or Antigen test due to fear of false positive"?

Also, like many people on this forum, I am suffering from increasing amounts of anxiety from playing everything around in my head.  Of course, I understand from logic this makes no sense, but telling myself this does not always help on the emotional side (which is one of the reasons I'm so eager to test and get results quickly to put this behind me).  I am sure you'll say that this is a VERY stupid question, but:  Is there any possible way that the results from the test can somehow be influenced by emotional fear?  For example, had a friend once who was very anxious and torn about taking a job overseas, and actually developed a kind of chronic fatigue syndrome.  Just thinking how this can actually effect the body's chemistry.   This is my last question, thanks!  Maggy

[Edward W Hook, MD]

You already know your risk is very low, which indeed is the case so straight to your questions:

1.  The false positive test rates for all of the antibody tests are similar, whether or not they are rapid tests.  the tests to worry about in terms of false positives would be the PCR or antigen tests which are not recommended for this purpose.  As for timing, in your situation, a 9 week test can be taken as definitive for all practical purposes.
2.  See above, no.  They are highly accurate.  Testing with such a test would be fine
3.  No, they perform equally well in person of both genders
4.  Privacy is an important concern and is well protected in virtually all settings.  Health Departments, in most cases do a better job of preserving your confidentiality than other settings.  In some very small locales, people have expressed concerns about confidentiality.  The other issue to be aware of is that some Health Departments may want to bill your insurance company.  If they do this, obviously they will have access to your results.  Otherwise, these are the best settings, in general, for assuring your confidentiality.

Hope this helps.  EWH