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Testing questions and anxieties
Dear doctors,
I am a 29 year old heterosexual male. On 08/02/12 in Shanghai China, I got drunk and had vaginal and oral sex with a female sex worker (HIV status unknown) in a message place. I remember she put on the condom for me (for both vaginal and oral) but I couldn’t be sure if the condom slipped or had broken during the intercourses. I also didn’t know what kind and brand of condoms she used.
I am very depressed right now as the thoughts of contracting HIV/AIDS had manifested my entire life. I have not had any sexual partners in my life other than my wife and I love my wife and family so much that I felt incredible guilt for what I have done.
After I came back to the US, I immediately went to the doctor and he ordered 3 HIV antibody tests for me, first one on 9/06/12 (5th week), second one on 11/02/12 (3 months) and third one on 02/02/13 (6 months).
I went in to have my blood draw from my arm on 09/06, exactly 5th week mark post possible exposure. I also tested for gonarria, syphilis and Chlamydia all together, everything was negative. Now I'm on my 9.5 week mark and just waiting for my 3 month test. I'm so nervous right now; I couldn’t help but thinking about my action and how I should deserve to get HIV.
My questions are:
1) What do you think my chances of contracting HIV from this exposure?
2) How accurate is my 5th week (35 day) negative antibody test?
3) Is LabCorp Panel 083824 HIV 1/O/2 Abs-ICMA test reliable test ordered by my primary care?
4) Have you ever seen anyone turn positive after a negative 5 week test?
5) If tested negative, should I be having any concerns until the 6 months test?
Thank you so much.
I am a 29 year old heterosexual male. On 08/02/12 in Shanghai China, I got drunk and had vaginal and oral sex with a female sex worker (HIV status unknown) in a message place. I remember she put on the condom for me (for both vaginal and oral) but I couldn’t be sure if the condom slipped or had broken during the intercourses. I also didn’t know what kind and brand of condoms she used.
I am very depressed right now as the thoughts of contracting HIV/AIDS had manifested my entire life. I have not had any sexual partners in my life other than my wife and I love my wife and family so much that I felt incredible guilt for what I have done.
After I came back to the US, I immediately went to the doctor and he ordered 3 HIV antibody tests for me, first one on 9/06/12 (5th week), second one on 11/02/12 (3 months) and third one on 02/02/13 (6 months).
I went in to have my blood draw from my arm on 09/06, exactly 5th week mark post possible exposure. I also tested for gonarria, syphilis and Chlamydia all together, everything was negative. Now I'm on my 9.5 week mark and just waiting for my 3 month test. I'm so nervous right now; I couldn’t help but thinking about my action and how I should deserve to get HIV.
My questions are:
1) What do you think my chances of contracting HIV from this exposure?
2) How accurate is my 5th week (35 day) negative antibody test?
3) Is LabCorp Panel 083824 HIV 1/O/2 Abs-ICMA test reliable test ordered by my primary care?
4) Have you ever seen anyone turn positive after a negative 5 week test?
5) If tested negative, should I be having any concerns until the 6 months test?
Thank you so much.
I will certainly do that Dr. Handsfield. Thanks again!
MEDICAL PROFESSIONAL
Give my greetings to Dr. Nienow. Take care.
Dr. Handsfiled,
How are you doing? I hope you are doing well and happy holidays! I thought my situation might be interesting for you to know. My anxieties are creeping back again so I mad an appointment and went to see a HIV expert here in San Francisco's Castro district.
The doctor whom I visited was Dr. John Nienow. Dr. Nienow said you were his professor at University of Washington. I later find out Dr. Nienow completed his residency in Internal Medicine at the University of Washington where he was chief resident. He's truly genuine and patient with all my questions and concerns.
Dr. Nienow read over your response to my questions on this forum and validated your accurate response. As a matter of fact, he's actually very interested to find out your responses to my questions. He also described you as a tall physician with a big presence who always wears a white coat.
I think my irrational fear still persists because CDC states in rare case one might take up to 6 months to detect antibodies. I know you described in your article that this is overly conservative approach by the government agency. However I still worried I might be one of those statistical outliers.
Anyway, Dr. Nienow asked me to schedule another appointment with him in January before my 6 months test to deal with this irrational fear and anxieties. Dr. Nienow is the only doctor whom I spoke to that told me I don't need 6 months test and the only reason for it is for my own peace of mind, but my negative status is not going to change.
How are you doing? I hope you are doing well and happy holidays! I thought my situation might be interesting for you to know. My anxieties are creeping back again so I mad an appointment and went to see a HIV expert here in San Francisco's Castro district.
The doctor whom I visited was Dr. John Nienow. Dr. Nienow said you were his professor at University of Washington. I later find out Dr. Nienow completed his residency in Internal Medicine at the University of Washington where he was chief resident. He's truly genuine and patient with all my questions and concerns.
Dr. Nienow read over your response to my questions on this forum and validated your accurate response. As a matter of fact, he's actually very interested to find out your responses to my questions. He also described you as a tall physician with a big presence who always wears a white coat.
I think my irrational fear still persists because CDC states in rare case one might take up to 6 months to detect antibodies. I know you described in your article that this is overly conservative approach by the government agency. However I still worried I might be one of those statistical outliers.
Anyway, Dr. Nienow asked me to schedule another appointment with him in January before my 6 months test to deal with this irrational fear and anxieties. Dr. Nienow is the only doctor whom I spoke to that told me I don't need 6 months test and the only reason for it is for my own peace of mind, but my negative status is not going to change.
Thanks Dr. Handsfield, I will try to put an end to my worries after this 12.5 week negative result.
MEDICAL PROFESSIONAL
This has already been answered! See my initial reply, no. 5. Congratulations -- now do your best to move on with no more worries about it.
Hi Dr. Handsfield,
I got my 12.5 week (88 days) blood HIV antibody test from LabCorp back today. It's non-reactive. It is conclusive right? I know you might not answer me but just want some reassurance from you again. Thank you so much.
I got my 12.5 week (88 days) blood HIV antibody test from LabCorp back today. It's non-reactive. It is conclusive right? I know you might not answer me but just want some reassurance from you again. Thank you so much.
MEDICAL PROFESSIONAL
"I'm still very much worried about the upcoming test in 3 weeks thinking about my chances": If you read and understood my initial reply, it is irrational to be worried. There is almost no chance you caught HIV, and the test already done shows you weren't infected. You don't need any more testing.
ARS symptoms cannot start any later than about 2-3 weeks after exposure. At this point, any symptoms you might have cannot be from in HIV acquired last August. Therefore, the proportion with symptoms makes no difference.
That will end this thread. I won't have any more comments or advice.
ARS symptoms cannot start any later than about 2-3 weeks after exposure. At this point, any symptoms you might have cannot be from in HIV acquired last August. Therefore, the proportion with symptoms makes no difference.
That will end this thread. I won't have any more comments or advice.
Dear doctor,
I know symptoms cannot be accurately used to diagnose HIV. But I just wanted to ask do most infected person experience ARS like >90%, or is it just like around 40%-70%? I'm still very much worried about the upcoming test in 3 weeks thinking about my chances, I haven't developed any ARS yet, at least not that I'm aware of, like flu or rash or severe sore throat. Please advice, you are my life saver!
I know symptoms cannot be accurately used to diagnose HIV. But I just wanted to ask do most infected person experience ARS like >90%, or is it just like around 40%-70%? I'm still very much worried about the upcoming test in 3 weeks thinking about my chances, I haven't developed any ARS yet, at least not that I'm aware of, like flu or rash or severe sore throat. Please advice, you are my life saver!
MEDICAL PROFESSIONAL
I agree with your doctor about the herpes blood tests. There is no need for it in situations like this one.
Sorry to bother again but I just have one more questions. I had ask my doctors to test for herpes but he said its generally not recommended to patient without any outbreaks or symptoms, and the test won't be accurate enough. And he said its hard to determine if it was oral or genital herpes, is this true no screen is warranted if no herpes symptoms are present? Thank you so much doctors.
Thanks doctor for the reply, I will wait till 3 months mark on Monday 11/05/12 (95th day) to get another antibody blood test. Hope for the best and I will stay safe for the rest of my life so I can take care of my family and loved ones.
MEDICAL PROFESSIONAL
It is entirely normal for blood specimens to be sent to lab facilities in different locations. Am yes, it would seem your psychologist is behind the times on HIV testing parameters. You might refer him or her to the thread I cited above, print it out for him.
Sorry to bother you again doctor. I went to psychotherapy last week to calm down my anxieties, the psychologist actually said 3 months antibody test is only 95% accurate, that actually make me feel even more anxious. The psychologist is wrong in the statistics right?
Hi Dr. HHH, thank you so much for your immediate response, I really appreciated your answers. I had my blood drawn in my doctor's practice in San Francisco, but the blood was sent to San Diego's LabCorp facility, and after about 3 business days I got an email from my doctors office indicating the results. Is this testing procedure normal? I mean they send your blood sample to a different Lab in a different location? I'm worried about miss handling of my blood samples. Should that cause a concern? Thank you again.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question. You had accurate replies on the community forum, so my replies are fairly brief.
1) It is statisticallly unlikely your Shanghai commercial sex partner had HIV; the large majority are not infected. You would have felt the difference if the condom had slipped off or broken, so you can safely assume the sex was protected. And even with entirely unprotected vaginal sex, if the woman has HIV the average transmission risk is only once for every 1,000 exposures. So even with no testing at all, the chance you caught HIV is less than 1 in a million.
2,3) The test you had is highly relieable, and for the antibody tests a negative result at 5 weeks is almost 100% secure, probably around 95%.
4) Whether or not I have had such a patient is irrelevant. I have not, but that doesn't mean it can't happen. But it would be extremely rare.
5) As you learned on the community forum, nobody ever needs testing at 6 months. Three months is always enough, and in fact 6-8 weeks is definitive. See the thread linked below:
http://www.medhelp.org/posts/show/1704700
My advice is that you have a final antibody test at 8 weeks after the exposure (or, if you prefer, 3 month); or have a combo test (antibody plus p24 antigen) at any time. You can expect negative results. There is no realistic chance you caught HIV.
I hope this has helped. Best wishes-- HHH, MD
1) It is statisticallly unlikely your Shanghai commercial sex partner had HIV; the large majority are not infected. You would have felt the difference if the condom had slipped off or broken, so you can safely assume the sex was protected. And even with entirely unprotected vaginal sex, if the woman has HIV the average transmission risk is only once for every 1,000 exposures. So even with no testing at all, the chance you caught HIV is less than 1 in a million.
2,3) The test you had is highly relieable, and for the antibody tests a negative result at 5 weeks is almost 100% secure, probably around 95%.
4) Whether or not I have had such a patient is irrelevant. I have not, but that doesn't mean it can't happen. But it would be extremely rare.
5) As you learned on the community forum, nobody ever needs testing at 6 months. Three months is always enough, and in fact 6-8 weeks is definitive. See the thread linked below:
http://www.medhelp.org/posts/show/1704700
My advice is that you have a final antibody test at 8 weeks after the exposure (or, if you prefer, 3 month); or have a combo test (antibody plus p24 antigen) at any time. You can expect negative results. There is no realistic chance you caught HIV.
I hope this has helped. Best wishes-- HHH, MD
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