[Question #10002] HIV testing

26 months ago

I apologize for my need to return to the forum and thank you for your help. I recently had unprotected sex with someone I have known for many years. I regret it deeply and wish I had protected myself better. The man has had a girlfriend from India where it is my understanding that HIV-2 is more common though unlikely.

When are the results of the 4th generation test 100% conclusive for HIV-2?

Do I ever need to be concerned that types or new variants of HIV (1 or 2) will not be detected by the existent 4th generation test?

When are other STI tests 100% conclusive?

Thank you so much for your help.

H. Hunter Handsfield, MD

26 months ago

Welcome back to the forum.

The chance your partner has HIV probably is very low, and the chance of HIV2 almost nonexistent. I really see no need for such worry.

The HIV AgAb (4th generation) blood tests are conclusive for HIV2 by 8 weeks. That said, we do not recommend HIV testing after any single exposure unless a lot higher risk than this seems to be. From the perspectives of risk and science, I see no reason for testing after this single exposure -- but of course you are free to seek testing for the purpose of reassurance, so feel free to do that.

There is no such thing as "new variants" of HIV not detected by the current blood tests. That is an urban myth.

Other STI tests: Gonorrhea and chlamydia tests (urine or genital swab) are accurate and conclusive within 5 days of exposure. Blood tests for HIV and syphilis, 6 weeks. HSV 12 weeks (but testing is never recommenced in absence of symptoms that suggest newly acquired herpes).

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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26 months ago

Thank you so much, Dr. Handsfield. My partner is older than 45 and was in a monogamous relationship prior to our relationship. I felt concerned because he ejaculated inside me which isn’t something I’ve permitted or felt comfortable with outside of committed relationships. I will test after 8 weeks for reassurance even though HIV2 sounds like an impossibility here.

Is it true that his having had a partner from India doesn’t sound like it changes the risk for HIV2 here for you? I will try not to worry needlessly either.

Would you recommend continuing to have sex with my current partner (we’ve patched things up, and he is aware of what happened) or waiting until I’ve tested?

Thank you for your work and help. It really helps to have a science-based perspective to balance my emotional response to this experience.

H. Hunter Handsfield, MD

26 months ago

You describe a partner at little or no risk for HIV, regardless of his national origin. I don't know the data about HIV2 in India: we do get occasional questions from people there who are concerned about it, but I don't think any more frequently than from the US or Western Europe, for example.

Only you can decide about your sexual choices this this or current partners. But rather than just you being tested, why don't you propose the two of you get tested together? After all, he probably has just as much reason to be uncertain about your sexual history and HIV as you do about his status. Mutual testing for HIV and STDs often can be a relationship-building experience, enhancing mutual trust and respect.

Thanks for the thanks. That's why we're here!

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26 months ago

Thank you so much, Dr. Handsfield. I will suggest we get tested together and learn from this.

As you said, the tests are conclusive at 6 weeks for HIV 1 and 8 weeks for HIV 2 so I can be entirely confident that I am ok, even after this experience.

Take care and thanks again!

H. Hunter Handsfield, MD

26 months ago

Thanks against for being so appeciative. Best wishes to you and your partner.---