It was a breif 2-3 minute one time vaginal encounter,what are my chances of contracting something?

I recently did my annual screening test which include hiv rna NAAT and 4th gen dou along with testing for everything else.I got the tested done 12 1/2 days after I had sex.

I am nervous about a possible false positive hiv rna NAAT.

1.I have read the if they have an acute infection it’s more transmissible?I don’t know if she has anything though.

2.How often is hiv rna NAAT false positive?

Every other woman before her will be conclusively ruled out by the 4th generation dou 6+ weeks after the last time I had sex.But I got the rna hiv nat test done at 12 1/2 days after.

From what you say, it seems your partner probably is at low risk for STIs in general and little or no risk for HIV. NAAT is not recommended for routine screening; I would advise the AgAb (4th generation) test alone. To your specific questions:

1. True that HIV often is highly transmissible during acute infection, but it depends on timing, which predicts viral load. That starts low, rises steadily from around 8 to 20 days after exposure, then begins to decline as antibody develops. Maximum transmission rate probably is in the 10-20 day range, but is highly variable from one infected person to the next and impossible to predict accurately in any particular case.

2. False positive NAAT results are very rare -- well under one in a thousand. You can expect a negative result, as well as negative results for your later AgAb test in a few weeks.

For quicker reassurance, if you are in touch with your partner, you could encourage her to be tested. If negative, you will know for sure you could not have acquired HIV. And maybe you would find she would appreciate the opportunity for the two of you to be tested at about the same time. After all, women are at greater HIV risk from new male partners than women are. (Why should she be any more confident in your past sexual history than you are in hers?)

You don't mention other STIs. In addition to HIV, you could consider having a urine test for gonorrhea and chlamydia (valid any time 5 days or more after exposure) and a syphilis blood test 6 weeks after the event.

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

HHH, MD

2.I have seen doctor hook say that hiv rna naat done at 12 days is very reliable?I think he’s said never seen someone test positive after 11 days.

3.I don’t really have any noticeable symptoms my balls ache a bit sometimes but it could be because I lift really heavy in the gym often.

Also she’s not my regular partner it was just a one time thing,I’m not sure if she’s clean.But she’s probably not a consistent condom user

1. Heterosexually acquire HIV is rare throughout the US, not just Texas. Most straight men with HIV acquire it through shared drug injection equipment. And yes, certainly many people claim more socially acceptable transmission (like vaginal sex) rather than admitting to sex with other men, injection drug use, etc. Others simply are mistaken about when and from whom they were infected.

2. True HIV NAAT is very reliable at 12 days (but I think you mean to say Dr. Hook hasn't seen anyone with a negative result after 11 days, not positive). But that doesn't mean that either he or I recommend NAAT testing after particular sexual exposures. Indeed, we typically don't recommend HIV testing at all after any particular sexual event unless it's particularly high risk, like sex with a known infected person, for example. Rather than testing after individual events, for most sexually active person it's smarter to just have regular testing from time to time. That interval could be as long as a year (or more), or as frequent as every 3 months, depending on the frequency of exposure.

3. A little testicular discomfort after weight workout isn't abnormal and doesn't suggest HIV.

-I think this is my last question,thanks for the helpful reassurance I have anxiety from this particular sex encounter.I usually have sex with American  white woman a pretty low risk group for hiv.I just thought hiv was higher in El Salvador?

Negative for everything but chlamydia.Do I have to get another test for hiv?

I got negative hiv rna naat at 12 1/2 days.This was my only possible exposure under 6 weeks

The hiv 4th gen dou was negative 

Had I answered promptly, I would have advised there was little risk you caught anything. Perhaps by now you have had a negative HIV AgAb (4th generation) blood test 6 weeks or more after the event. If so, it proves you didn't catch HIV.

I don't understand "Negative for everything but chlamydia." Were you not yet tested for chlamydia, or did you have a positive test result? If so, I hope you have been treated for now.

Normally threads are closed after 28 days or after two follow-up questions and replies. But because of my delay in this reply, I'll leave the thread open for a few more days in case you see it and have more to ask or clarify. Apologies again for taking so long.

1.I have seen doctor hook say hiv rna is virtually conclusive at 11+ days?I was negative on a 12 1/2 day hiv rna/dou test,isn’t that virtually conclusive?

2.I have had another 6+ week hiv rna/dou test.You said this combo is conclusive at 4 weeks?Im waiting for the results of the test.

3.In the future what’s the soonest I can be tested with hiv rna naat/dou test for conclusive results if I’m worried?Ive seen you do probabilities before it seems basically impossible I caught anything and tested negative on hiv rna NAAT/dou at 12 1/2 days from 1 time vaginal sex.

1,2. "Virtually" conclusive for RNA/NAAT at 11-12 days is right, i.e. not quite 100%. All experts advise an antibody test or AgAb (4th generation) HIV test in addition to RNA for conclusive results and you're doing that. You can expect a negative result, confirming you don't have3 HIV. I would skip the 6 week RNA test. It's expensive and completely unnecessary.

3. The RNA tests actually are not designed for the main purpose of early diagnosis. Their main use is to evaluate viral load and the effectiveness of treatment in people known to have HIV. Don't get me wrong:  RNA is often used to rule out early infection, but as noted above always followed by Ab or AgAb testing. Whether you should pursue RNA testing in the future should depend on the risk of the exposure. If you only have sex with women, I don't see the need.

That said, I'm interested to learn the Dallas HD does NAAT routinely. It's the first I've heard of such a policy by a respected health agency. In that case, I see no reason not to keep using them following high risk sexual exposure. But I'm pretty confident they would agree that the low frequency of HIV in most females in North America usually doesn't warrant testing at all after any one exposure, unless she is at particularly high risk (e.g. IV drug user, sex worker) or known to be infected. Rather than testing after individual exposures, most sexually active people should just have routine testing from time to time, like every 3-12 months depending on sexual frequency.

That concludes this thread. Thanks again for your confidence in our services. Apologies again for the long delay in this reply.