[Question #10069] Test Reliability
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26 months ago
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Hello! I’m a heterosexual, non-drug-using male from East Asia. I did my last test (HIV1&2 antibody + p24 antigen) in Oct 2022 after getting out of an exclusive long-term relationship with a girl. Test was done on exactly the 18th day since my last unprotected vaginal sex with my ex. The result was negative, and the clinic's doctor said it's safe to move on. I didn't doubt it until I recently read info on different websites that the window should actually be up to 4 or even 6 weeks. This got my confused and worried because I did ask the doctor if 18 days were long enough, and they said the window period for my test was just at least 14 days. My questions: (1) Am I still safe? (2) Would 14 days be the latest norm in terms of window for the HIV 1&2 antibody + p24 antigen test? I started dating someone this year, and did inform the girl that I am clean (based on the test in Oct 2022) before we engaged in sex. I certainly don't want to put myself or anyone at risk.
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Edward W. Hook M.D.
26 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment. Most women do not have HIV so unless there is something in particular about your ex, I suspect that your risk for HIV was low. Despite that, testing is reasonable. In terms of your last unprotected exposure to your ex, you were tested too early. The results of 4th generation, combination HIV antigen/antibody tests are not entirely conclusive until at least 6 weeks after an exposure. After that time, results are entirely reliable however, if you want to assure yourself that you did not acquire HIV from you prior relationship, re-testing is reasonable.
I hope this information is helpful. If there are further questions, please don't hesitate to use your up to two follow-ups for clarification. EWH
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Edward W. Hook M.D.
26 months ago
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In follow on to your 2nd question. The woman you describe certainly sounds to be low risk and she indicated that she had been tested and was negative. Most people tell the truth and if I were you, I would believe here. As a generalization, there are 3 main reasons for testing:
1. To relieve anxiety following a risky exposure or exposure to a partner whom you are unsure about.
2. If you know that you were exposed to a person with HIV
3. As a good sexual health practice we recommend that persons entering new relationships or with multiple sexual partners be tested periodically, usually about once a year for HIV and other STIs. Such testing would include tests not only for HIV but for other, more common STIs such as gonorrhea and chlamydia. When done by both partners at the beginning of a relationship, this providers each person with confidence in the other.
I hope this perspective is helpful. You still have two follow-ups if any part of this reply is unclear. EWH
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26 months ago
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Thank you, Dr Hook! For my test in Oct 2022, it seems it wasn't conclusive. I plan to re-test now, but a high sense of anxiety has kicked in, knowing that the previous result may not be accurate. A few follow-up questions:
(1) What might be the chance of my result turning out different? If a test on the 18th day was negative, how likely would that change after that?
(2) Will be test be affected by any medication I took earlier this month, or health supplements that I have been taking on a regular basis ?
(3) It's been long than six weeks since I had any possible exposure via sex. If I test now, result should be absolutely conclusive, right?
(4) Could it be my HIV-anxiety that has contributed to what I am feeling/thinking/fearing right now?
P.S. Both my partners last year and this year are heterosexual female who are not drug users. They have both indicated that they have no STDs that they "know of", and there is nothing I should "worry about" (though I haven't seen any of their test report as proof.) They're both from good education and family background, and lead healthy lifestyles. Speaking rationally, I wouldn't have any reason to doubt them, but my mind has been playing tricks on me, especially when I realised that there's now some uncertainty regarding my previous test.
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Edward W. Hook M.D.
26 months ago
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From all that you say, your anxiety is misplaced. In response to your follow-ups:
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(1) What might be the chance of my result turning out different? If a test on the 18th day was negative, how likely would that change after that?
I suspect the result is the same. My reasoning was explained in my original reply. Repeating the question will not change my response..
(2) Will be test be affected by any medication I took earlier this month, or health supplements that I have been taking on a regular basis ?
No
(3) It's been long than six weeks since I had any possible exposure via sex. If I test now, result should be absolutely conclusive, right?
Yes
(4) Could it be my HIV-anxiety that has contributed to what I am feeling/thinking/fearing right now?
Yes
EWH
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26 months ago
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Thank you again, doctor. I went for an antibody+antigen test on Monday here in my time zone, and got my result from the lab in just over a day's time. It's NEGATIVE. I can now move on in peace, and put all my past relationships/exposures behind.
Last question: In these 2-3 days, there's been a cold sore developing on the corner my mouth. I know it's probably not considered an "open wound", but when I wiped it with a napkin, I found out that it was bleeding a bit, which still got me concerned. It's likely that this cold sore was exposed in open air while I was out there in the clinic, in public bathrooms and a crowded subway train. Not sure if any fluid got in touch with it. I might have even touched it with my own dirty fingers at some point. An active cold sore is not an opening for HIV to get in, right? (Even if it's bleeding?) Just hope to make sure.
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Edward W. Hook M.D.
26 months ago
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Thanks for sharing your results. They are as I predicted, and I trust they will allow you to move forward without continuing concert.
Please don’t worry about your cold, sore, bleeding or not, as a potential source of infection. Without direct contact, there is certainly not even theoretical risk of infection. Similarly, touching it would not result in infection.
As you know, with this third reply, this thread is completed and will be closed shortly. I hope the information I have provided has been helpful to you and that you will be able to move forward without continuing concern. Take care. EWH.
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26 months ago
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Sorry, doctor,I know I shouldn't make another post, but I just hope to clarify what you mean by "direct contact". Someone was coughing right in front of my face in a crowded space and that person wasn't wearing a mask. If there's blood being coughed out and touching my cold sore, is that a "contact"?
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Edward W. Hook M.D.
26 months ago
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Coughing is not direct contact. Direct contact is one when one surface directly touches another. End of thread. EWH.---