Hello Doctor,Last week my friend asked a question here about an exposure I had. Given your advice, I created a personal account and came here to ask some follow-up questions. As you suggested, my friend allowed me to use his cc for payment and is also here to do the translation because my english is very bad. You already know my exposure, and you also commented on the fact that my friends exposure was very similar. That is why I am here, because I knew how worried my friend was about his exposure some months ago, and I kinda was supporting him during that time. I'm way more anxious about STDs than him, and now I find myself here due to his advice. Let me tell you that he definetly learned a lot with you on this forum and he gave me great advice.

However, my worries are still here, and I will explain: After your advice a week and a half ago, I was prepared to move forward without worries. However, my anxiety got the best of me and my friend told me that maybe a test would calm me down. So, 27 days after my possible exposure, I did a 4th gen rapid determine fingerprick test that was negative. What got me worrying again was that 2 days after the test i developed something that I can only describe as a mild folliculitis on my abdominal area (on the left and right side of my belly button) in areas where I have stretch marks. Once again I consulted with my friend, and he told me that he learned here that a rash would never be the only symptom of HIV ARS and it would have to be coupled with sore throat, fever, etc. Also, he knows that I'm very hairy, I sweat a lot and that this folliculitis happen right after a session that I did at the gym, so that was most likely the cause. Furthermore, he let me know that this would be rather late for ARS that normally happens between 7-10 days after exposure. Me being me, still felt the need to go back for another rapid 4th gen test that was negative 2 days after this "rash" (31 days post exposure)

My questions:

1- Can I believe this rapid 4th gen test? Are they as good as lab tests?

2- When is this test conclusive? Nurse at the testing center told me 3 months, but my friend said that you advise that all 4th gen is conclusive at 6 weeks.

3 - Do you think this rash/folliculitis could be HIV ARS? Is the timeline even right? I dont have any other symptoms and even this rash is going away already

4- Can I have symptoms and test negative with a 4th gen rapid test? 

5 - If my results are to be believed, should I even proceed with further testing at a later point?

6 - What is the likelihood of my results changing if I were to test again taking into account my exposure?

7- Nurse told me that I had a 0 risk situation and that I shouldn't be worried, what is your advice?

Thank you so much

Welcome back. Glad to see you're asking your own question now. However, I'm not sure I can help much. Clearly you have misunderstood the previous advice from the other discussions, both your own and your friend's:  negative test results PROVE that any symptoms you have are not possibly due to HIV. Having had a negative test, nothing you describe after your negative test cannot possibly change our advice that you do not have HIV and need to look to other explanations for your symptoms. Your possible exposure(s) to HIV do not matter:  whatever the risk at the time of those events, your tests show you were not infected. To your specific questions:---

Thank you so much for your answer doctor, I just have a couple of follow questions and I will try not to be repetitive:

1. At 31 days, the AgAb tests probably detect around 99% of infections. Since the risk of HIV was extremely low, you can consider this result conclusive. But if emotionally you require a 100% conclusive test, you'll need to do it again 45 days or more after the event you are concerned about.---
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Dear Dr HHH, I hope you are doing well.
First of all thank you for the advice that you gave me.
Since then I managed to control my anxiety a little bit, and I also followed your advice and went to have a 4th gen Abbot rapid fingerprick test at 50 days (7 weeks) post possible exposure. Like you predicted, it was negative.

I was ready to move forward but after searching the CDC website, they mention that these tests, even though they are ag/ab,  have a 90 day Window period just like the the antibody only tests, which got me a little confused since you told me that they were just as good as the 4th gen lab tests that are conclusive at 6 weeks. 

1- Can you please clarify why the CDC gives a 90 day window for these tests just so I can understand better the logic behind the guidelines?

2- Can I now consider myself 100% clear of HIV? Or would you recomend for me to pursue a lab based 4th gen test?

3- Would you say that to consider myself 100% clear I would need a test at 12 weeks or is further testing unecessary? Were I to test again further down the line, would my results change regarding this exposure?

4- In your opinion, is there any "next steps" I must take in order to move forward regarding testing or possible window periods?

Thank you so much for your patiente Doctor HHH, I appreciate all the work that both you and doctor Hook do in helping people, and I apologize if my questions are a bit repetitive. 

Ps: if you can, please let me know how I can donate to help the fight against HIV, thank you so much 

Sorry for the delayed response.---