The bottom line is that you can be completely certain you don't have HIV; no more testing is needed. Here's why:

There are two take-home messages from the HIV tests in general:  1) whether or not someone is infected, usually the only thing people think about; but equally important is 2) whether or not symptoms are due to HIV. Your negative test results show both of these desirable outcomes. The symptoms of a new HIV infection are not caused by the virus itself, but by the immune response to it. At the same time, the virus must be present as well if symptoms are due to HIV. As a result, it is impossible to have symptoms of a new HIV infection and test negative. This is true even for much earlier symptoms than you had. Your test results therefore mean that your symptoms cannot possible be from a recently acquired HIV infection.

The negative results at the times you had them are 100% proof you didn't catch HIV. That would be the case even if you had no s ymptoms:  negative RNA at 2-4 weeks plus negative antigen-antibody testing (AgAb test, i.e. 4th generation) at 28 and 34 days, taken together, are conclusive. (Without RNA testing, the AgAb test can take up to 6 weeks, so you might want to consider another AgAb test at that time. But it relly isn't necssary.

On top of all that, you describe a very safe sexual exposure. Congratulations on using a condo for anal sex. That said, you might consider this a learning experience:  you also could and should have discussed your mutual HIV status with your partner. And assuming such exposures are likely to continue from time to time, please consider pre- or post-exposure prophylaxis with anti-HIV drugs. 

For what it's worth, your symptoms are not particularly suggestive of HIV, but at this point it doesn't matter anyway. (FYI, coated tongue and/or white patches orally isn't necessarily oral thrush, i.e. yeast infetion. Coated tongue is far more common than thrush and occurs with innumerable minor health problems.

So all is well -- no further worries about this event. See a doctor if your symptoms continue or you otherwise remain concerned, but for sure you don't have HIV.

Best wishes--   HHH, MD

I know the CDC says after 45 days it is conclusive but on the std check website they say their 4th gen test is conclusive at 3 months. The labcorp test that was taken is the "Ab/p24 Ag with Reflex" test. Is this the correct 4th generation test? Im not sure if there are other types.

Also do you know how reliable LabCorp is? I've gotten all my tests done from there and I'm not sure if testing somewhere else might change my result. I would go to MedExpress but I'm pretty sure they also use labcorp for testing.

The 4th generation test says they test for HIV - 2 antibodies and not antigen. Do i need to test again to rule out hiv - 2? I know HIV antigen tests are accurate starting 8 weeks. so, should i get tested again at that time or wait three months? 

I know tests always overrule symptoms, but my symptoms are still here after 3 weeks. Do ARS Typically last that long or after a month of exposure? 

Also have you ever seen a test negative at 46 days test positive later? I'm worried if i ever engage in sexual activity with someone and dont test again after my last test (46 days) that there might be a chance that i still have the virus and might pass it on. 

Also thank you for your response. I think the more I know will help me calm down a bit. 

 

And no, I have never seen or heard of a patient who tested negative after 45 days who later tested positive. As I said above, it has not been known to happen (not counting people who took anti-HIV drugs as post-exposure prophylaxis that didn't work -- and even this is rare). There is no possibility you have HIV or that you can infect anyone else.

It doesn't matter whether or not you have an oral yeast infection (thrush). It is common in people without HIV or other immune deficiencies, and your HIV test results prove you do not have HIV regardless of what symptoms or health problems you have now or might develop in the future. There are no medical conditions of any kind that alter the reliability or timing of the HIV AgAb (4th generation) blood tests. Of course you are free to be retested for HIV -- you can discuss with your doctor -- but if you do, you can count on another negative result. 

Oral thrush or similar conditions, and your other symptoms, are not consistent with any other STD. However, your "full screening 2 weeks after exposure" was too soon for any and all blood tests. Also, it would have had to include throat and rectal swabs for chlamydia and gonorrhea to be valid -- the usual tests of urine or urethral swab of course cannot detect infection at other exposed sites. You were protected from these and almost all other STDs during the condom-protected anal exposure, and oral exposure is inherently low risk. However, you could ask your doctor about further testing. That said, for sure you don't need another "full panel":  maybe throat swab for gonorrhea/chlamydia, and a syphilis blood test. But no other tests need be repeated. (OTOH, sometimes a "full panel" is less expensive than a small number of individual tests, so feel free if that's most economical. But in any case, none of these other STDs has any bearing on your symptoms or on your HIV test results.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.