So here’s the story, I had 3 possible exposures and I’m worried mostly about the first one. 

1) First was sex with a condom but she was on her period slightly so there was a little blood at the base of my penis where the condom doesn’t cover, and that’s worrying me, I was tested 29 & 43 days from this exposure with 4th gen lab test and was negative, I contacted her about it and she basically got offended and said she doesn’t have anything, but didn’t provide proof or go get tested for me. That raised some concerns. 

2) The second girl was the day after so 42 days when I took my last test, we didn’t wear a condom for like 2 mins then I got paranoid and put one on, but she was very nice and even got tested with a finger prick 4th gen and a lab and both were negative. She also stated her only partner before me was 3 weeks prior and was completely protected.

3) The last girl, was 40 days prior exactly from when I got tested last, no condom at all, but she also was very forthcoming and got tested multiple times for me with two 4th gen finger prick tests, a lab test, and a 4th gen rapid home test, and was negative. She has also explicitly stated I was her only partner in a year or more and is willing to get tested again.

So, this is all my info. I was tested twice with the 4th gen lab test roughly 4 weeks and 6 weeks from each exposure give or take a few days. My question is, can I let this go and move on, or not yet? I still have lingering anxiety about this and would like to move on, preferably without testing again because I have had extreme anxiety/depression waiting for results both times.

Thank you for your time.

This is an easy one with a brief answer that should be completely reassuring. Your test results conclusively prove you were not infected with HIV during the first exposure, and so close to conclusive for the second and third that you should not be worried at all. Since the test results are conclusive that you do not have HIV, the level of risk for the exposures themselves is irrelevant. 

1) The first exposure was risk free for all practical purposes. Blood on the skin of the penis doesn't risk HIV at all.

2,3) Both virtually zero risk exposures with a partners who proved to you they don't have HIV, so no worries.

So all is well, let it go. Don't have any more HIV tests on account of these events. (Actually, you didn't need testing anyway given the zero risk nature of all three exposures.)

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

HHH, MD

I kind of knew that the first exposure was no risk but as you know anxiety and the mind will play tricks on you, and I started thinking of irrational what if scenarios. I also tested for all other STDs during the week 4 test, I know it’s not conclusive for all STDs but given the first girl I wore a condom with, and the other two both got tested I’m not too worried about it.

I will follow your advice and try my best to accept these results, I have started therapy due to this health anxiety because I know that a lot of my fears and anxiety are irrational. I still may do one more test in the future just to completely reassure myself, if I can work up the courage. (One of the reasons I have lingering doubts, is the telehealth provider who ordered my 2nd test said I need to re-test at 4-6 months “just incase”). But I don’t want to end up like some people who get repeatedly tested for no reason and make it an addiction. 

Thank you again for your time, answering my question, and reading through many of the questions here has really reassured me. I will continue to work on moving past this.

I'm happy to hear you're taking steps to deal with your anxieties on this. As I starting point, I would simply advise that you think about what you're actually anxious about. Is it really infection? Or about a sexual lifestyle and sexual choices you might regret? As you well know -- intellectually if not in your gut -- they aren't the same.

Thanks for the thanks. I'm glad to have helped. Each question comes with two follow-ups, so I'll leave this open in case something else comes to mind in the next few days.

But I do have lingering doubts, like could I be immuno compromised and that’s why I’m still negative. I mean I don’t think I am, but I think the reason the conclusiveness of the test was changed from 4 weeks to 6 weeks in the first place was due to to the immuno compromised people/late seroconverters in the first place correct?

Yes I am trying to do a lot of work with my anxiety because I know that this is likely where all the fears come from. I think my biggest thing is I recently got into a serious relationship with a woman I really care about and my fear is that I would infect her and hurt her some how. That and maybe the guilt of sleeping around is weighing on me I think. 

Thank you again, your expertise and knowledge has eased my fears a lot, now I must work on my mental health to completely get over it.

You entirely are wrong on the rest and do not understand the biology of HIV and the immune response to it.  Outwardly healthy people never are significantly immunocompromised, and such immune problems INCREASE the speed and strength of a positive test result, not decrease it!  And It is not correct that "the conclusiveness of the test was changed from 4 weeks to 6 weeks because of anyone's immune system problems. The few with delayed positive results had normal immune systems.

Perhaps it will help you also to know that in the 20 years (!) of this and our previous forum, with thousands (!) of questions from persons worried about possible HIV risk, not one has yet reported they eventually tested positive. If and when that finally happens, it surely will be a truly risky event and not a trivial exposure like the ones you describe. (Think unprotected anal sex between men at true risk.) People with exposures like yours virtually never get HIV.

Best wishes.