Thank you both for being so gracious with your time to help individuals such as myself with OCD and anxiety. I cannot seem to get out of my head regarding testing using 4th generation, and how P24 antigens and antibodies work. You can read a multitude of information online and you will find cases where it seems that infections were missed. If you could please provide me with some reassurance that would be great. 

1. How long do P24 antigens last in your system?

2. Will a 4th generation test at 7 months miss the antibodies or antigens? Repeated false-negative HIV rapid test results in a patient presenting to care with advanced HIV disease: A case report - PMC (nih.gov)

3. Have you ever had someone test positive after 45 day negative 4th gen test?

4. Is it possible for the 4th generations to give false negatives after 3 months?

5. Does saliva kill HIV?

I don't know why I cannot let this go. I have had repeated testing from an oral exposure in October of 2023. I know Dr. Hook had reassured me before. And I feel foolish for coming again. I am just so scared of having a positive test randomly pop up and all this time I thought I was ok. 

The case you cite is irrelevant to your situation. It involves someone who had advanced infection, i.e. overt AIDS, when the immune system is so damaged that it affects some but not all test results. Nobody with infection under a few years in duration ever has negative results on the tests you had.

1. How long do P24 antigens last in your system? This doesn't matter. After 2-3 weeks, and always after 6 weeks, p24 antigen or antibody or both are detectable for life.

2. Will a 4th generation test at 7 months miss the antibodies or antigens?  No, never.

3. Have you ever had someone test positive after 45 day negative 4th gen test?  No, I have not even heard of it ever happening.

4. Is it possible for the 4th generations to give false negatives after 3 months? Same question using different words. No.

5. Does saliva kill HIV? Saliva at least inhibits the virus, and exposure to saliva rarely if ever transmits HIV.

I don't know why I cannot let this go. I'm no psychologist, but I imagine it's the result of ambivalence, shame, regret or other negative reactions to the sexual exposure you described. It definitely is abnormal to be so resistant to the reasoned, science based explanations you have had. If you cannot shake it, professional counseling probably will be necessary. I suggest it from compassion, not criticism.

In the meantime, stay off the internet. Like most persons anxious about a health problem, you're being drawn to the rare, unusual cases that inflame your fears and missing the reassuring information that also is available. It isn't worth it and I suggest you stop searching. Perhaps it will also help you to know that in the 20 years of this and our preceding forum on MedHelp.org, with thousands of questions from people worried about possibly having HIV, not one has yet turned out positive. You will not be the first. If and when it finally happens, it certainly will not be a trivially risky event of the sort you describe.

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

HHH, MD

There is no such thing as HIV "hiding in the body unable to be detected".

If you cannot stop this obsession, the logical next step is professional counseling. It is not normal to be so resistant to reasoned, repeated, science based advice as you have had.

It will not change our advice to find another way to ask for the same reassurance in different words. Therefore, I am closing this thread now. Please do not post another question along these lines:  there is a forum policy against repeat questions on the same exposure or topic, especially when anxiety driven. This being your second, it must be your last. Further attempts will deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism (as is my suggestion about professional counseling); repeated replies often prolong anxiety rather than relieving it, and ASHA is not keen on collecting fees with obvious, unchanged answers. Finally, such questions have little educational value for other users, one of the forum's main goals.

Thank you for your understanding. I hope the previous advice from Dr. Hook and this discussion help you move on with your life. Best wishes and stay safe.