A condom was worn and it was relatively short 5-10 mins without ejaculation, there was unprotected oral each way also. On day 23 i had 3rd gen home test(non reactive), on day 28 i visited a sex clinic and had an insti ag/ab ( finger prick) which was negative, same again on day 38 negative also. This created some peace of mind until yesterday when i woke up with a pain in my armpit, i suddenly got worried again, but i believe from reading your posts this js too late to seroconvert is this true? I also developed general malaise although i believe this could be due to ongoing stress in relation to overthinking and reading about the subject on forums. Basically my question is what do you think my risk is? And do you think based on my symptoms should i get tested again. I know they say 45 days but is 38 days nearly as good? I tested with finger prick 4th gen and im reading venous and lab test are more accurate, how much more accurate? Thank you again and thanks for your work

It is 100% certain your armpit pain isn't due to HIV from the exposure described. It is not possible to have HIV symptoms in the face of a negative test 10 days previously. And armpit pain doesn't suggest acute retroviral syndrome (ARS, i.e. new HIV infection) anyway. (And whenever someone suspects his or her own symptoms have a psychological explanation, like stress, usually s/he is right!)

As for your risk for HIV, it was near zero. Condoms work well in preventing HIV anally, and oral sex is nearly zero risk even unprotected. And your test results are nearly 100% reliable. The rapid tests are extremely reliable -- they miss a few more infections than lab-based blood tests, but negative results are at least 99% equally accurate. The main issue on your testing is that 38 days is a bit early. The AgAb tests detect 100% of infections after 45 days. Your negative result still is proof your symptoms aren't HIV -- but to be certain you don't have an asymptomatic infection, test one more time after 45 days.

Stay mellow in the meantime. You definitely can expect a negative result.

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

HHH, MD

I also reached out to the person who said they were on Prep although i have no way of confirming this. But the escort was a high end expert and seemed very professional and clean. So just to conclude my symtoms aren't HIV related but should test just for absolute certainty. 

Thank you again