[Question #12220] Hiv Risk

9 months ago

Hi,I’m 25 old male from Armenia (caucasus). I had protected vaginal and oral sex with strip club worker and she showed her test results that were 4month ago before the event and all were negative including hiv and all other stis. After 11 days I had weird body aches that lasted only one day, mouth ulcers like herpes , sore throat lasted 3 days and nasal cognestion without drip. After that 19 days after the event( sex with her) I had hiv 4th generation and PCR tests and both came back negative. Can I move on or more testing is needed .

I trust and respect all the docs here but would really like to get answer from dr HHH

9 months ago

And condom with outside part touched head of my penis after sex when pulling off ( nota slipped or teared during sex) and also tested the condom with water and it didn’t leak or tear

Edward W. Hook M.D.

9 months ago

Welcome to the Forum. I will be replying. Clients do not get to choose who replies to them. FYI, Dr. Handsfield and I have worked together for over 40 years and while our verbal styles differ, we have NEVER disagreed on the facts of our reply.

The exposure you describe was virtually no risk. Most commercial sex workers do not have STIs and the fact that your partner had negative tests just 4 months ago made it unlikely that she had become infected since she last tested. Further, even most unprotected single exposures do not lead to infection and in your case you used a condom which eliminates the risk for most STIs including HIV. The fact that you had a negative test proves that the symptoms you describe were NOT due to HIV.

That your penis touched the outside of your used condom does not change this assessment. You do not need further testing.

I hope that this information is helpful. EWH

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9 months ago

Thank you Dr for the answer!

Let’s assume that that was a high risk and again I tested negative both pcr and 4th gen test after 19 days. Can I consider it as conclusive? I saw dr Hunter Handsfield answered to another question that at 20 days negative pcr result is 100% conclusive. Why most of the internet says that except pcr people need anither 4th gen test after 6 weeks? Is it likely to get positive after testing negative at 19 days? (pcr and 4th gen)

Edward W. Hook M.D.

9 months ago

Whether or not your partner was "high risk", whatever that means, an HIC RNA PCR is conclusive any time more than 11 days after an exposure. You can be confident that you did not acquire HIV. In the past, before there was much experience with PCR, it was recommended that persons with negative PCR tests get a 4th generation test in follow-up about 6 weeks after an exposure of concern. With more experience, clinicians have become more comfortable with PCR test results and I see no medical reason for follow-up 4th generation testing in your case. Like so many of our clients, you have been mislead by the interent which has given you out of date information

Please don't worry. You have one follow-up remaining. EWH

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9 months ago

Got it! And my last question: Approximately from when experts find it conclusive after 11 days? I ask this because in my country they still recommend 4th gen test :) and I must admit that we're not that advanced in Health Care industry...
And finally, negative PCR and 4th gen test after 19 days is 100% conclusive and no furher testing is needed right?

And thanks a lot doctor! A true professional!

Edward W. Hook M.D.

9 months ago

Any time more than 11 days, for instance at 12 days and beyond, HIV PCR tests are conclusive. The recommendation of additional testing with 4th generation tests is out of date although, in large part because of the greater expense of PCR testing, 4th generation tests are preferred. For 4th generation tests- when performed in the presence of symptoms a negative test proves that the symptoms are not due to HIV. Otherwise, in the absence of symptoms due to HIV, 4th generation tests are more than 98% conclusive at 28 days and entirely conclusive at 6 weeks (42 days)

Your negative HIV PCR test at 19 days is conclusive, proving that you were not infected, There is no need for additional testing at this time.

This completes this thread. Take care, please don't worry. EWH

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