First off, I am so grateful for this site and you have brought me a lot of peace during the last 6 months. 

I am a 31 year old woman and had out of character unprotected sex 6 months ago after a first date and went into a dark shame spiral. I was so terrified I could have contracted HIV. I took a rapid finger prick test (was told it was antigen/antibody) at a little over 6 weeks after the encounter. The doctor at urgent care told me the results could only be 70% accurate at this time (what!?) and that I’d need to do a vein test to confirm. 

I haven’t gotten my arm test done as I read on here that at 6 weeks it would be conclusive. However, I went back to urgent care yesterday and found out today I tested positive for BV and candida, both of which are things I’ve never had. Also, my urinalysis came back with out of range ketones and blood. Ever since, I have been extremely terrified that these all are happening because perhaps that doctor was right and my rapid test was only 70% true and it could have been a false negative. 

Would it make sense that my bv/candida as well as ketones and blood could all point to HIV? You are all the doctors I trust the most on this subject after researching your backgrounds and I am totally needing some support. I can get my arm blood test but am hoping to wait until after the holiday due to anxiety during waiting for the result. Thank you thank you thank you for this site and I hope you have a lovely holiday

You really should not be at all worried about HIV. You don't say anything about your partner 6 months ago, but if you're in the US, I would bet that not one person in 10 million would acquire HIV from such an exposure. And even if your partner were at high risk (sex with men, injection drug user, recently incarcerated, etc), your negative rapid test is much more reliable than you were told. I'm sorry you found an urgent care doc who doesn't understand HIV testing, but your negative AgAb test at 6+ weeks was nearly 100% reliable. (I say "nearly" only because the rapid tests aren't quite as reliable as the lab based tests. But I've never seen or heard of a patient with a negative rapid AgAb test at 6+ weeks who later turned out to be infected.)

Your vaginal yeast infection and bacterial vaginosis do not hint at having HIV. Candida isn't sexually transmitted or acquired:  it results from normal candida, previously in the vagina, that overgrows; it's not an infection you catch somewhere. And BV is extremely common in sexually active women, independent of STD risk. Have you been sexually active since the event 6 months ago? And were you tested for STDs in addition to HIV? If not, that would make sense now.

A urinalysis with ketones is not abnormal. Ketones are mainly a reflection of diet in the previous 24 hours:  perhaps you hadn't eaten much in that time. Blood in urine? The first consideration, and by far the most common in women, is a non clean-catch specimen with vaginal fluid contamination, especially in women menstruating at the time. Your candida also could have had an influence. In any case, there is nothing in this that suggests HIV.

Bottom line:  Repeat the urinalysis. Get tested for common STDs if not yet done (gonorrhea, chlamydia, syphilis). And have a lab based HIV test, ideally another AgAb test. It will be negative.

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

HHH, MD

That gives me so much peace that the blood and candida do not point to HIV and I’m also grateful to hear the urgent care doctor was wrong. I was considering getting a follow up finger rapid test again as waiting for results makes me so anxious, but I have read it is possible to have false positives ? 

I have medical related ocd so HIV is a big source of anxiety. I have been abstinent ever since as this experience has been so traumatic. Tremendously grateful for your reply— I will try to stop worrying !

Glad to hear your other STD tests were negative.

But for reassurance, and given your health-related OCD, why rely on another fingerstick test with its small level of doubt? Just have a lab based test. Then stop worrying when you get the negative result.