[Question #12361] Qualitative PCR Detection Negative
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8 months ago
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Hi Doctor
I had unprotected vaginal sex with a female friend three times over 3 days. We discussed historic sexual partners in advance and the fact neither of us had STI’s. However, I have since learned that she was tested 7 months ago.
I had a blood test for HIV1&2, p24 and Syphilis 14 days after our last encounter. This returned ‘non-reactive’ for all. A week later (21 days) I had a Qualitative PCR for HIV1&2. This returned ‘not detected’.
I want to know please if this latest result is official and no further testing is required. I have seen some saying that it is official after 14 days, and others say get tested again after 42 days.
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Edward W. Hook M.D.
8 months ago
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Welcome to our Forum. Thanks for your questions and for your implied confidence in our service. I'll be glad to comment. The encounter you describe was very low risk to start with- I'm not sure I'd even recommend testing unless there is some other reason to do so. We do not necessarily suggest testing for everyone following sexual encounters with a new partner.
You tested however, proving that you were not infected with HIV. In the past we recommended follow-up testing at 6 weeks for persons with negative HIV RNA PCR tests however we no longer do this. Early PCR tests had limited data behind them and suffered with occasional falsely positive results. More recently however, PRC testing has become more reliable with much data to support the fact that a negative PCR test any time more than 11 days following an encounter of concern is conclusive and does not require follow-up testing. We are not aware of any instance in which a person with a negative test at day 11 of beyond went on to develop a positive test.
Your encounter was likewise close to zero risk for syphilis. Syphilis is, statistically rare and most syphilis today occurs among men with other men as sex partners. If you want a technically conclusive test for syphilis however, you will need to wait until 6 weeks following your last encounter of concern.
I hope that this information and perspective is helpful. EWH
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8 months ago
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Thank you for your reply, Dr Hook.
The reason for my message was that today (day 31 since the last sexual encounter) I have come down with a bit of a head cold, with some mild discomfort when swallowing last night and a cough whilst laying down and throughout today. I understand that flu-like symptoms are common with HIV infection, however I am hoping the change in weather and Air Conditioning are to blame.
Up until today/last night, I have experienced zero symptoms (i.e no rashes, lumps, loss of appetite or pain when urinating etc). My main concern was HIV as I know many don’t develop symptoms potentially for years and don’t know they have it, and my friend lives overseas so I cannot determine who she is seeing (and if she is engaging in intercourse with others unprotected who may be positive for HIV).
If the Qualitative PCR RNA result I have for HIV1&2 is now conclusive and there is zero risk of that ‘not detected’ outcome changing in the months ahead, I will follow your advice and not schedule any further testing for HIV.
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Edward W. Hook M.D.
8 months ago
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Like you, I would attribute your current symptoms to something other than HIV. Typically the symptoms of recently acquired HIV occur 10-12 days after an eexpsoure. They virtually never begin at 30 days you the onset of your symptoms is on thelate side.
I really would not worry and see no reason for additional testing. EWH
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7 months ago
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Thank you, Doctor. It is now 46 days since the last encounter and I have not had a further test for Syphilis based on your ‘almost zero risk’ comments. If you believe I should reconsider at all, please let me know.
One final question from me. Based on your experience, in your opinion, do you regard these three encounters as low / non-existent risk for Hepatitis B? (i.e if testing is recommended in your view). I am from the UK (as is my friend) and I do not recall being vaccinated for Hepatitis as a child. I do not know my friend’s vaccination status (albeit I will ask), however there is every chance she too is unvaccinated for Hepatitis as it was not compulsory for babies in the 90’s in the UK.
As mentioned above, it is now 46 days since the last sexual encounter and I have experienced zero symptoms aside from the head cold which disappeared after 2-3 days and occasionally feeling tired (we both suggested this was down to other factors). I would hope that any fear of contracting any STD from these encounters can now be put to bed and I can be worry free. Any assurance from yourself would be greatly appreciated (I admit I do get anxious when it comes to health).
Thank you for your assistance and all the best for 2025!
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Edward W. Hook M.D.
7 months ago
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My assessment is unchanged. Your risk of syphilis is close to zero. If it helps address your anxiety then by all means test. I anticipate the test will show that you don’t have syphilis.
The risk of hepatitis B is likewise very, very low. I see no need for you to test.
This completes this thread which will be closed shortly. It’s time for you to move forward. EWH
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