[Question #12995] HIV Testing Concerns

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3 months ago
Hello Doctors,

Hoping you can help ease some anxieties I’ve been dealing with over this whole ordeal. 27 days ago I had protected vaginal intercourse with a female ex girlfriend. She was on her period when we had sex but I am confident the condom did not break as I checked after removal. I am prone to health anxiety so I have been freaking out ever since. At 19 days post potential exposure I had a 4th gen antigen/antibody HIV 1/2 blood test done which came back negative. At 24 days I had an HIV-1 RNA blood test done which also came back negative. Can I put my mind at ease and believe that I don’t have this disease now that I have these results?
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H. Hunter Handsfield, MD
3 months ago
Welcome to the forum. I'm happy to help.

You were at little or no risk for HIV. Had you asked ahead of time, I would have said HIV testing wasn't necessary. Given your assumed uncertainty about your ex-GF's risk for HIV and other STIs, you were smart to use a condom. It made an already near zero risk even lower.

More detail:  Assuming your ex gf isn't a sex worker, injection drug user, or the sex partner of such a person, the chance she has HIV is near zero. And condoms are very effective prevention. Further, blood exposure makes no difference:  the amount of HIV in menstrual blood is no higher than in vaginal fluids, sex during menstruation doesn't raise the risk of infection even if she had been infected. Even before you were tested, I would judge your risk of HIV from this event to be under one chance in a billion. More important, your test results are 100% proof you were not infected.

So all is well, nothing more to worry about. Let me know if anything isn't clear.

HHH, MD
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3 months ago
Thank you very much for your reply! Definitely helped put my mind at ease. I was planning on get one more 4th gen test tomorrow on the 28th day (based on guidelines I read on the internet) to completely close this chapter, but it seems that you wouldn’t deem that necessary based on the fact that it was a low risk event and my already negative test results. Is that correct?

Thanks again for all the info. This forum has been a blessing for my anxiety.
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H. Hunter Handsfield, MD
3 months ago
Six weeks (actually 45 days) is now the consensus on conclusive testing with the AgAb (4th generation) HIV tests. Four weeks (28 days) is ~98% conclusive. However, the RNA tests are conclusive any time after 11 days; and the combination of your two test results so far is absolute proof you don't have HIV. You don't need any more tests; as I said, you didn't need any testing at all except for reassurance.

I'm glad my comments have been helpful. Thanks for the thanks.
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