[Question #13006] #12924 follow-up - quick question

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3 months ago
Good morning,

In my last question (#12924), Dr. Handsfield reassured me that I had nothing to worry about since having unprotected oral sex performed and received with a woman.  Due to lingering thoughts, I've been planning to get a single HIV test through Quest once 42 full days have passed, but I have a question about the timing.  I have travel plans for Memorial Day weekend and this Thursday morning it will be 42 full days since the oral sex stuff I talked about in the last question.  The issue is that I'm supposed to leave town and I would have to test 2 or 3 hours before a full 42 days have passed (in other words, something like 41 days and 22 hours).  Would this be considered conclusive or should I wait until next week?  I'd prefer to have this done earlier as it's clearly still on my mind a bit and I'd like to get rid of it.  I appreciate all of your help!  Thanks!

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3 months ago
Slight typo - meant to say 2 to 4 hours before a full 42 days.
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H. Hunter Handsfield, MD
3 months ago
Welcome back, but I'm sorry you found it necessary.

You're way overthinking the situation. A few hours makes no difference in test reliability. And the actual interval to conclusive testing is 45 days; we just round it off to 6 weeks which is 42 days -- in other words, even a 3 days variation probably makes no difference. But anyway, given your zero risk and 100% certainty of a negative test result, it shouldn't be a big deal to wait until after you return home to be tested. Or do it at a few hours under 42 days if you just can't wait. There is no chance you have HIV. Believe it, stop worrying, and maybe don't get tested at all.

HHH, MD
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3 months ago
Thanks doctor for the reassurance.  I have lingering anxiety which is why I'm trying to have a conclusive result.  Unless I misunderstood something, it seems like a few hours short of a full 42 days doesn't make any difference when calculating 6 weeks.  I'd rather get this done asap and get rid of lingering anxiety, so I appreciate you helping me out.

I also wanted to mention that my annual physical was last week and I discussed this with my nurse practitioner, who I respect and trust.  It was her opinion that the quest 4th generation test was "conclusive at one month."  Is that the old standard or did something change?  From your response it seems like she might be mistaken.  Anyway, I just wanted to check on her advice with you.  Thanks!
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3 months ago
Also wanted to add that I 100% trust your responses and that I really don't need testing at all, but seemingly like many, many other people on this forum, I can get stuff stuck in my head.  Just want to get rid of it and move on.
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H. Hunter Handsfield, MD
3 months ago
I can't answer the issues about time to conclusive testing -- and test reliability just short of 42 days -- any better than I already did. In principle the AgAb tests should be conclusive at 28 days and many experts cite that figure. But the fact remains that rare cases have been documented in which it took as long as 45 days. However, if 42 days is say 98% conclusive and the risk of HIV was say one chance in a million, then with a negative result your odds of having caught HIV become one chance in 50 million. I hope you would agree that's zero for all practical purposes.

Our role is to give our best evaluation based on the science and not otherwise to address your anxieties about all this. We aren't psychologists and that part is up to you. How to "get rid of it and just move on" is in your department, not ours. Thanks for your understanding. 
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