[Question #13169] HIV Testing

1 months ago

Hello!

Long time reader, first question! I’m a 28 year old straight male from east coast US. I have been talking to this girl for multiple months now and having random hook ups since we are not officially together. All protected besides receiving oral sex (blow job.)

We are going ton vacation next week and I would like to make it official. I got tested at a labcorp and all results are negative! I asked my doctor if I am allowed to have unprotected sex with my hopeful new girlfriend, and she said I had to wait three months for HIV to be 100% accurate!

So, now I’m anxious! I’ve read before that you guys trust it at 45 days. So I’ll go through my exposures and tests and want your advice!

30 days protected vaginal sex, woman said she tested in December and was clean. I know her and she has multiple partners, but uses condoms. Said she had one hook up without a condom but said it was after me. Could be a lie.

7 days post unprotected receiving of oral. No idea on status of STI’s/HIV.

I did a full hiv ag/ab 4th gen and syphilis blood test, gonorrhea/chlamydia urine test. What do you guys think I should? Not have sex with her unprotected, even if I ask her to be my girlfriend? How accurate are my tests? Why did my doctor say three months?

1 months ago

Tomorrow will be day 38. I am thinking of getting tested for HIV RNA/PCR and another 4th gen if advised by you guys for 100% accuracy

Edward W. Hook M.D.

1 months ago

Welcome to the Forum. I'll be glad to comment. If you are going to move forward with this relationship, trust, rather than worrying that your partner might be lying is an important foundation for the relationship. You've done well to talk about each others' recent testing history and believe the information you have each shared makes it most unlikely that she has HIV (or other STIs). She managed to not have STIs thus far, you use protection and infection in the interval since your last tests is unlikely. The doctor you spoke with in misinformed - results of 4th generation tests for HIV are more than 98% conclusive at 28 days and entirely conclusive after 6 weeks. For all practical purposes, there is not a meaningful difference between results at 38 and 42 days.

HIV is both less common than many people are aware of and not readily transmitted. Less than 1/10th of 1% of women in the US have HIV and when they do, transmission from infected to uninfected persons occurs, on average only once in every more than 2000 encounters.

Were I in your situation, I would not be worried and would not hesitate to engage in unprotected sexual contact.

I hope this perspective is helpful. If anything above is unclear, please use your up to two follow ups for clarification.

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1 months ago

Thank you for the number stats doctor!

I do believe we had confusion on the exposures though. The 30 days post protected vaginal sex and 7 days post unprotected oral were from women who I am not planning on asking to be my girlfriend. Those are women who I’m asking my risk factor with vs my test results.

I’ll restate quickly, 30 days woman tested in December, she’s was clean but does have multiple partners, says she uses condoms but sometimes doesnt. 7 days ago woman, unknown status of STD/HIV but fewer partners.

So, I’ll ask in number form and then ask for a summary at the end.

1. Are my gonorrhea and chlamydia test results 100% at 7 day post unprotected oral?

2. So, since my 4th gen was non reactive at 30 days, and the chance of me getting HIV are slim since it was protected, can I assume I am as close to a zero percent chance of HIV as it can get without waiting the 42 days (six weeks)?

3. What are the odds of being reactive between 30 days and 42 days on the 4th gen?

4. Should I do a RNA and another 4th gen tomorrow at 38 days and be considered 100%?

5. Crazy how my doctor said three months. Why did she say that? Is there a chance?

Thank you!

Edward W. Hook M.D.

1 months ago

1. Are my gonorrhea and chlamydia test results 100% at 7 day post unprotected oral?

Yes

Yes, as I mentioned at 28 days results are more than 98% conclusive. In fact, while it happens, neither of us on this forum have ever had or deard of a patient with a negative 28 day result who went on to become positive.

3. What are the odds of being reactive between 30 days and 42 days on the 4th gen?

See above

4. Should I do a RNA and another 4th gen tomorrow at 38 days and be considered 100%?

This is a personal choice. Were I you, I would not bother

5. Crazy how my doctor said three months. Why did she say that? Is there a chance?

Three months is a recommendation which is long out of date.

Your risk is close to zero. I would not be worrying. EWH

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1 months ago

Awesome! Thank you, doctor. I am going to move on. I guess just a couple more questions for future information and not freaking out!

1. I did have an exposure the night before testing, I’ve seen you say it’s no risk but I will ask. I did have bare penis rubbing against the butt/back of vagina. Maybe fingered. This is no risk for HIV/STD’s?

2. 5 days post exposure is good for gonorrhea/chlamydia, 28 days for 4th gen for HIV, and six weeks for syphilis for testing?

3. An I good to have unprotected sex with this new girl?

4. If it doesnt work out with her, how often should I be tested with the exposures I do?

Thank you doctor, I hope you have a good weekend and a 4th of July next weekend!

1 months ago

Also, deeper dive into the HIV testing for my knowledge.

5. What are the window periods for the NRA/PCR test? Do they become less accurate with time? Or is it anytime after the last day of the window period is always 100%

6. Same for 4th gen

Edward W. Hook M.D.

1 months ago

Final responses. There should be no need to return with further anxiety-driven questions. If you do, the thread may be closed without a response and without return of your posting fee.

Correct, no risk for STIs, including HIV

2. 5 days post exposure is good for gonorrhea/chlamydia, 28 days for 4th gen for HIV, and six weeks for syphilis for testing?

Correct for gonorrhea, chlamydia and syphilis. At 4 weeks/28 days results of 4th generation HIV tests are more than 98% conclusive but to be entirely conclusive testing should be done at 6 weeks or later. For tests to become positive between 4 and 6 weeks is very, very rare.

3. An I good to have unprotected sex with this new girl?

Yes

4. If it doesnt work out with her, how often should I be tested with the exposures I do?

Testing is always a personal choice and varies with the numbers of partners and their risk

5. What are the window periods for the NRA/PCR test? Do they become less accurate with time? Or is it anytime after the last day of the window period is always 100%

PCR tests for HIV are conclusive at any time more than 11 days after an exposure. They do not become less sensitive over time

6. Same for 4th gen

See my response to question number 2 above

This thread is now complete and will be closed. EWH

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