[Question #13373] HIV test accuracy at 23 days?
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1 months ago
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On aug 3rd I gave unprotected oral to 2 tops, protected anal with one of them.
Aug 5th started 100x2 doxycycline for 7 days for stitches that ripped open (wound is irrelevant) finished Aug 12th
Aug 9th (6 days post event) had unprotected vaginal sex with wife. No ejaculation.
Aug 14th hiv 5th gen duo (lab) -neg
Oral/anal chlamydia test negative Aug 15th.
Aug 26 (23 days post) hiv 5th gen duo (lab)
Aug 28th 1 neck and 1 knee lymph nodes swollen and tender, minor soar throat in morning, minor headache. No rash. Oral temp 98.6, forehead temp 100.9 -102 but is not consistent. I have taken no medicine. No night sweats
My questions
1) how accurate is this at 23 days? I know 28 days is conclusive and will retest then. P24 would definitely have been reactive right?
2) is this late to start hiv symptoms?
3) would sex with wife if contracted hiv, pass it to her after 6 days post?
4) I know protected sex is mostly safe, my concern is from playing with himself, then putting on condom with hand with pre cum, then using hand to apply lube, would external hiv die by then?
Also, thank you for this service! I loved med help and reading the answers to most questions has helped tremendously.
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1 months ago
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Apologies I realize I left off hiv 5th Gen at 23 days Negative
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Edward W. Hook M.D.
1 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. As you point out, the risk of the exposures you describe was low. You do not know that your partners have untreated HIV and statistically it is unlikely. If one did have untreated HIV, your risk for acquiring HIV is, on average, less than 1 in 10,000. Condoms provide excellent protection against STIs, including HIV. It would be unusual to cevelop ARS symptoms 25 days following an exposure. In response to your specific questions:
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1) how accurate is this at 23 days? I know 28 days is conclusive and will retest then. P24 would definitely have been reactive right?
At 23 days your test would detect about 80% of recent infections. At 28 days tests would detect 0ver 98% of recent infections and at 6 weeks 4th generation (or beyond) test would detect all recent infections.
2) is this late to start hiv symptoms?
It would be most unusual.
3) would sex with wife if contracted hiv, pass it to her after 6 days post?
Mo since your tests more than 2 weeks later were negative. You could not have transmitted HIV at that time
4) I know protected sex is mostly safe, my concern is from playing with himself, then putting on condom with hand with pre cum, then using hand to apply lube, would external hiv die by then?
HIV (and other STIs) are not transmitted through transfer of genital secretions on a person's hands. I would have no concerns a bout the scenario you describe.
Please don't worry. Your current symptoms are almost certainly due to something other than HIV or other STI.
I hope this information is helpful. If anything is unclear, please use your up to two follow-ups for clarification.
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1 months ago
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Thats great news and thanks for the reassurance!
I did notice the temp fluctuations starting on day 7, and have seen mostly normal temps during that time, with only a few instances each day when the forehead thermometer is high. But oral temp has remained under 99 degrees that whole time. Am I correct that if that WAS ARS, I would have tested positive at the 23 days? Or is that incorrect. Thats the only symptoms I noticed early on and my guess is honestly, it's anxiety looking to find a symptom instead of a true symptom.
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Edward W. Hook M.D.
1 months ago
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You are correct. If you were sent, those had been due to the ARS your test would’ve been positive. I really would not worry. EWH.---
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1 months ago
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Thank you! I've got not other questions outside of just academic questions for my own curiosity lol, so I will refrain. Would it be helpful to the forum if I gave my results back here in a couple of weeks? If not, this can be closed!
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Edward W. Hook M.D.
1 months ago
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Thank you. I’m pleased we could help. It is always helpful to hear about test results from those who have visited the Forum. We’ll leave the thread open until you post your results or 30 days have passed. Thanks again. Take care. EWH---
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1 months ago
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One thing I noticed and I realize this won't change any advice already or my plans to retest in a couple of weeks, but I noticed in the thread "question #1734 HIV/STD concern", that dr Hook mentioned ag/ab test at 3 weeks is almost 99% certain hiv was not acquired, and you mentioned 80%.
1) is the difference in these assessments contributed to conservative estimates and the multiple years that have passed?
2) would that 80% mean basically that 80% of people would have detectable levels of the p24 antigen or that the tests can actually miss the p24 antigen? I know that p24 antigen decreases as IgG increases, so just curious of there is a small window in which p24 antigen decreases to undetectable, while IgG increases but is not at detectable levels.
Im feeling more and more confident about my results and very much appreciate this site you have. I know the dangers of becoming a 'Google certified' doctor, and very much appreciate your in depth knowledge on these topics here. If you have studies that i could read, that would be incredible but realize that may not be possible.
Will update on results in a couple of weeks and I realize this is my final question!
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1 months ago
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Apologies, dr hansfield mentioned in that previous reply, not Dr Hook (you) lol
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Edward W. Hook M.D.
1 months ago
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The thread was left open so that you could post your test results. Instead, you’ve come back with more questions. I will respond briefly and then the thread will be closed.
I’m not going to go back and look at responses made years ago. There is general agreement that at four weeks fourth generation combination HIV antigen/antibody tests are more than 98% conclusive. There are a few data regarding day-to-day positivity rates. Certainly however at just over three weeks less than 98% of tests would be positive. Whether that figure is 80% or 90% is hard to say.
What’s a person has developed P2 four antigen which is variable, those persons will have either a positive antibody or antigen test and as a result fourth generation test will give positive results. There is no room for speculating on whether there are occasionally brief periods as antibody binds to P2 four antigen when the test will be negative.
You need to stop overthinking this. This thread is now closed. EWH.
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