Hello doctors,

The other day I asked about my exposures and the rapid immuno chromatographic test I took at a specialized clinic in Spain. It was a 4th generation combo test for HIV—detecting both the p24 antigen for HIV-1 and antibodies for HIV-1/2—and it came back negative for both. However, after reading some information online and some of your responses, I would like to understand a few things in order to put my concerns to rest once and for all.

1 - The clinic informed me that blood was drawn from a vein, then centrifuged, and the test was performed using the serum, which is part of the protocol. This is a very good method, right? I understood that at 21 days it would detect around 90% of cases (more or less), at 28 days around 98%, and that one should wait until 6 weeks for a conclusive result, even though you have not seen cases that were negative at 28 days and later turned positive?

2 - Now I’ve started to feel anxious after reading things about HIV-2 (although I understand it's not common in Europe, right? And my exposures haven't been with people from Africa). But my question is: for this type, is the conclusive window period 8 weeks? Or is it something so rare that I shouldn’t even be worried about it

3 - If I review my experiences from 8 weeks ago until I took the test, they were basically erotic body-to-body massages, with some kissing, possible rubbing between body parts, contact with fluids during mutual masturbation but without seeking penetration itself,

4 - 8/9 days after the last contact (August 4), I had a cold that seemed typical, with a mild sore throat, headache, congestion, a lot of mucus, bit of cough, and fatigue — but no fever. It lasted about a week. The test I mentioned earlier was done on August 25. thanks a lot

1.  Your summary of my comments is correct.  This remains my assessment

2.  HIV-2 is rare and becoming less common in Spain and all of Europe.  In Spain there are fewer than 10 cases per year and nearly all have occurred in persons from West Africa or whose partners were from there.  Further, the test you had provides strong evidence that you did not get HIV-2.  As you pint out, results of 4th generation tests such as the one you had provide conclusive results at 8 weeks or beyond.

3.  The encounters you describe above were no risk

4.  If your symptoms had been due to HIV, including HIV-2, your test on August 25 would have been positive.

Please don't worry.  EWH

1 - Happy to hear that and what about the part of the blood being centrifuged and the test performed with the serum,. is that a great protocol? 

2 - Yes, I've also read that there are very few cases of HIV-2 in Spain, mostly among immigrants from Africa. None of my contacts were with people from those countries, and I understand that HIV-2 is conclusive at 8 weeks — but it could show up earlier too, right? I know that the antigen part only applies to HIV-1, but that would be the one that could affect or concern me the most.

3 - I understand that these situations weren’t really risky, but honestly, I needed this test to be sure, because some time has passed. Doctor, I’d also like to ask — about7 years ago, I did have a higher-risk exposures (with trans). Given that I had a 4th generation test last year and another one this year both negative, can I be at ease now? These past few years, it's only been erotic massages with women, maybe some years ago some vaginal penetration but not this year (also remember now had a PCR test at 2022 negative)

4.- So my test confirms that these symptoms were due to a common cold and had nothing to do with HIV, right? Because otherwise, I would have antibodies by now, correct?

Appreciate a lot your help and knowledge 

1.  Yes that is a standard, well established protocol.

2.  Yes, HIV-2 could certainly be detected well before 8 weeks.  I urge you not to worry about HIV-2.

3.  Yes, if you had acquired HIV at any time in the past, your tests would have been positive.  be confident you do not have HIV.

4.  Correct.  Your negative tests eliminate any possibility that your symptoms were due to HIV.

Please don't worry.  EWH

To wrap up the post, let's see if I can finally close the matter and get some rest

1 - Great then, the private clinic is called Open House, in case you ever want to check it out. Honestly, the service was excellent. So, despite it being a 4gen quick test, it was done as I mentioned. The window period is still the same as we've discussed, right?

2 - Doctor, if we understand that HIV2 in this case wouldn't be concerning, the most normal thing is that by 30 days either the antigen or the antibody would be present for HIV1,  and a negative result would be fairly conclusive and reassuring, right?

3 - Is this because the antibodies would remain permanently present and detectable for years by the 4th generation test?

4 - From the last exposure, which was on the 4th of August (21 days ago), and the test done on the 25th of August, I know it wouldn’t be conclusive, but if I think about the exposure, I don’t believe it was risky. Plus, I have this test, so the antigen could have appeared, right? Also, because the last encounter with my new girlfriend was on the 1st of August (she’s traveling now), and the other erotic massages before being with her were 35 days before the test.

Thanks a lot again for your time and knowledge 

1.  The window period is as discussed in my earlier responses.  

2.  Your negative result is not "fairly" conclusive, it is highly conclusive and should be believed

3.  Correct

4  Correct

End of thread.  Please don't worry.  EWH