[Question #13453] Exposure and test

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1 days ago
Hello doctor,

I would like your expert opinion on a situation that happened to me

In a moment of weakness, one I'm not proud of, quite the opposite, I had an encounter with a woman I met through a social media platform. To make a long story short, we ended up having about five minutes of unprotected vaginal sex. She's Colombian and likely over 35 years old.

Afterwards, I became very anxious about the situation and insisted that we both get tested. At first, she didn’t want to, but eventually agreed when I offered to pay. She took a 4th-generation HIV test 23 days after our encounter, and her result came back negative for antigen and antibody 

To be sure, I took another test myself at 31 days post-exposure, which was also negative. Both tests were rapid tests in 30 minutes,I believe the brand because I`ve asked was Abbott  but they drew blood from a vein and used serum or something similar.

Could she still have transmited despite her negative test at 23 days? And regarding my own test at 31 days, should I take another one now that I see it's considered conclusive at 6 weeks?

Thanks a lot



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Edward W. Hook M.D.
1 days ago
Welcome back to the Forum.  Thanks for your continued confidence in our efforts.  The exposure you describe was low risk and your subsequent testing proves that you could not have been infected by the encounter you described.

The exposure was low risk because you do not know that your partner has HIV and statistically it is unlikely that she was, particularly at age 35.  Even if she had untreated HIV however, the likelihood of becoming infected is low, on average less than one infection for more than 2500 exposures, I.e. if she was infected there is a more than 99.9% probability that you would not become infected.

Since then testing has proven that you were not exposed.  Person’s with negative tests virtually never transmit HIV and her negative test at 23 days proves that she could not have transmitted infection to you.

You are in the clear.  No need for further testing.  EWH
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1 days ago
Thank you doctor for your response. 

I know that in theory the risk is low. In fact, she is more mature, being over 40 years old, why would this be relevant? 

But still, what reassures me the most is the science or reliability of the tests. If I understood correctly, for her to have been able to transmit to me, it would be very unlikely that a test done, let’s say, 21 days later would not detect anything, right? In other words, after the RNA, the antigen should inevitably appear? 

Also my negative test a 31 days is some conclusive, right? Im an sport person with no medication (only supplements creatine, curcuma, vitd, berberine, omega3) 

Does the fact that it was a rapid test make any difference? The clinic seemed very professional, they drew blood from a vein and used serum, the paper says it detects 99,9% 

Thanks again
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Edward W. Hook M.D.
1 days ago
HIV  prevalence rates decline in women with age.

You are correct that, if she were infected, at 21 days HIV antigens would be detectable in her blood.

At 28 days, 4th generation tests such as yours are more than 98% conclusive.  They are entirely conclusive after 42-45 days.

That you were tested with a rapid test makes no difference.

One follow up remaining.  Please don’t worry. EWH
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1 days ago
Thanks again doctor for sharing your knowledge 

I understand that just knowing she had a negative 4th-generation test at 23 days should already put me at ease, because it’s biology, right? I mean, there’s no way of transmission with a negative test that late.?  I wish I`ve took a RNA test instead

And even more knowing that my test at 31 days would already be about 99% conclusive, which is really solid. I don’t know why it’s still hard for me to move on knowing all this

I forgot to mention that around 18 days after the exposure, I've experienced some flue like symptoms, itchy throat then mucus, headache, cough but not fever (lasted one week to be 100% okay/ then 7 days later was my test 

One quick question before we finish, doctor. The test I took would also have detected exposures from a longer time ago, let’s say a year? I read somewhere that it might not be as reliable for that because antibodies 'capture the antigen' or something like that, but then I saw that this test also detects both IgG and IgM.

Best regards 





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Edward W. Hook M.D.
1 days ago
Repeating your question will not change the answer.  Your partner could not have transmitted HIV to you.  

If your symptoms at 18 days had been due to HIV , your test at 31 days would have been positive.

Your test at 31 days certainly would have detected more longstanding infections as well.

One last time, you are in the clear.

This thread is now complete and will be closed.  EWH


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