[Question #1387] Hiv ars at 6 months negetive test at 9 months

46 months ago
Hi,
I had a condom break esposure 9 months ago with a csw. I then got ars like symptoms after 6 months of exposure (fever for 3 days chills,sore throat and body aches, lost of appetite.
I then tested at 7 months after exposure for an duo 4th gen hiv test non-reactive 
Then again at 9 months with a hiv duo 4th gen with labcorp non-reactive and also with orasure oraquick finger prick at 9.5months negetive.
I contine to have stress and anxiety due to having flu like symptoms at 6 months after exposure for 4 days ,when I rearly ever get sick with a fever.

I wanted to know if I can relay on my hiv results and resume unprotected sex with my significant other.
Thanks.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question.

My answer should be reassuring. It is impossible to have HIV or ARS in presence of a negative HIV test more than a few weeks after exposure. Your negative tests -- which included analysis for antibody (the immune system's response to HIV) and for the virus itself (the antigen component of the 4th gen/duo test) -- prove for sure you didn't catch HIV. Also, you misunderstand ARS symptoms. The identical symptoms occur with at least a hundred medical conditions, mostly minor. Even the most typical symptoms of ARS usually have other causes, as they did for you. To put it another way, the HIV diagnostic tests are among the most accurate ever developed, for any medical conditions. Therefore, the result overrule everything else: no matter how high risk an exposure and no matter now typical the symptoms, the test result rules.

I'll also point out that the large majority of CSWs don't have HIV. And even if your partner had HIV, the transmission risk for a single episode of unprotected vaginal sex averages once for every 2,000 exposures.

So as I said, the answer is good news:  you don't have HIV and for sure can safely resume sex with your regular partner. You could have had a duo test 4 weeks after the CSW event and, when it was negative, resumed sex with your partner 8 months ago. For sure you should do so now!

And of course if symptoms persist that concern you, see a doctor. But don't worry about HIV!

I hope these comments have helped. Let me know if anything isn't clear.

HHH, MD

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46 months ago
Thank you Doctor, for such a good detail answer, you have relief by stress and anxiety with your answer. 

As for my fallow up question, I will ask this just for my personal knowledge.

1. Do hiv ARS symptoms ever come after 6 months of exposure?

2. All three of my test were for (hiv1)and (hiv2), 
Does( Hiv2) have a different window period than Hiv-1?

3. I live in California, how common is hiv2 in california?

Thank you once again Doctor.
You make a big difference in this wrold.
I apreciate your help and knowledge.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
ARS always occurs much sooner, usually 10-15 days after exposure. Sorry I didn't think to say this in my reply above. Second, the HIV2 and HIV1 window period are the same. Third, although I don't know specific data in CA, HIV2 is very rare in all of the US. To my knowledge, nearly all in the US have been in people who caught it in Africa, or in their regular sex partners. If you didn't have sex with someone from parts of East Africa, there is no chance you were exposed to HIV2.

I'm glad to have helped. Thanks for your kind comments about our services.

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45 months ago
Hi. Doctor
Sorry to bother you again however I seen posts where you recommend patients a syphilis test alog with a Hiv test after an exposure.
In regards of the same exposure I also had an RPR test done that was non-reactive  at 8 months after exposure. My doctor had it order wich I didnt know what kind of test it was until I looked it up online yesterday and it says its a [ Rapid plasma reagin, a blood test for syphilis that looks for an antibody that is present in the bloodstream when a patient has syphilis.]
I have a fallow up appointment with my doctor this week, however I wanted to know if the RPR test is the recommended test for syphilis or would you prefer a 
Enzyme immunoassay (EIA) test

Would my RPR test be conclusive at 8 months aftet exposure?

Thanks in advance.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
The RPR is conclusive any time 6 weeks or more after the last possible exposure. For sure you do not have syphilis and should not have an EIA or any other syphilis tests.

That concludes the two follow up comments and replies included with each questions, and so concludes this thread. You can safely move on with absolutely no further STD/HIV worries on the basis of the sexual encounter described above.

Best wishes and stay safe.

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