[Question #1721] Testing performed at 72 Days

43 months ago
Hi Doctors,

Firstly let me thank you for this forum its been a great help to me.

I Understand now I am being anxious from the guilt of the exposure I had which I feel is a great step towards letting this go and continuing to be happy. But would love for you to help me put another couple of nails in the coffin.

I had unprotected oral (performed on 
me)  and condom protected intercourse with a Chinese CSW in Beijing.

I have had a full STI check up at my local Sexual Health Clinic here in Australia and everything was negative at 72 Days. On the day of receiving my results the Dr told me that they considered this a 3 month screening and no further testing was nessacery. 

A week later I went back panicking cause of information related to conclusive only after 90 days for Syphilis and HIV on the internet. The Dr said she would test me if I wanted but would rather talk it out and see if I could get through this without another test, which is what happened, I left feeling really positive about myself and also had intercourse with my wife unprotected oral and protected intercourse (birth control reasons). 

It's been a couple weeks since then and been a bit anxious last night and today cause I have come down with a head cold and all the fears are coming back to me. 

Am I being crazy? 

Tell me why I should trust 72 Days post exposure testing for HIV and Syphilis (both blood test in labs)?

Are my test rock solid conclusive?

Thanks for your time and answers. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Welcome to the forum. Thanks for your question and for your confidence in our services.

Some questions can be accurately answered based on the first few words or, in this case, from the title you chose for your question. Just about every HIV test that exists is conclusive by 4-6 weeks after the last possible exposure. I haven't even read your question, only the title-- but if you had a negative HIV test result 72 days after your last possible exposure, you can be certain you did not catch HIV, no matter what details you describe about the exposure itself or any symptoms you might have had.

Now I have read the rest. Guess what?

In answer to "Am I being crazy?", I would say no, not crazy -- just anxious. And more concerned than necessary. I think you don't understand the level of expertise you have had at your local sexual health centre. Among other things, Australia's nationally funded SHCs are, in my opinion, the world's very best network of STD/HIV clinics. Their knowlege and expertise are every bit as high as mine and the other forum moderators and you can rely on whatever they told you. (If you are in Sydney or Melbourne, the SHCs there are the best of the best. And you can give the directors my greetings:  we know each other well.) I absolutely agree that both your HIV and syphilis tests at 72 days were "rock solid conclusive". As noted above, the standard HIV tests are conclusive by 4 weeks (for the 4th generation, i.e. antigen-antibody tests, which I understand are routine for virtually all testing in Australia. For syphilis, 6 weeks is sufficient for conclusive results, not 3 months.

Finally, I would add that you had a very low risk exposure. You used a condom for vaginal sex (good move!), and oral sex carries very low risks for HIV and all STDs. Not zero, but close. As for syphilis, simple absence of the primary lesion (the sore called a chancre) is strong evidence you weren't infected. The blood test result confirms that.

So all is well. You have not put your wife at risk, even if you were not regular condom users. I hope this information has been helpful, but let me know if anything isn't clear.

HHH, MD

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43 months ago
Thanks so much for your reply.

Unfortunately or fortunately depending on how you look at it I am in Adelaide so I went to Clinic 275. I'm not sure if you have heard of it or Adelaide.

I think I had a 4th gen test but if I hadn't and it was a 3rd it wouldn't matter right cause is still longer than the window?

Also do you have any recommendations for people like me who do have anxiety towards sexual health? Should we speak to someone? Do you know of a book we should read? Etc.

Once again thanks for this service!

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
The Adelaide SHC also is excellent. I had the opportunity to visit it a few years ago, as the host of the clinic director, who is highly regarded by Australian and international STD specialists. I believe all SHCs use 4th gen HIV tests routinely, but you were tested well beyond the 3rd gen window as well.

In dealing with health anxieties, STD or otherwise, the first step is always to become knowledgeable about them. With an objective eye, you should come to understand that most STDs are less common than you might assume (most sexually active singles never get gonorrhea, chlamydia, HIV, syphilis, or herpes -- although everyone gets HPV). You'll also learn that most are less harmful than you might assume (including HPV). Some excellent starting points are the US Centers for Disease Control and Prevention (www.cdc.gov/std) and the American Sexual Health Association (ASHA, sponsor of this forum, www.ashasexualhealth.org). And although I don't have much personal experience with similar services in Australia, I'm sure the various SHCs have accurate online information, as does the Australian Sexual Health Association (a different "ASHA"). But do limit your research to these or similar sites, run professionally -- and be wary of those offered by commercial entitites disease-oriented websites, which tend to attract horror stories by atypically affected persons.

Second, get vaccinated against HPV, to prevent infection with 9 of the most troublesome types, responsible for 90% of all important HPV health problems; and against hepatitis B, if you didn't receive routine immunized in childhood.

Thirst, to the extent your anxieties continue, professional counseling is often very helpful. For that, I would suggest asking the Adelaide SHC about counselors or other resources in your area. You can be sure they have dealt with many patients with concerns like yours and probably have developed a sense of quality providers who can help.

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43 months ago
Thanks so much Dr.

I agree we are very lucky with the level of care we receive in Australia with basically free health care, medicine and the quality of our Dr's and Nurses.

Its awesome that you have created a resource such as this that gives real advise by real professionals!

Cheers,
Aussie-Worried.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
I'm glad I was able to help -- that's why we're here. Thanks for the thanks!

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