[Question #173] Can I accept my hiv results as absolutely conclusive??

95 months ago

Dear Doctors Handsfield and Hook,

Thank you both so much for the service and help you provide.  I can't tell you how many times I have searched answers/advice from you both and how helpful it has been.  You're both life-savers, and please know that you're appreciated more than I can say.  I think I already know the answers to my questions, but I'm in a bad way these days, and it'd be worth any amount of money to have you confirm what I think I already know. 

Possible exposure: mutual masturbation with another male (I'm male - 56 years old).  Participated in this activity three times with same man.  He assured me he was hiv negative, but I have no proof and no way of knowing.  We masturbated ourselves and each other, and I'm assuming, at the very least, precum was involved and it got on my penis, although I'm not sure.  Let's just say, worst case scenario, he came and I used the cum for lube.  That really wasn't the case, but I want to try to alleviate all my fears regarding this situation.

I panicked soon after this exposure and began hiv testing through STD Express.  I've read everything I can about this company, and it seems legit, although in my anxiety driven state, I'm beginning to wonder if perhaps they maybe don't really test and just take the money and send random results.  That's probably ridiculous, but as you'll see, this is consuming my every thought.  Even as I'm typing this, my hands are shaking so badly I can barely type.

Here are the results from the 10 tests I have taken through them:  all negative, by the way, but I'll give you the rundown just the same.




7/24/13...  all of these were tests for HIV 1and 2 plus HIV 1 early detection DNA

Results:  HIV 1- antibody, value<1, range<1, result negative   HIV 1/0/2- Abs qual, value - non-reactive, range - non-reactive, result, negative

                HIV 1 - DNA value - negative, result negative




3/3/15....all of these tests were HIV1 and HIV 2 antibody tests.  No early detection.

According to STD Express, the antibody tests were 3rd generation.  The blood for these tests was taken at Labcorp.


9/30/15...these were labeled 4th generation by STD Express, but when I asked if they included the p24 test, the customer rep didn't seem to know.  They labeled them "HIV 1/2 4th Generation" on my order and on my results, so I don't know if they included the p24 or not.  The results for both of these was

Value - non-reactive

Range - non-reactive

Result - negative

The blood for these two tests was taken at Questlabs.  STD Express is now using them

Okay...despite this overwhelming evidence that I can  probably accept the results and move on, I can't.  I have been working with my family doctor for about a year now, and he has been a saving grace, just as you guys are!  He has told me on every occasion that first of all - there was absolutely NO risk to begin with, even if the other man was positive and even if ejaculate was used for lubricant and came incontact with my penis.  Again, this was not the case, but I want to think of every thing I can Just in case.  He has also told me that, while he would've tested me ONCE, if I had INSISTED, he would never have deemed it necessary other than for my piece of mind.  And, once he found out that I've tested 10 times, aside from telling me I'm nuts, he has assured me that I can absolutely rest knowing that whatever else is wrong with me, HIV is not the culprit.  On my last visit the other day, he suggested counseling, and I'm sure he's not wrong about that.  I'm not adverse to that idea at all - just want to rule out any chance of HIV before I go that route.  I asked if there was anything more I could do from a medical standpoint, and he assured me there wasn't.  His only suggestion was that if I couldn't accept what he was telling me, that he'd set me up with an infectious disease specialist.  He didn't mean to, but this caused a panic in me which is still going on today, even after he assured me that the ONLY reason he would suggest that was so I could have confirmation that there is NO way I'm the only person in the world to have ever contracted HIV from this kind of exposure, and to further assure me that I'm NOT the only person in the world who would continue to test negative and yet still be positive.  I calmed down a bit, but I told him that once he said that, it triggered this, "do you think I do have it and just am not testing positive?" dialogue, and he told me absolutely not.  He was just saying that he wanted to do his best to try and get rid of this crazy, guilt-driven, abnormal fear I have in the face of absolute proof, and he just was trying whatever he could to tell me to let it go.  I asked if it would be a waste of time, medically, to see anyone else, and he said that it would, indeed.  He assured me nothing would be different, the test results are never going to change, etc., he was just trying to tell me that if I couldn't accept his truths, there just wasn't much else to do.  Naturally, I got him to go over it all once again and to tell me what he thought - of course, it's the same thing he always tells me, which is that he's my doctor and he cares about me; he would NEVER tell me not to worry about something like this if he didn't truly believe it.  He's not worried at all about my physical well-being as far as potential HIV is concerned - he just wants me to quit putting myself through the torment I can't ease or rid myself of.  I trust him completely, even though it might not sound that way.  The first time I brought this whole matter up, he said virtually the exact same things that you guys always do. For a while, I was doing all right, but lately, it seems as if there's a new "symptom" every day, and I can't shake the fear that I am the one who, for whatever reason, has HIV but is never going to show it.

My biggest fear all along has been the possibility of infecting my wife.  We rarely have unprotected sex to begin with, but until I got the first 3 tests results back, I was particularly careful to ensure that we did not have unprotected sex.  I'm still worried that somehow I've infected her, which I think if probably ridiculous too.  My doctor has assured me that I was never at risk, even without a test, and therefore I couldn't have passed it to her.  Then, my latest fear was that perhaps she had it and I've caught it from her.  That was the reason for the very last test in September.  We had a brief, unprotected sexual encounter, so I waited 87 days and took the last test.  I wanted to wait a full 90, but once again, the anxiety wouldn't let me. 

I guess my question is, is there ANY chance of infection at this point?  I tested so many times because even though my wife and I do practice safe sex, I kept thinking even when we did, that was changing the testing window period, so I needed to do it again.  Again, that's why I took the last one in hopes of thinking that that encounter was the last unprotected event, and maybe now I can put it behind me. And, this is a stupid question, but would that last one more than "cover" the mutual masturbation episodes from before??

I won't go into all the symptoms I'm experiencing.  As I said, my doctor is convinced that while he believes I'm experiencing them, he continues to be convinced that it's all anxiety-induced.  It could very well be - the anxiety never completely goes away.  I'm just wondering how much that can affect me?  As I've said, I just keep thinking that I'm the exception to all the "rules" of HIV here.  I'm truly sorry to bother you all, and truly sorry for being so long - winded, but any help would be greatly appreciated.  Thanks again for all you do!

H. Hunter Handsfield, MD
95 months ago
Welcome to the forum and thanks for your question. I'll be happy to answer. However, it is far, far longer than necessary or than permitted. The character limit is intended to prevent questions with more than 2,000 characteris, i.e. about 400 words. Yours is 4 times that length, about 1,600 words. You probably overcame the limit by writing your question in a word processor then pasting it in. If not, I apologize that the limitation system apparently isn't working. In any case, the moderators cannot be expected to read such long essays, and in 10 years doing online forums, I've never seen a question that could not cover the necessary information in 2,000 characters; in fact, 1,000 usually is plenty.

So please re-write your question to a maximum of 2,000 characters and post it in a follow-up comment window, then I will reply. This won't count against your allowance of the original question plus two follow-ups for the original posting fee. Thanks for your understandings of the policy.

95 months ago
So sorry for overdoing it on word limit...I did not copy and paste nor did I see any limit, warning, etc.  
I'd give anything if you could read original but I'll re-ask and try to be brief.  Exposure was male mut masturbation with another male.  Said he was hiv negative but I don't know for sure.  10 hiv tests sine exposure 12/2012 and all negative.  Last test was last week due to onset of symptoms which continue today. Also, had unprotected sex with my wife 88 days ago and wanted to make certain I didn't infect 
95 months ago
Sorry again...hit submit too soon...is last test at 88 days after sex with wife conclusive?  There were 9 other tests before that in the course of the time since first exposure.  My doctor has repeatedly told me that there was never any risk but still scared to death that I'm the one person who got it that way and will always test negative.  All tests were done through STD Express...all were hiv 1/2 and the first four also included DNA EARLY DETECTION...
95 months ago
I promise I'm not trying to get around any limits...this is just a very confusing site to use ...please don't be mad at me...you're one of my heroes!
H. Hunter Handsfield, MD
95 months ago
Thanks for the succinct version. Nobody is mad and I certainly didn't think you were purposefully trying to game the system. As it happens, investigating this event has revealed that the software designed to impose character limits apparently isn't working. We expect it to be fixed soon.

The HIV blood tests are among the most accurate ever devised, for any medical condition. You cannot have HIV with the negative test results you have had, based on the list of tests in your original question. It is impossible to have HIV with a negative third generation antibody test beyond 6-8 weeks (and for sure beyond 12 weeks); equally impossible to have it with a negative DNA test beyond 3-4 weeks; and doubly impossible for both kinds of tests to be negative beyond 4 weeks. Same for any 4th generation blood test(s) more than 4 weeks after the exposure you are concerned about. To say it another way, every test you had after 4/3/13 was superfluous.

As for the exposure itself and any symptoms you have had, they are irrelevant. That's the main reason your very long initial question was unnecessary for me to give an accurate reply. HIV test results, done sufficiently long after the last possible exposure, always overrule symptoms and exposure history, no matter how typical the symptoms might seem and no matter how high the risk at the time of the exposure. You could have told me you had an AIDS definiing opportunistic infection or that you had the exposure was the highest imaginable risk, e.g. transfusion with HIV infected blood. My reply would be the same:  you don't have HIV.

So my advice is that you put that sexual exposure behind you; go forward in 100% confidence you don't have HIV; and if you continue to have any symptoms that concern you, continue to work with your physician to find the actual cause. And by all means continue unprotected sex with your wife. Undoubtedly it will do you both a lot of good, and for sure you won't be putting her at risk of HIV.

I hope this has helped. Thanks again for the compressed question. I've certainly done nothing to be judged one of your heroes, but thank you as well for the vote of confidence.

Best wishes--  HHH, MD

95 months ago
I don't know if I'm entitled to a follow up based on all I've written already, but I thought I'd try anyway.  First off, thanks so much for replying and for understanding!  You've done more than you know to warrant being my hero, and quite frankly, I was in such a state before reading your response that wasn't sure if I'd ever get through this.  I also want to thank you for reading the original epistle I wrote. I've been telling myself all night that the only help is get tonight would be if you found it in your heart to read that and respond.  Just a couple things...you said testing after 4/2013 was superfluous...does that mean you think testing was necessary at all after the possible exposure?  I think I know the answer but it helps to have it repeated. And, just to make certain, there's no chance I'm seroconverting since yesterday even though I'm convinced I am?  I've read before that you've said anxiety can cause many problems. Could the fact that I'm worried all the time be the culprit?  Okay...I'll stop.  I can't thank you enough.  It's amazing that you do for folks like me what you do.  You've truly helped me more than I can say.  You're a lifesaver!
95 months ago
Okay...last one...dumbest question of the day, I'm sure, but, can you get/have AIDS if hiv test is negative?  Reading through some of your responses  from other sites and saw where a person was diagnosed with AIDS but all tests were negative.  You were convinced the diagnosis was wrong, but the person never came back with final diagnosis.  New fear that even with all these negative tests, I could still have AIDS?  Please forgive my insanity.  If you say, as you have, that I don't have to remotely worry about AIDS or hiv, I'm going to do my best to accept and move on.  Thank you!
H. Hunter Handsfield, MD
95 months ago
My reply above was based an assumption you had a high risk exposure. But you didn't. HIV absolutely cannot be transmitted by hand-genital contact. With mutual masturbation the only exposure, you absolutely were not at risk. All your HIV tests were superfluous, as you apparently suspected.

HIV seroconversion takes a few weeks, which is why antibody tests become positive in that time. That's the only purpose of an antibody test: to detect that seroconversion has happened. It is not possible to still be seroconverting a couple years later, regardless of how "convinced" you are. And no, of course you cannot have AIDS. AIDS is the increasingly outmoded term for what is now recognized as the end stage of HIV infection.

Finally, I agree with your self diagnosis:  your anxiety over all this is the only problem in evidnce, perhaps with other mental health issues. Most likely you are going to continue to obsess and worry over this. Most people in your situation are not relieved by simply hearing the evidence, no matter now reasoned and science based, and probably you have heard it innumerable times, from your own doctors and now from me. If your worries continue, professional counseling would be a logical step. I suggest it from compassion, not criticism.

In the meantime, let's not have any more "yes but", "what if", or "could I be the exception" questions. Trust me on this:  there is NOTHING that will come to your mind that would possibly change my opinions or advice.

Best wishes--   

95 months ago
Okay, I said I'd try and move on but slight panic attack this evening when I remembered that I've had 2 basal cell carcinomas cut out in the last two years...one yesterday, and probably another one in a few weeks.  One almost two years ago. Looked online and saw that this is a possible symptom of hiv? Couldn't quite tell if I read the info correctly, but now I'm scared that my immune system is weakened from hiv and that is causing the carcinomas along with the continual keratosis spots on my head.  Do tests results still trump even these obvious symptoms?
Also, as I said, all testing was done through STD Express...everything I've read says this is a legitimate service, but I worry - ridiculously- that maybe they don't really test?  Another stupid idea, I'm sure.  I beg you to forgive me and promise to stop.  Just got really worried about the cancers and this was something I hadn't talked about with my doctor.  Thanks! I know I need help, but right now, I'm begging for your help once again!
H. Hunter Handsfield, MD
95 months ago
From my last reply:  "...there is NOTHING that will come to your mind that would possibly change my opinions or advice." That applies to these comments. And the notion that STD Express "maybe don't really test"??? This almost more than any of your other comments reflects disordered thinking and reinforces my advice about counseling.

That ends this thread. Do not be tempted to start a new one. Repetative questions are against forum policy, and it would be deleted without reply. 

Do your best to move on. Best wishes.