[Question #2022] Reporting back with HIV test result

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86 months ago
Dear Dr Hook and Handsfield,

I wrote to you a few weeks ago because I was concerned about an incident where a CSW applied some kind of substance to my penis. Later I also became worried about a trip in Asia a few years before that where I had protected intercourse with some CSWs but apparently the region has lots of poor quality/unreliable condoms.

After reading your Medhelp posts, I noted the great praise for the MSHC which happens to be located in the city where I live, so I paid the place a visit and it was as good as described. They advised me that the window period for their HIV test was 6 weeks, so I faced an excruciating wait despite knowing and being told the statistical unlikelihood by many parties.  In the meantime, a rapid finger prick HIV test returned a non-reactive result.

6 weeks and 2 days after the fluid/lubricant incident with the CSW, I returned to the MSHC and explained to the nurse that I had just crossed the window period for an HIV test and he steered me into a process for quickly testing low-risk heterosexuals. I read the pamphlet and then had a urine and blood sample taken. Two days later I received an SMS telling me that my HIV test result was negative. I returned to the MSHC to collect the actual results. I tested negative for Chlamydia and Syphilis. The laboratory results for the HIV test were: (Test Description) HIV 1/2 Ag-Ab CLIA, (Array) Liaison XL, (Result) Non-Reactive.

I feel much better than the last time I was on the forum a few weeks ago. Interestingly, the counsellor at the MSHC told me that my main issue was not HIV but anxiety- this was before being tested. The incident has been something of a personal crisis and has exposed deep frailties so I have taken his advice and signed up for therapy with a psychologist. Sometimes I still feel afraid and I plan on being tested again sometime, probably when I have a long term partner which would make it wise for both of us to be tested prior to unprotected intercourse.



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H. Hunter Handsfield, MD
86 months ago
I'm glad to hear you had a good experience at the Melbourne clinic. They do exactly the same test as done worldwide, and most experts would agree it is conclusive at 4 weeks. MSHC obviously interprets the data more conservatively if they advise final testing at 6 weeks. In any case, your result is conclusive. I agree with the MSHC counselor's believe about anxiety being your main problem in all this, which Dr. Hook and I also said in your previous threads. I have no other comments about your symptoms, exposure, etc; everything we might say was included in the previous discussions.

From the standpoint of risk, there is no reason for you to have another HIV test until and unless you have a new potentially risky sexual exposure. But if you strike up a new relationship and your prospective partner would like it you both were tested together, feel free. OTOH, if she has had a low risk lifestyle up til then, or if she was tested recently for HIV and other STDs with negative results, I would see no need for it.

Best wishes--  HHH, MD

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86 months ago
Dear Dr Handsfield,

I hope you won't be annoyed by this follow up post but I think it is valuable for gaining clarity on the test window period.

The pathologist of the laboratory that conducted the 4th gen test informed me that it is around 99.5% accurate (in terms of detecting all infections) at 6 weeks.

However he said there is a long tail where a rare few people require 3 months, 6 months, or even a year to be detected by a 4th gen test.

He gave me the option of testing again at 12 weeks at which point the possibility of a false negative would be 'incredibly low' but he wouldn't put a definitive number on it.




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H. Hunter Handsfield, MD
86 months ago
Actually, I have seen data recently that makes me rethink giving 100% reassurance on the basis of a 4 week result on the 4th generation tests. However, all the experts I'm in touch with are confident the "long tail" doesn't go beyond 6 weeks, or so rarely it can be ignored. I'm not aware of any reported cases in which it took so long. At most, I agree with the "incredibly low" statement, and I can tell you for sure that the large majority of experts and clinics do not recommend additional testing in anyone with negative 4th gen results at 6 weeks, except in special circumstances such as having taken PEP, which might prolong the window period. If somehow I were in your situation, I would not get tested again. But of course you are free to do so.

Thanks for the follow-up. 
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86 months ago
Dear Dr Handsfield,

I couldn't help myself and got tested 10 weeks after exposure.

The results have come back:

HIV Antibody/Antigen Combo (Serum)

Not Detected (by Siemens Centaur HIV-1 and HIV-2)


Interestingly, the comments below the results say:

'This result does not exclude recent infection with HIV. If serum was tested within 3 months of exposure, please retest after that time.'


My HIV tests so far have been accompanied by tests for other STIs. The results seem to indicate that I have none of the STIs out there that exist, which is odd for someone who (as you undoubtedly have notice) lives with intense fear of being infected by HIV. I feel almost compelled to follow the instructions and get tested after 3 months.



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H. Hunter Handsfield, MD
86 months ago
The laboratory is still using an old statement that doesn't apply to the current HIV tests. Most likely they just haven't gotten around to changing it; or maybe the lab does several kinds of blood tests, and uses the same statement for all of them. Or their lawyers have recommended an overly conservative statemetn about it. You are free to be tested again or as often as you wish. But it really isn't necessary. You don't have HIV.

That completes the two follow-up questions and replies included with each question, so this thread is now closed. Please note the forum does not permit repeated questions on the same topic or exposure. This is your third question and will have to be your last one; any more questions about this exposure, testing, and your fears about HIV or other STDs will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

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