[Question #2449] Test Reliability

44 months ago
Hello again; a couple of months ago, I inquired you (Dr. Handsfield) about the reliability of my HIV tests with regards to my exposure in Indonesia.  My concern was the accuracy of the test involving specimens potentially exposed to rare strains.  Nonetheless, you answered my question and reassured me that 4th gen tests are accurate at 6 weeks regardless of where the exposure occurred.  My anxiety has gotten the best of me and I now have new fears.  My first HIV test (>3 months past exposure) was an Oraquick oral test done at home which yielded a negative result.  My subsequent tests were 2 4th generation HIV tests done at over 6 months past exposure (over a year actually).  These 2 4th gen tests were done through an online testing service by the name of stdcheck.com.  For privacy reasons, I chose them as opposed to my family doctor because I liked the fact that I could do a 10 panel STD test in cash (did not want to use my insurance for privacy reasons).  Essentially, after my order, they sent me a lab form which I then took to Quest Diagnostics to have my blood drawn.  A few days later, a PDF of my results was emailed (the PDF belonged to Quest Diagnostics) to me which showed that I was non-reactive for HIV 1 antigen and HIV 1/2 antibodies.  My OCD and anxiety has led me to do vigorous research to ensure that this outfit is legit and it seems to be.  My results have the exact time of when my blood was collected, so I trust that these must be real and not falsified?  It is my understanding that places such as stdcheck.com function by having their physicians order tests for the patients and relay the results back...sort of acting as middlemen.To sum it up1.  Can I trust my results with stdcheck.com? They sent me to Quest Diagnostics and my results were indeed on a Quest form.  2.  I have not had any sexual exposures since my results.  Do I need to test again with my personal doctor or are the results through this private company sufficient?
44 months ago
Cont.  3.  I read a post where you recommend seeing a doctor or public health clinic for STD testing needs as opposed to an online private service.  Is this simply due to the high costs and added unnecessary tests associated with private outfits? Not the reliability of the tests they use?
4.  I got into contact with stdcheck.com and after speaking to a few representatives (the first one did not know), it seems that my particular test was done using the Abbott Architect 4th gen test (via Quest).  Is this the same one doctors use?
5.  Do my worries concerning falsified results and whether or not I can trust this outfit seem legitimate, or rather a manifestation of health anxiety?  I am quite paranoid about my health so maybe I should just trust my results and move on.

Thanks so much
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome back to the forum. But I'm sorry to see you remain so concerned despite the reasoned, science based reassurance you have already had. (FYI, it is by luck I checked the forum soon after your question arrived. Most users should not expect nearly real time replies.)

I would encourage you to re-read my replies in your earlier thread. For the most part, the answers to these questions are obvious from that discussion. Therefore, my answers are very succinct.

1. I don't know Sidetrack, but most if not all online testing services contract with standard, respected laboratories for testing. Quest is a respected national laboratory wit high quality standards. And the standard HIV tests are highly automated and pretty much foolproof. All labs provide completely reliable results.

2. No further testing is necessary nor wise.

3. Most anxious or frightened persons do best with the personal counseling and advice that come with an in-person visit with a physician or clinic.

4. There are 10 or more HIV tests on the market in the US, and different doctors and labs use different ones. Abbot Architect is highly reliable, as are all the others as well.

5. Your worries definitely are not legitimate and you should "trust [your] results and move on". If you cannot, professional counseling should be your next step. It is not normal to remain so concerned in the face of the test results and reassurances you have had. I suggest this from compassion, not criticism. If you are in care for your OCD, discuss these issues with your therapist. Your continuing concerns are not reasonable (which I also say not from criticism, but as an objective clinical observation).

I hope these comments have helped. Best wishes.

HHH, MD

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44 months ago
Thank you for the reply doctor!  And do not worry - I do not take your suggestions as criticism.  I am well aware of my problem concerning health anxiety.  I will be starting school again (university) in the Fall and as a result, things are quite hectic for me at the moment.  Once I get settled down, I will certainly seek a therapist equipped to deal with my particular issue and get proper counseling.  I noticed that you mentioned "sidetrack".  I take it this was a typo and you meant "stdcheck"?  Lastly, you are saying that my results through Stdcheck.com who sent me to Quest Diagnositcs for blood collection are thus conclusive and definitive (tests done past 3 months after exposure, 4th gen)?  I do not need further tests until I become sexually active again and can safely engage in sex with future partners (I also tested negative for Hep A, B, C, HSV 1 & 2, syhpills, chlamydia, and gonorrhea)?  Thank you again for the service and yes, I am already looking for counseling to deal with this (I heard cognitive behavioral therapy is particularly useful for this type of anxiety).
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Yes, I did misread "stdcheck" as "sidetrack". I'm familiar with the stdcheck name -- and my comments apply to all online STD testing services.

All blood tests (3rd or 4th generation) are conclusive after 3 months. The 4th gen tests are conclusive any time after 6 weeks. In other words, after 3 months it makes no difference whether you have 3rd or 4th gen; they are equally reliable. All the other tests you had are highly reliable as well.

I have no comment on what types of treatment might be best for your anxiety issues.

Thanks for the thanks about our services. Best wishes and stay well.

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44 months ago
Thanks for the prompt reply! I will thus take comfort in my negative HIV status and move on as well as seeking some counseling for my anxiety.  Thanks again for the great service and you can go ahead and close the thread.  Cheers!