Sorry but I wanted to clarify some things regarding my last post #2683. 

You previously said that my test proved my latest possible symptoms were not ARS, Is this the case considering they started on day 18 (4days after my negative duo test @ 14 days)? 

In terms of ARS are symptoms always severe? I am particularly interested in the body pain and sore throat which are what I currently have. 

I know you said it was unlikely the condom broke without being noticeable, but have you ever had a believable case of this happening?

This whole episode really hangs on whether condom broke and I have no reference point so worry we may have missed it. 

I appreciate your comments regarding my level of concern and the implications for having unprotected sex with my partner, but really wanted to know if, had I have come to you as a patient, you would be recommending that I do or do not test. Anxiety aside, I just want to know what you would be telling me to do outside of calming nerves etc. 

Is there a reason you now say 6 weeks conclusive? I understood you both said 28 days would be the mark?

I appreciate you have touched on some of this, but would appreciate if you could elaborate. I say this because I have spent hours on sites reading posts and know that I appreciated where answers have been elaborate as there may be parts that relate to me, despite not being so relevant to the poster/answerer! Looking out for those trawling anxiously as I have. 

Thank you!

Whether your symptoms started on day 14 or 18 makes no difference. Your negative test proves HIV isn't the cause of your symptoms.

ARS symptoms can be very mild. However, HIV would be very unlikely to cause sore throat and body pain with no other symptoms.

Whether Dr. Hook or I has ever had a patient who was unaware that a condom broke is a somewhat irrational question: if the condom broke, but the patient was unaware, obviously s/he would not have said anything and we would not know.

Even if the condom broke, you were at little risk of HIV. The average HIV transmission risk in unprotected vaginal sex is under 1 chance in a thousand, if the female partner has HIV; and your partner probably was not infected. In other words, you are wrong that whether or not you have HIV "hangs on" whether the condom broke. It does not.

Both Dr. Hook's advice and mine would be exactly the same if you were one of our own clinic patients. We never provide advice simply to "calm nerves":  on this forum, you get our best judgment based on the available science and our clinical experience.

As for time to conclusive results with the antigen-antibody (4th generation) tests, a new review of all published studies of the HIV blood tests concluded that although nearly all 4th generation tests are conclusive by 4 weeks, 6 weeks is required for 100% certainty. Our updated advice on this forum is based on more precise interpretation of the available studies.

HHH, MD

I also a big follower of your work and am honoured to have your input on this matter also. 

A few follow up questions:

1. Taking your point about differing severity. I am suffering from back pains and aches. Are ARS body pains every localised to one part of the body?

2. When I ask about a similar case, I mean where the patient is sure they did not notice a break in the condom. 

3. Take your point regarding it all turning on the csw actually being positive. I guess, I mean that if the condom did not fail there would be no exposure even if she were positive. 

4. I have never experienced a condom break (quite new to sexual activity) - what would it have looked like and how hard would it have been to miss? Condom was there at end, but could it have failed surreptitiously?

5. Lastly - apologies if it sounded like I suggested you and Dr H give advice to cam nerves. Not my intention. I only meant that should I test because I need to to (medically)?

Many Thanks Doctor!

Didn't want to waste my remaining question, but not sure if my below question got lost in the mix. Sent an email, but no reply.

Any feedback on my questions?

In addition, I have been experiencing a whole host of body pains - lower back pains, and pains around my shoulders and neck. A few other muscles feel tender too around my chest and sides. Mainly small muscles here and there. Other than this and mild throat pain, no other symptoms.

This might be my last correspondence, but hoped you can help with understanding my previous questions.

In addition to the below, how good would a 21 day duo be if I were to take one?

Many Thanks

At this point perhaps these replies are moot. I'll just say that body pains alone, or mild throat pain, would never be a symptom of a new HIV infection. ARS is a short-lived syndrome of multiple symptoms that clears up entirely within 2-3 weeks.

If you had a duo test at 21 days, it was around 90% reliable.

I'll leave this thread open a couple more days in case you have additional comments or questions. But by now it should be even more evident you did not catch HIV.