[Question #3029] HIV Testing and Risk

41 months ago
Hi Doctors.  

I had unprotected sex a month ago with a man that I did not really know.  It was really brief and he did not ejaculate.   About 18 days later I developed a sore throats and glands, muscle and joint pain and pain in my elbows and knees.  I tested at 14 days for HIV and it was negative. 

After 29 days I went to a clinic and got the Rapid Aleve Duo combo test.   It was negative.  The counselor said I did not need further testing and to considerate it 99.6 percent accurate.  I called him today just to make sure I was correct and he said it was up to me whether I wanted to test at 6 weeks but they considerate it conclusive.   I'm nervous about it and wanted to get your opinion. 

What are the odds I contacted HIV from this exposure?  

Could my symptoms be ARS and if they were would I have tested negative? 

How many people have a negative 4 week test followed by a 6 week positive? 

Thank you in advance.
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to our Forum.  I'll be glad to comment.  I agree with all that the counselor has said.  Your flu-like symptoms at 18 days occurred at the right time and sound similar to those of the ARS however, if your symptoms were due to the ARS is certain that your repeat combination HIV antigen/antibody test taken at 29 days would have been positive.  The ARS occurs at the time that a person's antibodies appear in the body and tests taken at the time or, or after the ARS are reliably positive. 

IN addition, in terms of combination test performance, while the CDC now indicates that such tests can take up to 6 weeks to be completely reliable, by 4 weeks most (over 99%) of tests are already positive. 

You can be confident that your symptoms were not the ARS and be highly confident that you did not acquire HIV from the exposure you have described.  If I were you, I would not feel the need for further testing.  I hope this information is helpful to you.  EWH 
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41 months ago
Thank you... 

I am still having joint pain and muscle pain and the sore throat.  This is concerning to me.   Could my 4 week test change to positive at 6 weeks.  I keep thinking that maybe the counselor didn't read the test right or didn't see the positive line.   

Would ARS appear without fever?  
41 months ago
Could you tell me my odds of contracting HIV statistically with a negative 28 day test? 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Your follow-up questions are a bit repetitive so I will try again:
1.  Your tests PROVE that your symptoms are not ARS.  I said this before.  Many other viruses can cause similar symptoms and that is the reason tests are used- to differentiate when these sorts of flu-like symptoms are due to HIV (less than 1% of the time in at risk persons) vs. caused by other community acquired viruses.
2.  As I explained above (and your counselor did as well) the chance that your 4 week test is going to change is less than 1%.
3.  Your counselor is trained and the tests are highly reliable.
4.  Fever is a part of the ARS.

I suspect your flu-like illness was a coincidence, nothing more.  Please try to believe your test results.  EWH
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41 months ago
Thank you... I know I am sounding repetitive.  I was doing some internet researching last night which I know is dangerous.  

1.). Would the test should ARS symptoms were negative after they started 8 days ago.  I was reading that when ARS symptoms appear that tests will not show a positive for at least 2 weeks.  

2.).   Based on what I told you woukd you feel confident I could resume intercourse unprotected with my husband. I did a full panel as well at 2 weeks for STD's and it was negative and they also tested me for Syphillis when I had my most recent HIV test. 

I'm trying to move past this huge mistake and I don't feel good so it just keeps bringing me back to HIV.  

Thank you again for all your help.  
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
The best advice I can offer you at this time beyond what has already been said is to stay our of the internet.  While a great source of communication, it is a TERRIBLE source for trying to evaluate one's health status.  All too much of what is prominent there are misinterpretations, statements taken out of context or just plain wrong. 

1.  The statement you found is a misstatement.  Years ago, using tests that are no longer used (by anyone) development of a positive test might have been delayed by a 1-3 days following the onset of ARS symptoms.  This is no longer the case and testing 8 days after symptom onset is completely reliable for ruling out the ARS as a cause of symptoms (third time I've said this).
2.  Yes, you can be confident in having unprotected sex with your husband, based on your negative tests.

As per Forum guidelines and since this is my 3rd reply, this thread will be closed later today.  EWH
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41 months ago
Thank you so much and I will believe my tear result and stay off the internet.  

Thank you again! 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Great plan.  Take care. EWH
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