[Question #3462] Time to stop? Is 102 days enough?

35 months ago
Hello Dr's, i asked questions last year around HIV testing and now find myself consumed with the same type of worries.
I will get right to the questions, and thank you.

1. I do not fully recall my event that has made me so worried  however know that oral both ways was involved. I have subsequently tested via lab based 4th gen tests through stdtestexpress which i was then diverted to quest labs for the actual blood draw from my arm. The test were on 27 day, 42 days, 72 days and 102 days after exposure. They were all negative, is this more than sufficient to conclusively say i am free to stop thinking about this disease that has caused me so much anguish?
(It is now 150 days past the event in question)

2. I continue to worry because my girlfriend whom i love a great deal seems to get sick every 2 weeks for a few days after we had intercourse about 2 months back. Could her illnesses have anything to do with HIV in leau of my testing history? She had the flu once, and cold type symptoms twice over the course of 8-9 weeks. Gets better and then happens again. 

3. Is there any reason for me to do another test? My girlfriend feels ill and it seems like this is the pattern for me to now go and get tested. I understand it sounds absurd!

4. Would any circumstance warrant testing past 102 days outside of perhaps Prep being used, which i did not?

5. Would ARS or sero-conversion happen at 5 months under any circumstance?

6. Just a comment but your feedback is appreciated, i feel that perhaps my anxiety and worry is getting the best of me and essentially whenever she gets sick i start to worry only to take another test with the same result which leads me to feel okay for a little while. How would you suggest i approach this, do you feel i need some in person therapy type assistance.

This obsession in thought about this disease has been the most horrible thing i have had to deal with in my entire life.

Any help is greatly appreciated. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome back to the forum. However, you have apparently established a new account with a different username, so I cannot see your previous thread(s). But assuming these and similar questions have already been addressed, my replies are very succinct. I'll start out by saying that only from the title you chose for your question, it is certain you do not have HIV. Any and all available HIV tests are 100% conclusive at 102 days after the last possible exposure. No matter how high the risk at the time, and no matter what symptoms you might have, the test results rule and prove you don't have HIV. To your specific questions:

1) Oral sex almost never transmits HIV. You were at little or no risk and did not need tesitng.

2) HIV does not make pepole more susceptible to minor colds, flu, and other infections. That your partner "seems to get sick" from time to time does not mean you have HIV and has nothing to do with your sexual exposure a few months ago.

3,4) There is no need for additional testing and there are no circumstances that could change this (except maybe PrEP, as you apparently know).

5) No. ARS always starts within 1-2 weeks of exposure, and seroconversion always is complete before 3 months and usually 6 weeks, depending on the particular test.

6) Whenever someone suspects his or her own problem has a psychological origin, and whenever someone suspects professional counseling might be a good idea, almost always s/he is correct. In other words, since you ask, the answer is yes:  you should talk to your doctor about referral for professional counseling to get past your worries about HIV, and to get past your apparent anxieties about a sexual decision you regret.

I hope these comments have been helpful. Let me know if anything isn't clear.

HHH, MD
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35 months ago
Thank you Dr. I appreciate your comments. 
Just a few follow up questions. 

1. Are you serious, Additional testing is pointless?
2. Are there instances in medical journals, etc in which 4th gen tests have multiple false negatives with the dates I have tested on?
3. In your expert opinion why do we still see information on the internet or via pcp offices in which some suggest 3 or 6 month testing even with a 4th gen. 
4. Oral sex almost never means it happens, why suggest no need for testing? I guess individuals like myself worry more than most folks?

I am definitely going to take your advice and seek some counseling. 

This is all I have on this follow up. 

Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
1. Of course I'm serious! Additional testing for HIV would be a waste of money. It has already been proved 100% that you were not infected.

2. To my knowledge there are no such instances.

3. First, people can post whatever they want; and many people are simply lying, e.g. covering up for an exposure they don't want to admit; some do not know when in fact they were infected; and some misunderstand what tests they have had.

4. Some people certainly worry more than others, and you're obviously in that group. The large majority of people in your situation just have a single test and accept the professional advice they receive about the result and go on with their lives without futhter worry. But I often recommend testing in people with no risk at all, because sometimes a negative test result gives a worried person more reassurance than my professional advice does. It's human nature and I don't take it personally. OTOH, I never recommend anyone be tested repeatedly, especially after they have had at least one test beyond the window period.
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