[Question #3725] HIV Test

36 months ago
Doctor,

I had a brief relationship with a lady last summer in which I had unprotected vaginal intercourse approximately 10 times.  She was just coming out of a divorce and said she had been tested early spring and also in July.  She is white, in her early 40s,  and as far as I know, she was a non drug user and not promiscuous.  After our relationship ended, I was tested at a local HIV clinic using a uni Gold rapid finger test at 91 days from last encounter.  It was non reactive and the technician at the clinic said I didn't require additional testing.  Since i had never had a rapid test I have been left with a few questions (I tried to find an answer in previous questions here, but couldn't easily find exactly what I was after).

1.  By my research, it looks like the uni-gold is a third gen antibody test; is this correct? With 4th gen tests out there, is it still a viable testing option.

2.    I notice many people you reassure here have multiple Duo tests after an encounter; is my single test at 90+ days adequate?

Thank you.

 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome to the forum. Thanks for your question.

You describe a partner at extremely low risk, with almost no chance she has HIV. While I understand and would support your decision to be tested for HIV, from a strictly medical standpoint it wasn't necessary (however valuable it may be for its reassurance value). To your questions:

1) Assuming "90+ days" is the time since your last exposure, i.e. you did not have unprotected sex within the 6-8 weeks before testing, your test result was 100% conclusive. Three months (90 days) is old news and doesn't apply to the third generation antibody tests, for which the window is around 6-8 weeks.

2) That many questioners on this forum have had several antigen-antibody ("duo", 4th generation) tests of course means nothing. There is never need for more than one such test, if done 6 weeks or more after the last exposure.

My final thought is that you don't mention other STDs. Based on your description of your partner, the chance she had any transmissible STD is low, but perhaps not quite as low as for HIV. If not done, you might consider a urine test for gonorrhea and chlamydia and a blood test for syphilis. You can expect negative results, but better safe than sorry!

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

HHH, MD

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36 months ago
Dr. Handsfield,

Thank you for your response.  You were correct in the 90 days being the time between the last time I had unprotected sex and the test.

I also was tested for Chlamydia, Gonnorrhea and Syphilis already, all negative.

The test really was for peace of mind since I had stepped outside my norms by not using protection (it was a conscious decision we made based on where we were in our relationship at the time).  My state actually publishes pretty detailed public health info so I knew HIV prevalence (as well as other STIs), to be very low in her demographic.  That, coupled what she told me of her sexual history and testing history, was pretty reassuring in of itself,  I just needed that last confirmation.  It was really just using the rapid test for the first time that drove me to ask the questions here (I have only done blood draws sent to a lab in the past).
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Thanks for the clarifications and glad to hear of your negative STD test results. And thanks for the thanks; I'm glad to have helped.

The rapid blood tests have almost identical performance characteristics as their lab-based counterparts. The only test that has even a slight chance of missing HIV after >90 days is the oral fluids test (Oraquick). You're good to go!

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