[Question #3743] Day 21 4th generation test

33 months ago
Dear Doctor 

on 28th April i went for a massage at 3.30 Pm  - It resulted in a handjob (nothing else - no kissing , oral , vaginal , anal etc - she was completely clothed ) . I was uncircumcised. I understood there was ZERO risk unless there was significant blood involved. While i didnt see any blood, i certainly couldnt be sure about it. 
I was under great stress as im married. I told my wife about it and ofcourse it has had an impact on our relationship.  Iv been taking counselling for anxiety but i have some very rough days in terms of my fear and anxiety  

Iv always had oral herpes and on 9th i had a breakout of fever blisters on my lips. This threw me off and i decided to get tested 
 
I wasnt sleeping well and i have slipped in my job as well. To try to reduce the stress, On 19th may I got a 4th generation ( p24 + antibody test ) . This was on Day 21 post the exposure.  The doctor in India said they take tests at 3-4 weeks post exposure.  I took it at 3 weeks (not after 3 weeks but on day 21 ) (exposure april 28th , test may 19th  p24+ antibody ) . Is this a good indicator and do you think i need any further testing ?

It is so nerve racking. 


Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Welcome to our Forum.  I'll do my best to help.  My sense is that intellectually, you already know that the event you describe were no risk for HIV.   No one has ever acquired HIV from receipt of masturbation. This is the case irrespective of whether blood was present or not. You are not going to be the first. Consequently we must assume that the test think you have performed represents your anxiety and perhaps guilt over the event you describe.   AT 21 days combination HIV antigen/antibody tests detect about 90% of recent infections and at 4 weeks these tests detect about 99% of recent infections.  Given that no one has ever acquired HIV from the sort of exposure you describe, your 21 day test result is strong further evidence that you did not get HIV.  From a medical (and statistical) perspective, there is simply no reason for further testing.

I hope my comments will help you to move forward.  EWH 
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33 months ago
Dear Doctor 
Thank you for your reply. It will help me move on, I hope. I keep imagining that every cough or every pimple is a sign of ARS . I read that they show up until 4 weeks. Is that true?  . This Saturday completes 4 weeks and I can’t wait to stop fearing those symptoms .
And my final query is -
 Am I at risk of syphillis? If I do need to get tested - when is the earliest I can get tested ? Do you think I can have sex with my wife ?
Thank you for all your help. Won’t need more answers after this
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
What you have heard about the onset of symptoms is incorrect.  Person who develop symptoms related to recently acquired HIV typically do so within 4 weeks of exposure with most persons developing symptoms at  somewhere between 7 and 14 days. 

Syphilis would not be transmitted by receipt of masturbation unless your partner had a syphilis sore on their hand.  You would have noticed.  Further, had you acquired syphilis, you would have developed a sore at the site of exposure, typically by about day 21 after contact.  In my opinion you do not need testing but if you must, syphilis blood tests would be conclusive at six weeks after the exposure.  I really do not think this is necessary. 

I hope these comments are helpful.  EWH
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33 months ago
Dear doctor

OMG . I didn’t think I needed to come back here but unfortunately I have a sore which looks like a large pimple ( or a small sore ) where my thigh meets the rest of the body near the butt .

I’m worried and extremely scared it’s probably syphillis. 

I noticed it on day 26 after exposure when I tried to sit on my bike but there was a small pain . When I saw it , it was there . There has also been a full pain today on day 28 above my groin . 

Out of fear and desperation - I went and got an hiv test ( duo test ) and a syphillis test ( cmia) on day 26 . They both came out negative . 

It was only a handjob ... nothing else happened . She was completely clothed 


Please help me -
1. Are these tests reliable . Is syphillis cmia rest reliable on day 26
2. What do you think I should do ? 

Please help me . I’m very very scared . If I need to pay another 25 dollars I will definitely do that


Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Oh please.  Your guilt and anxiety are causing you to be hyper-aware of bumps, rashes and lesions between your navel and knees and then assuming that they are an STI related to the NO RISK encounter you described.  Your tests, not surprisingly PROVE that you do not have syphilis of HIV form the encounter.  What you describe is likely a pimple or boil, nothing more. 

I urge you to believe your test results, they confirm that you did not have these diseases.

I think you need to find a way to address your anxiety and (I assume) guilt).  Since you are not able to do this on your own, even after professional assurance AND negative tests, it appears you need help.  To get that help, I suggest you seek professional counseling. this should be confidential and may help you to address your concerns.  You may want tp print out this thread and show it to a counselor as part of steps in seeking counseling. 

As this is my 3rd reply to your questions, this thread is now over and will be closed later today without further replies.  I hope my comments and assurances have been helpful to you.  EWH
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