[Question #4519] Test Results - Follow Up 4349

81 months ago

Hello Doctors,

Thank you for this service, and in advance for your response.

This is a follow-up to Question 4349. I received test results and would very much appreciate your expert interpretation.

Dr. Hook gave clear and confident responses to my original question. As he stated I was at no risk, I inferred no testing was necessary. However, due to a number of factors (guilt, anxiety, fear of infecting my wife and our breastfeeding newborn through her breast milk, and that this behavior was out of character for me), I wanted to pursue HIV testing to receive assurance. The thought of infecting a loved one was too much to bear. I was tested through LabCorp after 3 full days, 30 full days (post 4 weeks), and 44 full days (post 6 weeks). The test was the HIV Screen 4th Generation wRfx. Results from all three tests were Non Reactive.

My questions are:

1. Is LabCorp a solid and reliable testing facility? I know it's a big name, but appreciate your confirmation.

2. Is it now safe to believe, without a doubt, that the results are conclusive, and I am HIV free?

3. Isn't it true that the negative 30 and 44 day tests should eliminate any doubt of a false negative?

4. More than anything, I want to ensure it is okay to resume unprotected intercourse with my wife without putting her, and then our breastfeeding newborn, at risk.

Thank you very much.

H. Hunter Handsfield, MD

81 months ago

Welcome back, but sorry you found it necessary after the reasoned, science based reassurince you had with Dr. Hook. I agree with all he said. You were not at risk and I agree with his advice against testing. If your HIV test had been positive, it could not have been from that event and so other possible exposures would have to be explored. That probably would have meant revealing to your wife why she would need to be tested, as the more likely source of your infection. Would you have been prepared for that, e.g. in the event of a false positive HIV test?

But that didn't happen, so all is well. To your specific questions:

1) Yes, Labcorp is solid in every way. But for HIV testing, the lab doesn't really matter anyway. The HIV blood test procedures are highly automated, with the exact same procedures wherever done, and pretty much idiot proof. Lab errors are exceedingly rare and no more or less common between various labs.

2) Yes, your 44 day result is conclusive.

3) Same question, different words. Yes.

4) It is impossible you have HIV from that event or that you could infect your wife.

I hope these comments settle things for you. Good luck and stay safe!

HHH, MD

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81 months ago

Thank you Dr. Handsfield. It is wonderful to receive confirmation from a second expert, especially such as yourself. I appreciate your patience with me as this has been the most terrifying time of my life. I did not know stress, anxiety, and terror until this episode. And my ignorance on the subject matter makes it that much worse.

1. I've since discovered that the CDC recommends 42-45 days for my test. I saw on a previous post of yours that there is no statistical difference between 44 and 45 days. My test was taken at 44 days, 7 hours to be specific. Should this be of any concern or is this result still conclusive as you mentioned previously?

2. Have you ever seen a non-reactive day 44 test later turn positive without an additional exposure? I have been 100% abstinent since the exposure in question some 53 days ago now.

3. Do you believe that sexual HIV transmission requires penetration? Even a hand job with vaginal secretion as lubrication is no risk?

4. If I had had the most high-risk sexual scenario, would you still be confident that my results are conclusive at 44 days?

5. Even if I had some vaginal secretion on my finger that briefly touched my penis before urination, wouldn't the fact that I undid my belt, unbuttoned and unzipped my pants, etc. help to neutralize any threat? To the best of my knowledge my hand was dry, or very close to it.

5. I am continuing to struggle with my own anxieties and doubts, which I'm aware are out of the realm of this forum. Do you have a counseling or therapy service you would recommend?

Thank you

H. Hunter Handsfield, MD

81 months ago

1) Correct, no difference between ~40 days and ~45 days. See answer 2 above; I see no need to repeat myself!

2) Nope, I've not only not seen such a patient myself, I've never heard of it happening.

3) In general yes, penestration is required. Can't say hand-genital contact or fingering is zero risk, but since there are no know cases, it's safe to assume it's exceedingly low, i.e. zero for all practial purposes.

4) Yes.

5) These details make no difference in my opinion or advice.

6) Professional counseling is all I can recommend. We don't recommend particular health care providers of any time. But it shouldn't be hard to find one in your area.

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80 months ago

Forgive me for returning. I'm still uncomfortable beginning intercourse with my wife out of fear of infecting her and our breastfeeding newborn. Because of this, I believed visiting an in-person specialist would be my final step before totally accepting my negative status (I pray). I did so today. The hope was for him to corroborate yours and Dr. Hook's advice and expertise. He agreed my "exposure" was very low and likely no risk. Unfortunately, he wasn't as confident in the conclusiveness of my 4th Gen test results (non-reactive at 30 and 44 days). So he did a blood draw and scheduled a PCR test to be able to combine it's hopefully negative result with my negative 44-day DUO result to deem me ready for spousal relations. I believe this doctor to be a bit more conservative and old-fashioned if that makes sense. I'm currently at 68 days, and now unfortunately have to wait a number of days for the results.

1. Can you please shed some light on this HIV test, and what thoughts you may have on me having taken it? What is its false positive rate, particularly at 68 days? To confirm, I have been 100% abstinent since this possible "exposure."

2. Part of me really feels like I've greatly overthinking and overreacting to this whole event, but my anxiety (diagnosed) and OCD (undiagnosed) are really getting me. I just really don't want to infect my family and so am going beyond to prevent that. Would you tend to agree with this assessment?

3. Would you say you feel extremely confident, nearly 100%, that this result will be negative?

Thank you in advance for your response and help. I've begun therapy so hope to continue to work through this episode.

H. Hunter Handsfield, MD

80 months ago

Oh good grief. You came here for our expertise and then decided to ignore it. What more do you want me to do? Your new specialist is ripping you off -- or, giving him the benefit of hte doubt, perhaps you exaggerated your exposure. (Re-read Dr. Hook's original comments, no risk for HIV.) Or he understood you are way beyond rational and hopes that still more testing will finally convince you.

1) There are no false positive results to speak of with the tests you have had or that are planned. But deal with that if in fact a test comes back positive, which won't happen. (If you actually mean false negative -- i.e. negative result even if you have HIV -- that's impossible with the tests you had or planned.)

2) "Part of me really feels like I've greatly overthinking and overreacting to this whole event...." You think? For sure. You're way off the deep end, even considering your worries about your family.

3) 100%. Not "nearly 100%".

Get to work with that therapy! I suggest you print out this tthread as a framework for a discussion with your counselor. Finally, please note the forum does not permit repeated questions on the same topic or exposure. This being your second, it will have to be your last one; future new questions about this exposure, testing, and your fears about HIV may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

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