[Question #4694] Follow up hiv scare

28 months ago
Hi 

I just wanted to follow up on my recent exposure. Condom burst while insertive vagina with brothal worker in London.  Today I tested both negative combo/duo and PCR for hiv at 14 days.  I also tested negative for gonorrhoea and chlamydia at 7 days. I appreciate that you mentioned this was not conclusive but would you know suggest any further testing? Just wanted a second opinion as my doctor at freedom health stated that there was no need for further testing as my risk was low. He’s said a10 negative PCR test was all I needed for this. Also as mentioned last week I made a donation to your Organization and the TH Trust in the UK. I hope my experience helps others on here. Never again . Happy Xmas 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome back to the forum and thanks for your continued confidence in our services, and for your donations!

But I'm sorry you found it necessary. As we discussed several days ago, your test results indeed are very nearly conclusive, especially given the low risk of the exposure. Freedom Health is a highly competent clinic. There are slight differences of opinion among equally qualified experts on whether PCR alone is conclusive; at what interval after exposure; and whether antibody testing also is required for conclusive results. On this forum, we prefer PCR testing at 2 weeks and follow-up antibody testing at 4 weeks.But these are quibbles. Why doesn't it matter? Let's say there was 1 chance in a thousand your partner had HIV. Let's say the risk you caught HIV, if she had it, was around 1 in 10,000. (With no condom, it's actually about 1 chance in 2500, so I'm assuming partial condom effectiveness because of your brief exposure after it broke.) So before you were even tested, your risk of HIV was 0.001 x 0.0001 = 0.0000001. That's 1 chance in 10 million. If we then assume the PCR test would detect 99% of infections, at this point the chance you have it is around 1 in a billion.

So when the Freedom Health doc says you're home free, he is exactly right -- even if there is a teeny theoretical possibility a later antibody test would be positive. In fact, the chance you'll be struck by a meteorite probably is higher.

I hope these comments are helpful. Thanks again for your donation, kind words, and holiday greetings. Marry Christmas yourself.

HHH, MD
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28 months ago
Hi. Thanks for your reply. 
As mentioned I had a negative PCR early detection test and duo test both negative,  since then between 14 and 24 days after exposure i have a couple of night sweets a sore in the corner or my mouth. I have also had a small outbreak of eczema however I am prone to eczema, lump in my throat (not sore) for 3 days and neck pain/ache. Also a heavy head not headache. I presume the neck pain, heavy head is anxiety based as I constantly google and I do suffer from bad anxiety over all things.  I’m guessing this could also be guilt. My questions are do Negative PCR change to positive antibody tests and how often? I know you gave me odds but has it happened? I will be going next week for ab test.  Does this sound like acute hiv? Can this be any other Sti? Can symptoms occur after negative PCR test? am so sorry to ask you again, I was happy with my PCR test but since all these symptoms I am now in panic mode again. I still have stayed away from my wife, 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
"Panic mode" is not warranted. This information does not change my opinion or advice. ARS symptoms don't start more than 1-2 weeks after infection, or in people with negagive test results at hte times you had them. And these symptoms are not suggestiv of ARS anyway. You'll get the same response if you check with Freedom Health about it.

That concludes this thread. Please note that repeated questions about the same exposure, risk, or symptoms are not permitted -- so no further questions on this topic, please.

Really, mellow out. Concentrate on the reasoned, science based reassurance you have had, both here and at the clinic. Good luck.
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