[Question #4701] Can I Rely on Four Different Rapid HIV Test Results?

28 months ago
My question relates to 3rd and 4th gen rapid testing performed by licensed tech in a clinical setting.  About 5 mos ago I put myself in a situation that I'm not proud of.  Unprotected oral sex and, I'm fairly certain, protected vaginal sex with woman that worked at a gentleman's club.  Fairly certain because while I believe condom was used, my mind is playing tricks on me.  Since the incident I've had significant episodes of anxiety.  I'm embarrassed, ashamed and full of guilt.  I've been to every type of doctor and specialist since the episode.  Urologist, Infectious Disease, Primary Care, Gastro, Dermatologist.  I've had blood drawn at a lab to test for STDs - all negative.  Lab did not perform HIV test since it was mistakenly left off the order.  I then had 4 Rapid HIV tests done at 2 different Planned Parenthoods.  Two Insti-HIV 3rd gen finger prick tests at 76 days and 85 days - - both negative.  Also had two Alere Combo 4th gen tests done at 104 days (14.9 weeks) and 129 days (18.4 weeks) - both neg.  CBC blood test last week - all normal.  Metabolic Panel - normal.  All doctors assure me I could rely on the Rapid test results and my symptoms are anxiety related.  I've had rash under armpit but Dermatologist says it's 100% not HIV related but dermatitis. My ID doctor said I could have relied on the first test at 76 days.  I'm having a hard time accepting results and would appreciate knowing, in your opinion, if any further testing is required.  I've read your posts where you haven't seen a negative test at this time frame later turn positive.  I do take meds for Colitis (Apriso - anti inflammatory).  My Gastro doctor says it would have no impact on the testing.  Could all 4 tests be wrong or could I be late converter?  Lately I'm experiencing aches and pains in both legs (similar to growing pains as a child) and warm sensitivity near armpits that come and go - but no swollen glands.  Can it be Anxiety related?  Can I rely on the negative test results?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome to the forum. THanks for your confidence in our services.

Sometimes I point out that the question itself -- in only a few words -- has enough information for an accurate answer. Yours comes close. As I write this initial reply, I have only seen the question, "Can I rely on four different rapid HIV test results?" My reaction is yes, you can rely entirely on only one test, as long as that was done at long enough (usually 6 weeks) after the last possible exposure. In that case, the next 3 tests were superfluous.

Now i have read the text itself. Guess what?

You were seriously overtested. You don't say exactly what advice you had from the several physicians in various specialties that you saw, but I assume they all reassured you that you do not have HIV. I agree. And certainly your symptoms do not suggest HIV -- but indeed they are typical for the physical manfiestations of anxiety, stress, or other psychological origin. And the HIV tests you had, at the times you had them, indeed are conclusive. They prove for sure that you do not have HIV.

So in reply to your closing questions:  "Can it be anxiety related?" Yes, it can and probably is. "Can I rely on the negative test results?" Yes, you can.

I hope this information is helpful. Let me know if anything isn't clear. But let's avoid "yes but" or "could I be the exception" sorts of questoins. Our replies are always the same:  negative HIV test results overrule everything else. No matter how high the risk of HIV at the time of exposure, and no matter what symptoms someone has, the test results are reliable; these other factors are not.

Cheers--  HHH, MD
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