[Question #4808] When is it enough?

27 months ago
Hello Dr,

I have some questions regarding a situation i had now almost 6 months back. The concern is primarily in regards to HIV and testing. I feel that is what my mind focuses on with this perceived exposure. I blacked out and that is reason for my concern and my mind makes up tons of scenarios around it. After the event i started getting major anxiety and worry. Here are some questions below:

1. I took two HIV Combo tests at quest at 55 days (8 weeks) and then again at 125 days (roughly 18 weeks). Both tests came back negative from quest diagnostics lab going thru STDcheck.com... Do I need further testing to absolutely 100% confirm that i do not have hiv?

2. I get concerned because my girlfriend starts feeling sick after intercourse (around 2 weeks later) and i somehow convince myself that the tests are wrong because of that. Is there reason for concern here, she is faithful so i'm only concerned about myself and her

3. Some state hotlines still say it takes 3 months even with a 4th generation, in particular New York which would always say 4 weeks for 4th gen (know this due to past concern about a year back) but now says 3 months. Could this be because they want to cover all types of tests?

4. Would it ever take 3 months for a 4th gen to be positive if in fact someone was infected?

5. Is there any reason for me to worry or take more tests, different type of test or is this going to be a waste of time for me?

I am in general a big worrier and now that someone i love more than anything gets ill after intercourse make my mind race like crazy. The two times i tested was essentially because of this worry and now i feel the same cycle coming back and wanting to test. I am forcing myself not to because as far as i know my test are beyone conclusive.

Thank you for your time.




Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to the Forum.  I'll be glad to comment. The short answer is you are long past "enough" for HIV and, presuming that you have tested for them, other STIs as well.  I trust you are not going to the internet for information.  If you are, you are going to be misled, either by information that is our of date, taken out of context or just plain wrong.  In answer to your specific questions:

1. I took two HIV Combo tests at quest at 55 days (8 weeks) and then again at 125 days (roughly 18 weeks). Both tests came back negative from quest diagnostics lab going thru STDcheck.com... Do I need further testing to absolutely 100% confirm that i do not have hiv?
Your results are both conclusive.  HIV tests are among the most accurate tests in all of medicine, Quest is a high quality laboratory, and any test results from specimens taken more than 6 weeks after exposure provide conclusive results.  

2. I get concerned because my girlfriend starts feeling sick after intercourse (around 2 weeks later) and i somehow convince myself that the tests are wrong because of that. Is there reason for concern here, she is faithful so i'm only concerned about myself and her.
This is your guilt speaking.  Your tests are correct, you do not have HIV.  

3. Some state hotlines still say it takes 3 months even with a 4th generation, in particular New York which would always say 4 weeks for 4th gen (know this due to past concern about a year back) but now says 3 months. Could this be because they want to cover all types of tests?
These hotlines are out of date.  "Official" organizations tend to be conservative for fear of being wrong.  

4. Would it ever take 3 months for a 4th gen to be positive if in fact someone was infected?
Only if that person had been taking PrEP or PEP with anti-HIV medications in efforts to avoid infection.  In such instances, test results can take longer to become positive.  There are no other medications which effect HIV test results

5. Is there any reason for me to worry or take more tests, different type of test or is this going to be a waste of time for me?
You are in the clear.  Time to put your concerns about HIV behind you.  Further testing related to your long past exposure would be a waste of time and resources.

I hope my comments are helpful to you.  Take care. EWH

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27 months ago

Dr, some sort of glitch. 


My response posted on someone else’s thread titled “hiv test differences”


FYI. 


Here is what I had asked:


Thank you Dr Hook,

So any of my girlfriends symptoms CANNOT POSSIBLY be related to what I am concerned about considering my two negatives outside the 45 days (6weeks)? (58 days and 130 days) Am I correct in that conclusion?

If that’s the case then I should have absolutely zero worry in having intercourse with her along with zero worry about hiv myself?

I appreciate your help a great deal, I think this scare along with two others in the past have really had an impact on me. I think perhaps some professional help is required to get a grip on my thoughts. 

I came here for answers and you have provided them, I should move forward not giving this any thought as well as not associating my girlfriend each time she gets sick with something I CLEARLY do not have. 

Thank you very very much for your assistance. 
27 months ago
Dr,  I wanted to make sure this last question didn’t fall by the waistline since there was a hiccup of being posted to another posters thread. 

Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Sorry about the glitch. Not sure what happened here but let's get to your follow-up questions:

So any of my girlfriends symptoms CANNOT POSSIBLY be related to what I am concerned about considering my two negatives outside the 45 days (6weeks)? (58 days and 130 days) Am I correct in that conclusion?
You are correct.  Sometimes when we are worried/feeling guilty we find ourselves attributing coincidental problems to whatever it is that is making us feel guilty.  This appears to be the case here.

If that’s the case then I should have absolutely zero worry in having intercourse with her along with zero worry about hiv myself?
Correct here as well.  No reason for concern about having sex with her because of the concerns you described above.  You clearly do NOT have HIV.  

Regarding counseling.  I certainly think that if you continue to experience these concerns, then I would encourage counseling.  It is confidential and it is often helpful to talk through things with someone in real time.

Hope this helps.  Again, sorry for the "glitch"  EWH
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27 months ago
Thank you Dr, i will move forward without worrying about symptoms (myself or girlfriend), and the need for any more testing considering i have tested outside 45 days 2 times with lab based 4th gen tests.

I appreciate your time and helping me get a grip to some degree. It's been very stressful last 2.5 years with numerous scares which i always test negative after. I think i will take up your recommendation to get some counseling to move past this. I feel very assured as i type this that there is absolutely 0% reason for me to continue to worry.

Thank you again for all you do on this forum.
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Thanks for your thanks.  I'm pleased that my advice has been helpful to you.  We try.

Closing this thread now. EWH
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