[Question #4864] HIV TESTING AND SYMPTOMS

27 months ago
Dear Doctors,
I had an encounter with a female friend in a hot tub in mid July 2018. (See questions 3975 and 4313) No penetration, just a lot of kissing and touching and mutual masturbation, nearly all of which occurred in water.  On Sept 20, ten weeks from the event and after some worry, I went to the local health clinic and had the Alere rapid point-of-care HIV test (finger stick) test, which I believe is the  combo 4th generation test and it was negative. I have had no encounters since that would have put me at risk and resumed sex with my regular partner. 
However, on Thanksgiving, I lost my voice completely and it still hasn't fully come back. I went to my ENT and he said I had an upper resp. infection and a small nodule on my vocal cords. The upper respiratory thing got progressively worse  and seemed to turn into bronchitis. So for about the last two months, I have been dealing with what seems like a cold with a serious cough that went from bad, to much worse, to better for now. I've been on three rounds of antibiotics, two steroid packs for my throat, and all manner or prescription and OTC medicine. Things seemed to be getting better, but then last week I had a bout with diarrhea, which is better now, but still having loose stools. Throughout all of this, I have not had a fever. 
Obviously, my concern is that the test came up a false negative and I am having symptoms of HIV infection. I really hate to ask these questions again, but it would give me some peace of mind.
1) My negative test results at 10 weeks with the Alere rapid point-of-care HIV test  are conclusive yes?
2) Test results always trump symptoms, correct?
3) I can continue sex with my regular partner?
Thank you all again for your patience and such a valuable service. 




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back, but sorry you found it necessary. I reviewed your three prior threads and can confirm the accuracy of both my and Dr. Hook's comments at that time.

You have missed a basic fact:  If an HIV blood test, including the duo test, is negative more than 6 weeks after the last possible exposure, the test result overrules all other factors. In other words, even if you had a high risk exposure (you did not) or if your symptoms were typical for a new HIV infection (they are not), the test results you report are conclusive. HIV does not cause cought, nasal congestion, etc. You caught some sort of garden variety respiratory virus.

Those comments, and our replies previously, cover your three questions, but to be explicit so there is no misunderstanding:

1) Yes, condlusive.

2) Correct.

3) You should never have stopped having sex with your regular partner and certainly can safely continue your normal sexual practices and partnership.

HHH, MD
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27 months ago
Dr. HHH,
Thank you so much for the reply!! I think my irrational mind  has been working a little overtime, as I can't remember the last time I've been this sick for this long.  Thanks again to you, Dr. Hook and Dr. Warren for all you do! This forum is truly invaluable!!!
All the best! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
I'm glad to have helped.This sounds most like an allergy of some sort, with some of your symptoms perhaps due to side effects from antibiotics -- which probably were unnecessary. Keep working with your doctor. 

Thanks for the kind words about our services.
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27 months ago
Just as one more follow up. I guess one of the reasons Iam a little paranoid about the accuracy of the fingerstick test is that I see in the questions here people talking about lab tests, PCR (?) tests, etc. i would imagine that far more blood is used in those tests.  I find it ather amazing that the Aelere rapid test can detect antibodies and what not with only a tiny bit of blood. But it must or health care clinics wouldn't use it. And if I am not mistaken, the longer you wait to test after and potential exposure, the more likely a rapid fingerstick tes would detext the imfection yes? Anyway, sorry for the paranoia! I sincerely thank you again for your time and advice doctor!! All the best to you amd yours!!
27 months ago
And my apologies for the typos.....sent from my phone....:-)
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
The amount of blood tested makes no difference. Each kind of test has gone through rigorous research and quality control, otherwise they would not have US FDA approval (or equivalent agencies in other countries) and would not be on the market.

All tests have increasing effectiveness in picking up new infections as time passes, but all are 100% conclusive after 6+ weeks (or 3 months in some of the older tests).

That completes the two follow-up comments and replies included with each question and so condludes this thread. I hope the discussion has been helpful. You can move on without worry; there is no chance you have HIV.
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