[Question #5258] HIV Testing Concerns

22 months ago
Hello Doctor,
I had a question about the effectiveness of 4th Generation HIV laboratory testing. After my latest encounters, encounter A and B respectively, the worry has been driving me insane. As far as encounter A : approximately 62 days ago I had vaginal sex with a friend [21/F] and the condom broke, additionally she was close to her period and may have gotten some blood on the broken condom and my penis. I immediately replaced the condom after that. We're both college students in Greek life at a smallish state school. Encounter B occurred about 44 days ago, when having sex with another person [20/F], also in Greek life, the condom broke and I was unprotected for roughly 1-2 minutes at the most. This time there was no blood. I have been tested several times using a laboratory 4th Gen Antigen/Antibody Duo. For encounter A I have received negative tests at: 26 days, 42 days,  49 days and 60 days while for encounter B I have received negative results at 9 days, 25 days, 33 days and 43 days. I also had normal blood work done  roughly 50 days after encounter A and 36 days after encounter B respectively. Would you consider these results conclusive?
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome to the Forum.  I'll be glad to address your questions, as well as to comment on what may be a misperception or two on your part.  Before I do, let me also congratulate you on  using condoms- they will protect you unless they are used incorrectly or you have the misfortune to have one break which occurs about 1% of the time they are used.

Without knowing more details, I would classify both of the exposures you describe as being relatively low risk.  They appear to have occurred in the U.S. where HIV is particularly uncommon among women (less than 1/2 of 1% of American women have HIV.  The average risk for acquiring HIV from a single episode of unprotected vaginal sex is about 1 infection in 1200 exposures.  Thus putting these two figures together, there is a 99.9% chance that you did not acquire HIV from either of them.  I should also add that the fact that partner A was menstruating at the time does not change the risk for acquiring infection.

Your test results with respect to both exposures are conclusive.  The 4th generation, combination HIV antigen/antibody tests provide completely conclusive results 6 weeks (42 days) after an exposure.

Finally, I will also pint out that from the encounters you describe, your risk for acquiring other STIs, chlamydia in particular, is at least 100 times more likely than any risk for HIV.  Still not high but worth getting checked.

I hope this information is helpful. EWH
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22 months ago
Thanks for the reply. For my first follow up I wanted to ask about the link between HCV and HIV seroconversion. I had seen something on the internet saying that if I were to have contracted both at the same time (say from Encounter A), I would have a delayed HIV seroconversion. Is that possible?
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
No, there is no link whatsoever between hepatitis C and HIV seroconversion.  Further, the Internet is full of is information as well as statements that are out of date or just plain wrong.  The myth of delayed seroconversion in persons who are not taking medications designed for HIV therapy is an Internet-based urban myth.  We urge clients to stay off the Internet when looking for health-related information. EWH---
22 months ago
Thanks for the information, Doctor. For my final follow up, should I be entirely confident in these results at 6 weeks, given that my blood test reflected normal immune system health, or would you recommend another test at 12 weeks? I have not had  any real symptoms of HIV, but I have had a lot of gas, burping and a rumbly stomach.
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
As I said above.  Your results are entirely conclusive.  Further testing would be a waste of time and resources.  The results are not going to change.  Gas and burping are not signs of HIV or any other STI.  

As you note, that was your 3 Rd question.  Thus this thread will be closed shortly without further responses.  Take care.  EWH
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