[Question #5800] Question on testing

21 months ago
  Hello, I had a unprotected intercourse exposure July 28.  I am going to do this panel of tests...below

   If you are concerned about recent exposure, we recommend adding our HIV RNA Early Detection Test. Our HIV RNA Early Detection Test can detect an HIV infection as early as 6 days after exposure and is conclusive if taken 9-11 days post exposure. Our standard HIV test is a 4th Generation HIV 1 & 2 Antibody/Antigen test that can detect HIV as early as 2-3 weeks after exposure.
  •  HIV Type 1
  •  HIV Type 2
  •  Herpes 1
  •  Herpes 2
  •  Hepatitis A
  •  Hepatitis B
  •  Hepatitis C
  •  Chlamydia
  •  Gonorrhea
  •  Syphilis 
  • My question is when should I do this to be absolutely 100% sure I am negative with everything, especially HIV rna and antibody/antigen.. and STDs.. everything at once for a 100 percent definite result and I can move on from this...? Also, what about HPV is that something I should be concerned with too? Thank you !!  PS.. I'm a 37 year old white male .. never no iv or drug issues.. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Welcome to the forum. Thanks for your quesiton.

You say nothing about your partner, so I cannot judge your risk from that standpoint. If a woman has untreated HIV, the chance of transmission for a single episode of unprotected vaginal sex is around 1 in 2,500 -- so she is a fairly average sexually active younger woman, in whom an average of 1 in 1,000 may have HIV -- your risk of catching HIV was 1 chance in 250,000, so HIV testing is opitional. The RNA test is not 100% conclusive at 9-11 days; it can take 14 days or longer, and even then, most experts recommend also having an antibody test (or antigen-antibody, "4th generation") test as well at 4-6 weeks. If you decide to pursue HIV testing, I would suggest a single AgAb test at 6 weeks. (It's 98-99% conclusive at 4 weeks but takes 6 weeks tor each 100%.) (The wording of the lab's advice seems designed to induce anxious persons to have several tests, including RNA, the most expensive.)

As for other STDs, the only tests recommencded by experts after a single vaginal sex exposure, in absence of symptoms, is a urine gonorrhea/chlamydia test (valid any time more than 4-5 days after exposure) and a syphilis blood test at 6 weeks. For sure hepatitis A testing is nonsense; hep B and C are so low risk for any single event as to be unnecessary; and the HSV blood tests are not sufficiently reliable to be tested at all unless herpes is truly suspicious based on contact (e.g. known infected partner) or symptoms. There is no point in having any blood tests until 6+ weeks after exposure, except as a baseline to show you were not infected before the exposure described.

There are no recommended, approved tests for HPV in males -- and at age 37, and assuming you have been sexually active in the past, you already have had HPV (everybody gets it), and this single exposure makes no significant difference in chance of being infected or having a significant heallth problem from it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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21 months ago
 Thank you... She hasn't done anything sexual in 3 years because she does not trust no one... 
 Also, so the test here for HIV 1 is rna? And HIV 2 is atibody/antigen?   These test for HIV I can do 6 or 8 weeks for definite 100% results  so from July 28 to Sept 30 that's 8 weeks ..this would be undoubtedly understandable definite 100% accurate results correct?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
HIV2 is almost non-existant in the US; only a few hundred cases ever known in the US, and most of those in people who were infected in Africa. The antibody portion of the AgAb test (or current antibody-only tests) detects HIV2; the RNA test is only for HIV1.

In any case, it sounds like there is no chance at all that your partner has HIV. Given what you know about her sexual lifestyle, why is it on your mind? Why not speak with her about all this? Since she doesn't trust most of her partners, she probably is just as scared that you have HIV as you are about her. Encourage her to be tested and share your results with her. If both of you are negative now -- on either antibody only test or AgAb -- it will prove you both don't have HIV and neither of you is at risk, and you could then forget about doing any further tests at all. But if you can't get ahold of her or she doesn't go along, just have a final AgAb test at 6 weeks and forget about all other testing.
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21 months ago
  Yeah I think I'm going to wait for a full weeks to pass which would be September 30th Monday and I think I'll either go to my doctor and get a blood draw for all the testing would that be fine? And I just always hear about the three-month wait. But I think you said that is outdated now right.. so at 8 weeks which would be two full months I would be 100% in the clear God willing
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Yes, many agencies still stick with 3 months out of legal conservatism. But I stand by my comments above on timing of conclusive results. But I don't understand why you apparently don't like my suggestion about speaking with your partner and asking her to be tested.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helfpul.
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