[Question #5812] HIV-anxiety quesion

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72 months ago
Am asking this question out of fear and anxiety sorry for repeating it. I had an unprotected sex with someone 60 days ago. and had below tests since then. I saw many responses on google saying 12 weeks conclusive but many responses from both Dr.HHH and Dr.Hook saying 6 weeks 4th gen is conclusive. I moved on after 6 weeks ( atleast I thuught I did) but then my fear is kicking back in as soon as I or my partner get sick (like col, diahherea, fatigue,back pain). I am getting scared thinking they are all HIV symptoms. Can I safely assume and 100% conclusive  that am not infected with HIV with below tests.

14th day - HIV-1 RNA Qualitative - Negative 
28th day - HIV-1 RNA Qualitative - Negative 
49th day - HIV-1 RNA Qualitative - Negative 


35th day - HIV Screen 4th Generation wRfx -- Non Reactive 
42th day - HIV Screen 4th Generation wRfx and 10test panel-- Non Reactive 
56th day - HIV Screen 4th Generation wRfx -- Non Reactive 
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H. Hunter Handsfield, MD
72 months ago
Welcome back to the forum, but sorry you found it necessary -- especially since there is nothing more to say. You recgonize yourself that you're repeating the same questions answered by Dr. Hook just two weeks ago. I hope you didn't think we might have chaned our minds! (Or that Dr. Hook and I might have different opinions or advice. That just about never happens.) These results of course still are conclusive. And you had an nearly zero risk exposure anyway, since few escorts (expensive female sex workers by appointment, as opposed to brothel workers or street walkers) have HIV; and even if she had HIV, the chance of infection after a single unprotected vaginal sex exposure is around 1 in 2,500. So even before you were tested, there was less than one chance in a quarter million you caught HIV. You still should be 100% certain anout it.

HHH, MD
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72 months ago
Thanks Dr. Handsfield for the response and reassurance. 
Irrespective of what the risk was or the scenarios were I can consider 100% conclusive with all my test results correct. None of the symptoms am having are not related to HIV
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H. Hunter Handsfield, MD
72 months ago
*Sigh* Does it really help to see it written a second, third, or maybe fourth time? Yes your results are conclusive, and test results always overrule both exposure history and symptoms. Even if yoiu had had the highest risk exposure you can imagine (e.g. unprotected sex with a known infected partner with high viral load) and even if your symptoms had been typical for a new HIV infection, the test results PROVE you don't have it. Please stop asking! ---
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72 months ago
Thank you Dr.Handsfield.

One more question, I saw many threads and many posts on Google and I didn't see anyone suggesting to get a HIV RNA test. Is there any reason for that, is that not accurate on how the websites like stdcheck.com is claiming like 99% after 11 days?

Any technical reason other than cost for not considering it especially since cuts down the window period?

I see many people saying HIV 4th gen test is the gold standard.why is the HIV RNA not publicized and considered as gold standard. Was there not many research trails done like it was for 4th gen test to prove the RNA Test accuracy?
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H. Hunter Handsfield, MD
72 months ago
The RNA test usually is unnecessary and not recommended except when the risk is especially high or symptoms are typical for a new HIV infection. (You had three of them -- probably none were necessary, and certainly there was no reason for that est after the first negative results at 14 days, which was nearly 100% proof you didn't have HIV. And you could have waited only another week to have your first 4th generation antigen-antibody test, with almost as strong assurance you were not infected. The RNA test is not publicized as a gold standard because it is too expensive to justify routine use, although indeed lots of nervous people use it that way. There is also a small chance of false positive result, resuling in unnecessary alarm -- and expensive testing to show that the positive result was indeed false.---
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72 months ago
Understood, false positive thing make sense. 

Would like to thank you for your help on this website. I truly believe your responses and reassurance help a lot of nervous people like me
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H. Hunter Handsfield, MD
72 months ago
Thanks for the thanks. I'm glad to have helped. But please note the forum policy against repeated anxiety driven questions on the same topic, exposure, etc. Thanks for your understanding.

That concludes this thread. I hope the disucssion has been helpful. 
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