[Question #6313] HIV 4th gen and RNA at 4 weeks

17 months ago
Hi Doctor, I had a low risk exposure and got very anxious about it. Had a handjob at a message parlor, and am very sure that her vaginal fluids were on my penis.,  28 days ago. Both me and partner got sick with flu and other symptoms 20 days after the exposure and that made me scared and anxious. I took a 4th gen and RNA test at 21 days and both were negaitve and another 4th gen and RNA test yesterday (27 days after the exposure), just got my 4th gen result it was negative and still wiating on RNA result. I saw other posts where you said 6week 4th gen test is conclusive. If my RNA test on 27th day come back negative can i consider that conclusive or still better to wait and get a test at 6 weeks mark.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Welcome to our Forum.  Thanks for your question and for your confidence in our service.  I would not characterize the encounter you describe as "low" risk, I would call it NO risk.  No one has ever been proven to have acquired HIV from receipt of masturbation, even when a partner's genital secretions get spread between partners.  You will not be the first.  Further, your testing has proven that your symptoms were not due to HIV.  When persons have flu-like symptoms due to HIV, their 4th generation, combination HIV antigen/antibody tests are always positive.  That yours is negative proves that your symptoms were not due to HIV (I would add that the time course of you  and your partner both becoming sick at about the same time is also not consistent with you acquiring HIV and then transmitting it to her.  It is however quite consistent with community acquired non-STI viral illnesses). 

When you get your negative RNA test result back please consider it, combined with your other test results  definitive evidence that you did not acquired HIV.  You are in the clear.  No further testing is needed related to the encounter.

I hope this information is helpful to you.  EWH

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17 months ago
Thanks for the reassurance Dr Hook. 
I just got the RNA result and it was negative also.

Want to ask another, is there any chance or possibility to transmit HIV without having a penetrative intercouse of somekind. Also irrespective of exposure have you ever came across anyone with negatvie RNA and 4th gen at 27 days to become positive later
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

HIV is transmitted only through unprotected penetrative sexual activity with an untreated infected partner or through injection of infected material deep into tissue. 

Your RNA proves that you are not infected.  I have never seen or heard of a person with a negative HIV RNA and negative 4th generation test for HIV who went on to convert their test to positive.  You are in the clear.  EWH

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17 months ago
Thanks dr. I haven been very anxious and want to ask one last question. 

 Is the HIV RNA and 4th gen combo test is 100% conclusive at 4 weeks even if the exposure was unprotected penetrative sex or would you say 6 weeks is conclusive  for diff exposure 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Your results are entirely conclusive, irrespective of the exposure.  Please believe them.

 As per forum guidelines this will now complete this thread. Please don't worry. Take care. EWH 
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