[Question #6749] Assessment

12 months ago
Good day, I have read many posts, and can say I had a high risk exposure (MSM). Although condoms were used I cannot guarantee they were used properly or for the entire time, my memory of this evening is very vague. This was a one night encounter and HIV status of partner was unknown. STD tests negative for syphilis, gonorrhea, chlamydia.  I never developed fever, rash, or sore throat. I have had random muscle pains throughout body, constant headache  and my main complaint is armpit pain and neck pain. I do not notice any swollen lymph nodes. It has been over 4 months and I still have these muscle pains so maybe unrelated. Currently my only option for testing is by rapid POC tests (fingerprick), I have had the following:
4th gen Alere Combo-25 days, 49 days, 65 days (all negative)
3rd gen Alere Determine Hiv1/2 70 days, 80 days, 87 days. (all negative)

I may answer my own question but would you consider all of these 100% conclusive I did not  contract HIV during this encounter? Well all but the 25 day test.  
Do you recommend any further testing? If so which test? 

Thank you in advance for your advice. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Welcome to the forum. Thanks for your question.

First, congratulations for your careful approach, i.e. entirely safe sex. For future sexual events with other men, in addition to condoms, I would encourage you to ask about HIV status and defer contact with those who don't know or are positive and not on effective anti-HIV treatment; also for those who seem evasive in answering.

Thanks also for reading other threads with questions similar to your own. Having done that, you may have predicted my reply:  there is no chance at all that you have HIV. Among the main themes and take-home messages from this forum is that the HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition. There has never been a reported case of anyone with newly acquired HIV who had negative antigen-antibody (AgAb, "4th generation") tests after 6 weeks (not counting a few who were taking prophylactic HIV drugs that didn't work). And probably none with negative 3rd gen blood tests beyond 8 weeks.

Therefore, the test results you had overrule all other considerations:  even if you knew your partner had HIV (which probably he did not) and had entirely unprotected sex, your results prove you were not infected. I do not recommend any more testing. You've been over tested already:  you could have stopped with complete confidence after the Alere Combo test at 49 days.

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

12 months ago
Dr. Handsfield, 

Thank you for the prompt reply and I appreciate your advice "I encourage you to ask about HIV...." To be honest, it never really crossed my mind until this encounter. 

Your comments are very helpful, as previous advice was from volunteers and not professionals. However,  both yours and their service is very much appreciated. Please feel free to close this blog, I will not "but if" or "what about" your comments. 

You have put me at ease and I truly appreciate your time and advice! Take care!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Thanks for the thanks; I'm glad to have helped. That's why we're here.---