Hi Docs,

I purchased my question, then realized I should read some others to see if they would spark some additional questions in my mind, but what really happened was most of my questions actually got answered by reading.

Anyways I've paid already so here it goes.

I thought that I had a "high risk" activity a while back with me being a Male age 40, having unprotected vaginal and oral sex with a female of unknown status.  Now that I read some other threads maybe the risk wasn't as "high" as I thought.  I perceived it as high because I didn't know the person and have no way of contacting her again.

Anyways this was 8 months ago.  I had some weird symptoms about 4 or 5 weeks after the incident (mostly fatigue, etc), however, I also have read symptoms aren't a good judge.

Here is my testing: (all negative on all accounts)

11 Days---HIV RNA Test
6 Weeks---4th Gen HIV test
12 Weeks--4th Gen HIV test
6 months--10 Test panel including 4th Gen HIV test
8 months---HIV RNA Test AND another 4th Gen HIV Test

I was told the 6 and 8 month tests weren't necessary, but not matter what the combo of the two test at 8 months are unequivocal proof and to move on.

Direct questions:
1. Is there any reason you can think of to have any more tests, as I've had no sexual contact since then?
2. What is the main difference between the RNA and 4th Gen Test (I think I know the answer, but would like official explanation)
3.  Can I move on without worry at this point?  I've gotten MUCH less worrisome over the last month or two, but would like confirmation.

Thanks!

T

Thanks for your question.  I'm also pleased that you reviewed some of the earlier posts on the Forum.  Over the years we have accumulated a fair number of questions on a variety of themes and while out knowledge has evolved in some areas, much of what we said a year or more ago is still relevant today.  I hope you will find my responses to your questions helpful.

You also raise an important, fundamental issue- that risk is relative and that even in situations where the risk is unequivocally high such as exposure to an infected partners, the majority of single, unprotected encounters with infected, untreated partners are not going to lead to infection.  OTOH, most STIs are spread by persons who are unaware of their infection and, as a result, we also advocate periodic regular screening (testing in the absence of signs or symptoms) for persons who have new partners, who have multiple partners or who have regular partners who may have other partners.  Following an encounter of the sort you describe, testing is reasonable, the question however becomes how much is enough.  Thus, in response to your questions:

1.  You can be completely confident that the encounter you describe did not result in HIV infection, You have been tested to antibodies to HIV, for HIV antigen (a protein from the virus itself) and for viral RNA (viral genetic material) at times when the results are conclusive.  You can have confidence in your test results and certainly there is no need for additional testing related to the encounter you describe. 

2.  see above.  The antigen is a viral protein, the RNA is the virus's genetic material.  As a rule, the RNA tests are somewhat more sensitive and becomes positive earlier in the course of infection.  it is also a more expensive test.

3.  Absolutely, you can move on without further concern about HIV.  I trust that at some point in this saga you were also tested for far more common STIs such as gonorrhea and chlamydia.

I hope my comments are h4lpful.  If there are further questions, as per Forum guidelines,  you have up to two more follow-up opportunities for clarification.  EWH

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Ah, thanks for pointing out your "ten test panel".  I agree, that provides completely reassuring results. 

The thread will remain open for up to 30 days should another question occur.  Take care.  EWH

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