[Question #7158] Test Accuracy at 41 days.

6 months ago
Hello and thanks for listening to my anxiety fueled questions, lol.  Due to covid19 i have been bounced around from doctor to doctor in order to get testing done and it seems like every single one has a different time frame where they consider a test conclusive. I'm a 29 year old female whose exposure was unprotected vaginal sex.  I was tested at the 28 day mark, and was willing to accept that as done but 'symptoms' pushed me to be concerned again.  I am willing to accept that most of them are anxiety based, such as dizzy feelings, stomach aches, headaches. I was tested again at the 41 day mark and got a negative result again.  Both of these tests were 4th gen duo lab tests.  I guess my questions to you are:

1. I read that dyshidrotic bumps on fingers can be related to HIV infection. This is the symptom that pushed me to test again. Is this a concern this early on if I were infected and if it occurred a day or 2 after that 41 day test would it have been picked up at that time?
2. Can I move forward and believe these results even tho it was technically a day before the 6 week mark? I am very anxious to move on from this because the stress just creates more physical problems that i then connect back to HIV and its a terrible cycle.
Thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Welcome to the forum and thanks for your confidence in our services.

Probably I could be most helpful if you would like to say something about your partner and his background and/or HIV status. Is there a reason to suspect he is at especially highr risk, such as known HIV? Sex with other men? Injection drug user?  But even without that information, it is exceedingly unlikely you have HIV. The most commonly used HIV blood test is the antgien-antibody (AgAb, "duo", "4th generation) test. If that's what you had, your negative result at 41 days is conclusive. (Officially conclusive at 6 weeks or 42 days, but I have never seen or heard or anyone with HIV who had a negative result beyond 40 days.) However, if you had an antibody-only test, you might need another one at 8+ weeks to be certain.

Those comments cover both your questions, but to assure no misunderstanding

1. People with advanced HIV, il.e. overt AIDS, can have dishydrosis, but this is possible only after being infeted for months or years -- and there would be many other symptoms as well. And your negative test result proves this  isn't from HIV. You cannot have any HIV symptoms and have a negative HIV antibody test.

2. Yes, 41 days is conclusive -- again, this assumes an AgAb test.

You haven't said much about thwe sexual exposure. If you consider your partner at high risk to have HIV, then other STDs also should be a concern. Have you been tested for gonhrrea, chlamydia, and syphilis? If not, I recommend it.

I hope this reply is helpful. Let me know if anything isn't clear.

HHH, MD
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6 months ago
Yes they were both AgAb tests done at a lab.  The partner is not really suspect, he doesn't do drugs and was confident he was negative,  he actually took an Oraquick test to try to help with my concerns and it was negative, but I know the oral swab tests are not the best and take much longer to be accurate.  If you say that the 41 days is conclusive considering all these things, I will have to accept that as fact and I very much appreciate your time and input.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
With your partner's low risk, both his and your negative tests, and your symptoms not even hinting at HIV, you can be 100% certain you were not infected. So all is well! Thanks for the thanks!---
6 months ago
One last question for complete peace of mind, you are saying even if it was a high risk exposure at 41 days it would be conclusive? I ask because the dishydrosis started literally the day after the test and had me worried it wouldn't have picked it up even tho it was the one day early.  Just want to make sure because every doctor here keeps pushing for the 12 week final test and i would really like to avoid it. The only other exposure i've had since then was condom protected so i know this is not considered an HIV risk when they are used correctly.  Thanks.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
"you are saying even if it was a high risk exposure at 41 days it would be conclusive?"  Yes. In addition, test results always overrule everything else. No matter how high the risk at the time of exposure, and no matter what symptoms someone has -- even typical symptoms (unlike yours) -- it the test was done long enough after the exposure, the result tells the truth. There are no exceptions.

"every doctor here keeps pushing for the 12 week final test..."  Anybody saying that is behind the times or just don't understand HIV teating. 12 weeks is old news, going back to the earlilest HIV tests over 30 years ago. All knowledgeable experts understand the AgAb tests are conclusive by 6 weeks. But of course you're free to test again if yet another negative result will help you feel better.

Even with a correctly used condom, sex can sometimes be considered high risk for HIV. A lot depends on how riskly the partner is, in addition to condom use. Even if you never have unprotected sex, from time to time you should be tested for HIV and other STDs.

That completes the two follow-up questions and replies included with each original question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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