[Question #7669] Followup 7642 - testing

2 months ago
Doctors,

Although Dr Hook explained I had a low risk (unprotected vaginal) exposure.   The fear / anxiety is eating me up inside.   Today is the 10th day since exposure and I am going in for chlamydia & Gonorrhea testing.   I also am getting a RNA HIV test.   It will be about 10days + 8 hours since exposure when I take the test.   Knock on wood, I've had no symptoms for anything yet.   I know a 4th Gen test is much better at 6 weeks, but I cannot wait.     Quest Diagnostics will be performing the tests.   If Negative on the HIV RNA, how conclusive would you take this as being?    I had Covid 6 months ago, not sure if this would affect results. (I have not had the vaccine)   
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Welcome back, but I'm sorry you found it necessary -- and there's not much more we can do. I reviewed and agree entirely with Dr. Hook's judgment and advice a few days ago. There is no realistic chance of HIV in this situation. (Perhaps you'll be further reassured by this fact:  in the nearly 17 years of this and a preceding forum that Dr. Hook and I have moderated, with thousands of questions from people worried about catching HIV, not one person has reported they ever tested positive. If and when that happens, I expect it to be from a genuinely high risk exposure (e.g. unprotected rectal sex with a known infected partner). You certainly will not be the first.

A 10 days, an RNA test probably detects 75-80% of infecitons. You definitely can expect a negative result.

I'm glad to hear that you apparently recovered uneventfully from COVID-19. No worries about your upcomiing HIV tests:  that won't affect the results.

Let me know if anything isn't clear.

HHH, MD
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2 months ago
Thanks Doctor.  

I am normally a cautious person, and upset i put myself in this situation.

So if the test comes back negative(Praying it does).  Would you consider testing again for syphilis, hiv, etc... in 6 weeks?   I know ya'll do not provide direct medical advice, so i would just appreciate your opinion.  

I know that HIV is not as common in heterosexuals as the news portrays, but i worry ALOT, and see statistics that thousands of Heterosexual Males get HIV every year in the US.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Yes, a final HIV AgAb (4th generation) test and a syphilis blood test at 6 weeks would be reasonable -- although I'd happily bet my life savings (if I were a gambler) that the results will be negative. If you have had a urine gonorrhea/chlamydia test any time more than 3-4 days after the event, that need not be repeated. No other testing of any kind is necessary or recommended.

Be cautious of information you find online. It may be true that "thousands" of heterosexual males acquire HIV each year in the US, but most of these are injection drug users; probably only a few hundred straight men acquire HIV sexually each year, and most of these cases are among inner city minorities, prisoners, and the regular partners of infected women -- not one-off partners in situations like yours.

The statistician Nate Silver, originator of the political/sports statistics website fivethirtyeight.com, wrote a popular book on statistics titled The Signal and the Noise. In it he writes -- approximate quote -- "Give an anxious person a computer with an internet connection in a dark room, and soon he'll believe his cold is the bubonic plague." In other words, anxious persons tend to be drawn to information that inflames their fears and to miss the reassuring bits. Sound familiar?
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2 months ago
Doctor...  you are exactly right.   My irrational fear gets the best of me.    Sooo.  Results came in this morning from my 10 day pcr, tma test.   Not Detected.    I about had a breakdown, it took so long for results, and all the what ifs crept up.     Even told the wife about it.   So not good.        

I know 10 days PCR, TMA is only 75-80% conclusive..  so I will test at 6 weeks.    But hoping I can sigh a little bit of relief until then
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Thanks for the follow-up. Glad your RNA test is negative, but of course not surprised.

Although it takes 6 weeks for 100% conclusive results for the AgAb tests, 4 weeks is at least 98-99% reliable. And the combination of that plus your current negative test is 100% for all practical purposes. If I were you, I would go for a 4 week test and stop there; although you could do both 4 and 6 weeks if you like.

This should be your last question/thread about this exposure and testing. There's nothing more Dr. Hook or I would have to say that you haven't heard. But I do hope this discussion has been helpful. Best wishes and stay safe.
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