I am 31 years of age Indian, living in France.

I have exposed to sexual contact on 11 January 2021 with a Colombian sex worker in Paris. Likewise, I was little  high during the incident because I smoked a little Marjuna. 

I am very sure that I wore condoms because  the sex worker herself wore it to me. I made a vaginal intercourse for about 2 minutes.  And sucked her breast not lasting a minute. After the work been done.

Then she herself  removed the condom. And cleaned my penis with wipes.

I am pretty much confident because the way she behaved .she was very hygienic. She gave some disinfectant lotion to wipe my hands as soon I entered the room.

Everything was ok. Then I went back and started to work normal. 

Days after hesitation started to panic me because of 

A. I am being high.

B. Even if I wore a condom, chances of the condoms have been torn or not fitted properly.?.(because I have not noticed while being high, condition of the condom when she removed out of my penis)

C.I don't know the status of the women.

So without waiting I went to  testing on the 4th day (4gen combo).The results came negative.

I started to witness some sore throat by the 15 day,

 I was very much terrified. Not only that, but I try to contact the women to know the status, but she was no more replying, her number is out of service.

Exactly on the 31st day  I went again for the test  with  symptoms of sore throat, chillness and tiredness too. The result was negative.  

 I came to know the French protocol  to be tested after 6 weeks with a 4 gen combo antigen antibody p24 in order to make sure, one is infected or not.

Now I need to mention some facts here

I am already having a scalp psoriasis in my head for the past 1.5 yrs. I sometimes feel itchy in my toes, hands and chest, Skin peeling on my head,scalping on head. And i have constipation problem too irregular bowel movements. 

Meanwhile 

After the 4 weeks test I find my self itching all over the body. But this time no more sore throat.I was very stressed.  I could not even able to sleep well or eat well.

Due to the itchiness I keep scratching which turn reddish on my toes and hands. I cannot control my anxiety I went again to tested on the 5 week, the results were negative. 

Finally, I did a test on 44 day after 6 weeks . I tested negative. 

And  again I find the itchiness, turning red,If I start to scratch. Not convinced went again for testing on the 7-week. The 51st day. It was negative. 

Summary :

Test all done by 4 gen combo antibody ,antigen p24 by blood test in laboratory done in France.

Exposure date : 11 January. 

1st   test  : 4th    day  (negative)

2nd  test  : 31st  day  (negative)

3rd   test  : 38th  day  (negative)

4th   test  : 44th  day  (negative)

5th   test  : 51st  day  (negative) last test March 3

My question are :

I am already having an itchiness before this exposure with a head scalp for about 1.5 years.

I don't have any sexual partner before this exposure other than my wife.

I read on the internet, a skin problem like Seborrhic dermatitis might occur due to immunity suppression problem or immune system is not working properly.

If in case I am immune suppressed the test might not able to detect sufficient antibody.?

Before two months I was 93 kg, now I am 89 kg. I lost 4 kg in two months ?is this normal?

I am being always find myself tired, itchiness and chillness.

The result is conclusive  or need to retest in 8th week.

I contacted the Aids Organization in France and asked about the test I have taken here they told any test after 6 weeks is conclusive  in France and  that should be the 4gen combo  test in laboratory by  blood test.

I asked about the waiting period of 3 months or the symptoms I am having, they are repeating the same answers.  Furthermore they advise me to see the skin doctor. They told that the protocol here are 6 weeks as per the virology research center France.

With this confusion. I  could not concentrate.  Furthermore, I don't have the stamina to bear the stress, doing a test after test and anxiously waiting for the results praying and hoping to be negative. 

If you can explain  me the medical facts and the risk factors based on the risk situation and test I have gone through.  I could find myself assured of the results.

Thanks in advance

Some questions can be answered accurately from the first few words or lines -- in this case, from the question itself. One of the most enduring responses on this forum is that if an HIV blood test -- especially the antigen-antibody tests (AgAb, "combo", "4th generation") -- is done long enough after the last possible exposure, always overrule all other considerations. No matter what symptoms are present, or how typical for HIV they seem to be, and no matter how high the risk of infection at the time of exposure, the test result rules. In these circumstances, a negative test always proves symptoms arenot possibly due to HIV. (The only exception is when someone takes anti-HIV drugs, e.g. PEP or PrEP, that don't work. In that event, accurate testing is delayed until several weeks afer the last dose of drug.)

Those comments apply now. The HIV tests in France are the same as those used ib all of North America and Europe, and in most of the rest of the world as well. The results are equally reliable everywhere. And for those reasons, I agree with the advice you had from the AIDS organization you contacted.

The exposure described was very low risk. Even if your partner had HIV, there is no cause for worry. And despite what you have read online, the symptoms described are not typical for a new HIV infection. All of them COULD occur with HIV, but never as the only or dominant symptoms:  only in combination with other, more typical problems. Seborrheic dermatitis is a problem in advanced HIV/AIDS (after several years), not early infection. Froma ll you say, I see no reason to suspect you are immunosuppressed. BUt if you were, that makes HIV tests MORE likely to be positive, not less. (Immunosuprresion in theory might reduce antibody production, but in that case the antigen component of hte test would be strongly positive.) There are hundreds of causes of weight loss, fatigue, and the other things you describe other than HIV.

Last fact:  It is not possible to have symptoms caused by HIV for more than a week and have a negative antibody test.

You can be 100% certain you do not have HIV. No further testing is necessary. If your symptoms continue, see a doctor for comprehensive evaluation. But please do your best to stop worrying about HIV, or any other infection from the sexual exposure described. Clearly you have no infection from that event. If your symptoms are related to it, probably it's your psychological reaction to a sexual decision you regret -- in which case professional counseling should be the next step.

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

HHH, MD

"A test as long after overrule all symptoms"Thank you very much sir, much relieved. 

It would be much appreciated if you can let me know what makes experts  test conclusive after 6 weeks ?

The symptoms of ARS are caused not b the virus, but by the immmune response to HIV. Therefore, whe symptoms are caused by HIV, antibody is always detectable in the blood. Here too there are no known exceptions.

Do your best to stop worrying about this. There is no chance you have HIV. Believe it and move on!

In all cases what is the maximum time for antigen & antibody to be reliably detected after the potential exposure?

And the answer to your quesiton "In the absence of antibody" is yes:  If for some reason antibody did not develop, the antigen component of hte test would still be positive (which I already discussed in my replies above).

That completes the two follow-up exchanes included with each question and so ends this thread. Do try not to worry -- all is well.