[Question #7727] Exposure + test

1 months ago
Hello and good evening doctors,
My exposure was on 16 January 2020 it’s was threesome with an 31 years old Arab woman and an African man in Dubai,, I don’t know their status my part in the threesome was unprotected oral and kissing with her and protected veginal intercourse ( I didn’t know if I penetrated or not because I was trying then I saw the condom slipped to the half of the penis while the head was covered because I was not fully erect I got scared so I hold it with my hand and start rubbing without penetration for about 30 second then I removed the condom with my hand and ended there.

I tested NAT RNA after 7 days the lap confirm it conclusive 
I tested combo Ag+Ab after 14 months exactly on 9/3/2021 and came back non reactive. I tested again to be sure on 13/3/2021 the test was (chemiluminescent microparticle immunoassay (CHIA) for the simultaneous qualitative detection of HIV p24 antigen and antibodies to human immunodeficiency and/or type 2 (HIV-1/HIV-2) came back non reactive. 
I also tested for all STD after a year and came back negative.
Note : all the tests was on Saudi Arabia 

My questions are :
1- are my three tests conclusive? Is the hiv combo Ag+Ab still reliable after 14 months of the exposure? 
2- did I have a risk on the first place?
3- before taking the hiv test I have blood withdrawal 3 times for different tests within a week on the same vein because I don’t have other one, so on the time of the hiv test there was redness and Green color and blood under the skin around the vein does this effect the results? 
4- Does anything effect the negative hiv result after 14 months? 
5- can the lap makes mistake on the tests? I did two tests in 2 different laps.
And Thank you so much 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome to the forum. Thanks for your question.

It is 100% certain you do not have HIV. The exposure event was very low risk for HIV, with little or no transmission chance even if one of your partners was infected. But the test results are conclusive regardless of the exposure risk at the time. The AgAb tests are highly reliable and always positive within 6 weeks of being infected. The only exceptions occur when anti-HIV drugs are taken to prevent infection (post-exposure prophylaxis, or PEP), delaying positive results if PEP doesn't work. And the tests for STDs other than HIV also are completely reliable at the times you were tested.

Those comments pretty well answer your numbered questions, but to assure no misunderstanding:

1. The NAAT (RNA) test at 7 days was pointless:  it was too soon for the negative result to be meaningful. If the lab says it is conclusive at 7 days, they are misinformed:  these tests start to become positive at about 7 days and are nearly conclusive at 2 weeks, but once in a while require 3-4 weeks to be positive. However, your later negative AgAb tests were conclusive.
2. There was no risk for HIV and only trivial risk for other STDs, based on your description of the exposure.
3. Such details of blood drawing etc have no effect.
4. There are no medical conditions of any kind, and no medications, that have any effect on reliability of the AgAb tests.
5. Lab errors virtually never occur with the HIV blood tests. All of them are highly automated and use standard procedures that make them more or less idiot-proof. I have never heard of any lab having troubles with test performance or reliability, anywhere in the world.

Thanks for your thanks in advance. I hope these replies meet your expectations. Let me know if anything isn't clear.

1 months ago
Thank you so much doctor. I was worried about my vein condition may have effect the results and the conclusive of the 14 months test after exposure but you clarify and relieved my concern 
everything was clear and absolutely meet my expectations.

Last quastion : I can understand that’s I am hiv negative and the tests won’t change unless I have other exposure, does that’s include the blood tests? i am talking about reused needle phobia.
I usually won’t be worried about that’s but I had medical clearance 5 days ago (17 March) for a job (cardiac catheterization technician) and I saw my results everything was negative (They didn’t post the hiv test and its only test results they didn’t post it) so that’s got me very worried thats might I was infected by needles?
My appointment with the hospital after 2 days and I am really stressed about my career.
The only things that’s keep me calm for now is that’s I did my part I tested on (3 + 11 March) after 14 months and your recent opinion on my situation.

Thank you again doctor.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Nobody ever gets HIV from having blood drawn. That hasn't happened anywhere in the world since disposable, single-use blood draw systems came into routine use 30-40 years ago. All labs and clinics use these systems, and it is pretty much impossible to re-use the same device on separate patients.---
1 months ago
Thanks doctor for your time and the information provided, I got my results today for the medical clearance it’s was all negative and I got the job, I will accept my results and move on for a new and happy chapter in my life. 
And I believe In anytime in the near future I can have any test for routine check up without worry about any infection, is thats right? 
Finally Thanks again doctor for your help, it was much needed.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
I'm not sure I understand your question about routine check-up and no infection worry. If that implies concern about catching an infection by having the text, the risk is zero. Nobody ever gets any infection from having blood drawn.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.