I hope you are both well, I’m back again with another question I hope it’s sufficiently different that it warrants answering.

I just wondered how you both can be so Sure that a 4th Gen at 6 weeks is so Conclusive.

I’ve seen a few people on the Poz Forum claim to have tested negative with a 4gh Gen and only later to be positive after years, and other who tested negative at 1-2 months then positive at 14-16 weeks.

I appreciate not everything is so black  and white and people can get facts mixed up or even Lie.

Saying to somebody that they 100 percent don’t have HIV is a massive statement, what if they went in to infect someone after thinking they were negative.

Are people allowed on this platform to confirm they are positive after being given info that they were in the clear and has that ever happened?

For me I guess that’s were my biggest anxiety comes from, nobody would ever believe me that I got it from my exposure that is said to be Zero risk, my life would be over.

As the guy on the Poz forum says he has heard all sort of stories how people get it but he doesn’t believe.

I thank you both for your kindness and patients helping people through, for me the most difficult period of my life, where I have been to some very dark places thinking how I can end it if I am positive. 

Best regards

To you both.

There are 4 kinds of evidence of conclusiveness of the AgAb HIV tests.

First, biological reasons (or what we in the medical sciences often call biological plausibility):  the timing of p24 antigen and of anti-p24 antibody are well known, and it is also clear that the test rarely if ever misses either antigen nor antibody.

Second, testing panels of stored serum from patients known to have HIV:  none known to be infected for 6 weeks or more ever tests negative.

Third, in preparing data for submission to FDA (or its counterparts in other countries), test manufacturers -- which must have FDA or equivalent approval to market the tests -- study HIV infected persons at various intervals after exposure.

Finally, there is the clinical experience of providers, such as those that run busy HIV/AIDS clinics and have cared for lots of patients with newly acquired HIV. No such experts have reported seeing any patient with negative AgAb test more than 6 weeks after catching the virus (except for rare cases in which the exposed person took anti-HIV drugs as post-exposure prophylaxis [PEP] and nevertheless became infected; in such persons the window period is calculated from the time PEP drugs are finished, instead of time since exposure.)

I would suggest great care in interpreting personal testimony of the type you cite from the Poz Forum. You are exactly right that "not everything is so black and white and people can get facts mixed up or even lie." In addition, most people with HIV don't know exactly when and by whom they were infected.

In our own replies, we usually try to remember to qualify our replies -- such as "100% for all practical purposes" or similar phrases. We are scientists and of course prepared for the possibility of a rare exception. However, since it has never been known to happen -- at least not with scientific confirmation -- we feel it's justified to give 100% reassurance. Another factor is that the large majority of questions about HIV risk on this forum involve such trivial risk that there was no realistic chance of infection anyway. Your report of hand-genital contact falls in this category. If an exposure carries, say, 1 chance in a million of infection, and a test is 99.9% reliable, the odds that person has HIV drop from 1 in a million to one in a billion. I hope you would agree that counts as zero chance!

Generally when a forum user has tested and negative before 6 weeks, we leave the thread open beyond the 6 week window to allow report of a final test after that time. In the 15 years of this and our preceding MedHelp forum, nobody has reported testing positive. Given the fears and anxieties of most questioners, I'm pretty sure that if someone tested positive after their thread was closed, we would have heard about it -- undoubtedly most would ask a new question, if only to tell us what dumbasses we are! It hasn't happened.

For all those reasons, I remain 100% confident you do not have HIV. The question then comes why you still have such anxiety. That really isn't normal once someone understands the facts intellectually; inability to integrate that knowledge at an emotional level often reflects an underlying psychological issue that often would benefit from professional attending, e.g. counseling. I suggest it from compassion, not criticism.

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

HHH, MD

In fact I’m having great difficulty in separating  what I’m doing to myself mentally in anxiety and stress and the physical symptoms I have of CPPS, LPR reflux and Oral thrush.

I had my colonoscopy on Monday and have mild diverticular colitis too.

So I believe nearly everybody would have come to a similar conclusion or doubts regarding STD and HIV as I have had after the receipt of the handjob.

It literally started that evening, I was in pain and the next day I was urinating every 20 mins, things just developed and I’ve been sick with different symptoms ever since, including swollen lymph node under my armpit and one in my stomach that came up two days ago and has gone down now.

I’ve never slept with anybody but my wife and these massage parkour handjobs were the first time I strayed, lockdown due to Covid has been difficult.

So you must be able to see why I have got to this point, questioning and second guessing everything.

CBT guys tell you how to breath and relax, I would be relaxed if I felt normal, everything feels buzzard to me, from my skin to muscle spasm’s, extreme fatigue during the day to getting 1-2 hours sleep at night.

Appetite is rubbish and the Parotis I have makes my mouth so sore and difficult to eat. 

I’ve made a pact with God that please to be Cancer rather than HIV so I can’t infect my wife or kids.

She is on the verge of kicking me out the house and wondering why I’ve done so many HIV tests, as I’ve only ever slept with her.

Most of the clinics won’t test me anymore and I’ve spent nearly a thousand pounds on private testing.

I understand your Einstein quote.

But coming out of this cycle seems impossible for me until I feel physically well again.

It’s a great comfort having you both answer questions , I just wish I could see one of  you in a clinic to talk it over.

As for many anxious persons, the last thing you should be doing is searching the internet about any of this. You're being drawn to crap that inflames your fears and missing the reassuring information that also is there, especially on professionally run or moderated sites. Don't do it any more, OK?

That completes the two follow-up comments ro questions included with each opening question and so ends this thread. I hope the discussion has been helpful.