He’s recently had another HIV test because my OCD was bad and he was trying to make me feel better. 4th gen negative. 

I’ve not been very well for a while now constant sore throat and all sorts of joint problems like knee and ankle pain and I have bad dandruff alllll the time. I’ve had a sore throat on and off since I was a teenager after 15 bouts of strep as a youngster. 

I’ve had a recent screen for everything else, not HIV,  but I’m panicking that my rapid test at the start of the relationship could have been wrong and actually I do have it. 

Would you suggest further testing? Are the rapid tests not very good? It had been a year since previous exposure when I had my last one.

I hope that I will be able to convince you to not worry about HIV. You are fortunate to have an understanding and agreeable partner.  HIV is very, very rare in heterosexual men and his initial as well as his recent HIV tests indicate that you are not at meaningful risk for HIV from him.  Likewise, from the sound of things your own risk for HIV from your prior partner is also quite low.  Given his two negative tests, he certainly does not need further testing.  Likewise, your negative point of care (POC) test for HIV antibodies is strong evidence that you were not infected. Admittedly, POC tests are our least favorite variety of tests for HIV, in part because there are occasional falsely negative tests in persons with recently acquired infections.  Acknowledging your OCD, rather than continue to worry about the possibility of HIV, it might be to your benefit do you have a fourth generation test performed to put your mind at rest. I am confident that if you do this your test will be negative but verification is often helpful.  Please note, the only reason I even suggest repeat testing for you is to help address your OCD driven fears and not because I have any concern that you have HIV.

I hope that this perspective is helpful to you. If any part of my response is unclear where there are further questions, please don’t hesitate to use your up to to follow ups for clarification. EWH

No I appreciate either of you responding I just realised I hadn’t addressed my HIV concerns in the last question. 

Well I’m kind of between a rock and a hard place to be honest. Repeat testing isn’t really healthy for OCD but then there’s always doubt. Not convinced a 4th gen actually addresses the underlying worry problem. 

I’m more worried I’m putting him at risk. We are due to get married. I know about the flaws regarding acute infection but is it okay a year after exposure? Or do u still not recommend them even this long after a risk? Due to start a family and I’m thinking do I risk feeding my OCD or shall I accept this rapid test and get on with my life? 

Basically - do u think it’s safe to accept that result or not? Sorry to be a massive pain in the arse. 

Thanks dr xx

I agree with your assessment regarding repeat testing.  OTOH, the POC tests do have a very modest false negative rate in persons with recent infections which is the reason I opened the door to another test, not that I’m worried I the least about HIV.  Had your earlier test been with a 4th generation test, i would not have suggested it.  That said, I am confident that your POC test was accurate and that you do not have HIV.  Thus there is little benefit to testing.

Sorry to waffle on this. EWH 

The internet is a minefield and it just sucks when you can’t accept a certain level of uncertainty. OCD is honestly a destructive disease I hate it. 

If it’s long-standing is it any more reliable? 

I know it’s my last question (sob) before you close the thread so just trying to make sure I’ve asked everything.

I have a feeling I’ll end up just getting the 4th gen haha. Although my ex didn’t have it either so it’s probably about 10 years since I may (or may not) ever have been exposed haha. 

Would the rapid HIV tests that I’ve done cover basically all partners for all of time (not that I’ve had many) 

I had my last one six months into the relationship with my current partner - about a year after exposure to anyone else. 

Also are generic syphilis serology tests pretty accurate? 

I know I need to get over this - I’m just paranoid about my sore throat and the joint pain. I know a prolonged sore throat is caused by a million different things- as is joint pain. 

In referring to the performance problems of POC tests with “recent” acquisition of infection, I was referring to infections acquired in the six-eight weeks before testing.  Beyond that, tests are highly reliable and should be believed.  Among persons who have acquired HIV, the levels of antibodies increase over time and, without treatment,  so do levels of the antigen. This makes the tests more reliable over time and test results will reflect any prior infection. Once a person has become infected, their test to remain positive from there on out.  So yes, Your test results would reflect all previous partners.